The Analyst's Experience of the Depressive Position

The melancholic errand of psychoanalysis

Steven H. Cooper

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317549505
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

In The Analyst's Experience of the Depressive Position: The Melancholic Errand of Psychoanalysis, Steven Cooper explores a subject matter previously applied more exclusively to patients, but rarely to psychoanalysts. Cooper probes the analyst's experience of the depressive position in the analytic situation. These experiences include the pleasures and warmth of helping patients to bear what appears unbearable, as well as the poignant experiences of limitation, incompleteness, repetition and disappointment as a vital part of clinical work. He describes a seam in clinical work in which the analyst is always trying to find and re-find a position from which he can help patients to work with these experiences.

The Analyst's Experience of the Depressive Position includes an exploration of the analyst's participation and resistance to helping patients hold some of the most unsettling parts of their experience. Cooper draws some analogies between elements of theory about aesthetic experience in terms of how we bear new and old experience. He provides an examination of the patient as an artist of sorts and the analyst as a form of psychic boundary artist. Just as the creative act of art involves the capacity to transform pain and ruin into the depressive position, so does the co-creation of how we understand the patient's mind through the mind of the analyst.

The Analyst's Experience of the Depressive Position explores a rich, provocative and long overdue topic relevant to psychoanalysts, psycho-dynamically oriented psychotherapists, as well as students and teachers of both psychoanalysis and psychodynamic psychotherapy.

Chapter 1

Ruin and beauty I: Some basic assumptions and models of the analyst’s relationship to the depressive position

The artist is not trying to produce pretty or even beautiful form, he is engaged in the most important task of re-creating his ruined internal world and the resulting form will depend on how well he succeeds in his task.

(Clive Bell, 1914, p33)

Great works of art, especially novels, challenge us rather than tell us how to decide who’s wrong and right at every turn. When the great novel is completed, more often than not, ambiguity rather than the satisfaction of harmony (fantasy) reigns. Recently, Elena Ferrante (2014) went even further and stated: “Books don’t change your life. At most, if they are good, they can hurt and bring confusion” (p7).

I begin with the novelist in part because just as some novelists are helping us to see characters as a whole without delusion or despair, I think that the analyst is trying to help her patient look as much as possible at her life as a whole. Patients come to know those who live inside them in new ways that transform particular kinds of disharmony into new, hopefully more satisfying or settled forms of disharmony.

For most of us, even after productive and inspiring analysis, we will contend with easier and more difficult parts of ourselves, and life will continue to be out of joint in certain ways. The analyst holds/contains this unsettling narrative in the service of helping the patient to better contain her narrative. That is, in the end, one of the most important ways that analysis is profoundly helpful and, in my view, among the best of what we offer. Every analysis is incomplete.

In a sense, this capacity to accept incompleteness is as good an explanation of the depressive position as any other. Freud summarized the depressive position (without referring to it with this name) so succinctly when he described his new form of treatment that, in the end, replaces human misery with ordinary unhappiness. It was one of the more important features of genius and courage that Freud could suggest such a bold treatment with such a breathtaking method, directed toward such a seemingly modest, ordinary aim. Anything but modest in its aim, though, Freud’s theory of mind takes at its core that freedom is never as organized as tyranny. Thus, we need to appreciate even a modicum of freedom that we eke out through analytic work.

Freud’s psychiatric discovery of something that, of course, had been deeply understood by artists, playwrights and philosophers for centuries—a basic respect for the dynamic tension between desire and prohibition, love and aggression, and expressiveness and restraint at the center of the psyche—required a practitioner who could work in the depressive position. This constant tension between therapeutic ambition and modesty was but one of many ways that he suggested working in the depressive position. Another was his ability to give himself over to investigation, hypothesis-generating activity, and revision in his theory, which we witness again and again in his letters to Fliess (e.g., Anzieu, 1986, p618). His evolving theory, in certain ways, embodied the notion of incompleteness, even though he suffered with its evolution.

Freud’s suggestions for therapeutic neutrality and modesty were technical prescriptions, thoughtful and wise regarding a realistic assessment of what analysis could achieve. In this reasoned modesty, Freud in essence put forward the deep understanding that if the analyst is not able to live in the realm (or close to the realm) of the depressive position regarding analytic work, he is unlikely to help the patient to reach this position vis-à-vis the patient’s interiority.

One of the great challenges of working as an analyst involves maintaining hopefulness and therapeutic ambition while respecting the patient’s limitations for change. I believe that this balance within the analyst is one of the most important parts of the patient’s experience of the analyst’s inner attitude (Nacht, 1962). Some analysts come naturally to a good balance of these attitudes, while others begin with levels of hopefulness and ambition that can feel insensitive to the patient’s anxiety or trepidation about change. Other analysts are so melancholic in their attitudes toward life that this inner attitude fails to productively truck with the parts of the patient that are ready and eager to change. Many of us go through different phases related to the balance of modesty and ambition in our work based on our developmental phases as analysts and as persons.

One cannot assume the depressive position through fiat or good intentions. The depressive position, like the Oedipus complex, is not something that can be finally achieved or entirely worked through. Britton et al. (2012) have argued this point in relationship to the Oedipus complex, and it has been implied in more implicit ways in many psychoanalytic writings. The analyst’s training or personal analysis is helpful in reaching it, but the depressive position for both patient and analyst is not a destination, it is a journey involving hard-fought achievement and ongoing struggle. The analyst works with each patient in finding that seam in which we help patients to reach new psychic achievements and equilibrium. We try to help patients to accept psychic limitation, an acceptance that is relatively distinct from resignation, submission and resentment.

My colleague Jonathan Palmer, an analyst and a painter, has put it (personal communication) that the analyst’s stance is a created surface as close to the depressive position that the analyst can achieve at any particular moment in a session or in analytic process. From this point of view, the analyst’s mind, the analytical mind of the analyst has to be constantly discovered and rediscovered as it is lost and found in clinical work.

The effort expended by both patients and analysts to help the patient bear psychic pain is often as much a source of enormous warmth and comfort as it is uncomfortable for the patient. One could characterize it as a kind of partnership in bearing the existential realities of the patient’s personhood as well as the analyst’s personhood.

Part of the notion of working toward the depressive position is working with the considerable ambiguity and risks related to the outcome of any analyses. Perhaps every analyst is a bit like Daedalus, who invented flight, but whose son Icarus flew too close to the sun. While his invention of wings didn’t hold up for Icarus, there was clearly some operator error in play. Each analysis begins with the intention and accompanying fantasies about leaving the bondage of internalized objects; each of our internalized scenarios leaves us in varying degrees of no exit situations. Psychoanalysis is an invention to help us work with this no exit situation, a psychic Crete from which we seek to escape. When analysis is successful, it is rarely a full escape, but Crete becomes a much more enlivening and aesthetically pleasing place than it felt to Daedalus and his son. Escape is, from the point of view of the analyst, tragic in its own right, since escape is a fantasy that cannot be achieved. If where we psychically live lies in our relationship to internalized objects, we are aiming for more freedom but not escape. As James Baldwin (1956) put it, “Perhaps home is less a particular place than an irrevocable condition” (p37). So our wings in analysis are put to work less in the service of flight from somewhere than a helping us to fly more freely, less rigidly, within our home territory.

Another dimension of the analyst’s work toward the depressive position—and among the most radical of Freud’s discoveries—was the notion that none of us can entirely trust ourselves in knowing what we claim to know. Clearly, there is more to each of us than meets the eye. Our capacities for dissemblance make us unreliable knowers and narrators. It was only a matter of time before the unreliability of the analyst’s knowing would become both a source of questioning and an essential tool in helping us to conduct the work of analysis.

This radical boundary in psychoanalytic work—that patient as well as analyst cannot know all that we are expressing—means that we put our minds, our psychic life in the mind of a trained professional so that we might see if he or she can help us understand more about what we were saying. Contemporary analytic thinking that questions the authority of the analyst has done so in some ways because the unreliability of the analyst’s mind is now better accepted as a given in the analytic situation. Bion had a great deal to do with advancing this particular idea, and of course it was developed significantly by the epistemological revolution in analytic thinking created by analysts from particularly within the array of Bionian, Independent, Relational and Kleinian traditions.

I want to try to give some experiential life to the analyst’s relationship to the depressive position—not just his patient’s, but his own in relationship to the process of analytic work and analysis as a profession. This means giving life to the sources of resistance for the analyst to experience and work with limitation and grief in the analytic process.

In this chapter, I begin to examine some background about several ways that the analyst’s work toward the depressive position has been described, both directly and indirectly. In the theoretically based chapter that follows, I will focus on some of the chief types of resistance to the analyst’s work in the depressive position.

Some ways of thinking about the analyst’s capacities for the depressive position

Many analysts have drawn our attention to the coexistence of primitive and more mature forms of thinking and symbolizing. Since Bion, many have understood that unconscious mental life is characterized by the healthy dialectical interplay of the paranoid-schizoid and depressive positions (Bion, 1962) and of the coexistence (in health and in psychopathological states) of the psychotic and non-psychotic parts of the personality (Bion, 1957). This insight was featured even earlier in Susan Isaacs’s (1952) paper alluding to the internal interplay for patients between the paranoid-schizoid and depressive positions (Ogden, 2012).

A great deal has been written about the analyst’s experience of the progress and limitations of analysis, especially in the context of termination. Analysts as diverse as Klein (1952), Winnicott (1960) and Schafer (2003) have written beautifully on the analyst’s relationship to the depressive position in the context of termination. Given the plethora of writing related to the patient’s manifestations and experiences of the depressive position, there are still relatively fewer discussions that specify what it is for the analyst to maintain this position in his ongoing work. Instead, we know that much of our analytic literature involves de facto our countertransference resistances to listening in the depressive position. We also can infer current thinking about a kind of analyst depressive position from other avenues, such as our thinking about neutrality, good enough interpretation, and the good enough ability to contain and metabolize the patient’s affects and unconscious fantasy.

Schafer (2003) is particularly noteworthy among current writers in how much he explicitly maps this territory related to the analyst’s ongoing attempts to maintain the depressive position. He does so by focusing on the necessary analytic talent for accepting incompleteness in the conduct of any piece of analytic work.

Klein (1957) suggested that the depressive position is characterized by the capacity to accept and regulate inevitable tendencies toward ambivalence in a relatively stable way. The individual learns that all goodness is imperfect, in that it is mixed with aggressive potential. Furthermore, defenses and unconscious fantasy operate to mitigate our experiences of goodness. Within the depressive position, we learn to live with ambivalence and to understand that this ambivalence will never be fully overcome. Samuel Beckett (1984) captured an acceptance of incompleteness in his melancholic phrase: “Ever tried. Ever failed. No matter. Try again. Fail again. Fail better.” In other words, to be human is to inevitably fail in certain ways, and striving is always embedded in the context of this appreciation.

Klein (1952) also argued that in the analyses of adults and children, together with a full experience of depression, feelings of hope emerge. She stated that “in early development, this is one of the factors which helps the infant to overcome the depressive position” (p214). Omnipotence decreases as the infant gains a greater confidence both in his objects and in his reparative powers, as he experiences that what he is able to achieve provides pleasure to those he loves and, in so doing, undoes the harm done or imagined to be done by his aggressive impulses.

As Ogden (2012) highlighted so well, Winnicott’s (1945) “Primitive Emotional Development” is a revolutionary essay in several different ways, one that has relevance to the analyst’s capacity for the depressive position. While Winnicott doesn’t mention the depressive position by name in this paper, and thus not the analyst’s relationship to the depressive position, he is de facto dealing with his understanding of this process in remarkably prescient and creative ways. He states:

The depressed patient requires of his analyst the understanding that the analyst’s work is to some extent his effort to cope with his own (the analyst’s) depression, or shall I say guilt and grief resultant from the destructive elements in his own (the analyst’s) love. To press further along these lines, the patient who is asking for help in regard to his primitive, pre-depressive relationship to objects needs his analyst to be able to see the analyst’s undisplaced and co-incident love and hate of him. In such cases the end of the hour, the end of the analysis, the rules and regulations, these all come in as important expressions of hate, just as the good interpretations are expressions of love, and symbolical of good food and care (Winnicott, 1945, p146).

As Ogden (2012) put it, Winnicott is doing nothing less than proposing a new model of countertransference. He is suggesting that depression is a manifestation of the patient’s taking on as his own, in fantasy, elements of his mother’s depression (or that of other loved objects) with the unconscious aim of relieving her of her depression. This is a kind of explanation that features the intergenerational origin and dynamic structure of depression. But more important to the present discussion, Winnicott is suggesting that if the analyst is unable to cope with his own feelings of depression (both normative as in the depressive position and problematic or pathological as in the paranoid position), the analyst will be unable to experience the ways in which the patient is trying to absorb the depression of the analyst as a transference mother. Again, returning to Ogden:

Winnicott is suggesting that only if the analyst is able to contain/live with the experience of the internal object mother’s depression (as distinct from his own depression) will he be able to experience the patient’s pathological effort to relieve the mother’s psychological pain (now felt to be located in the analyst) by introjecting it into himself (the patient) as a noxious foreign body (Ogden, 2012, p80).

It’s worth noting that part of what is revolutionary here is that Winnicott is not primarily focused on the important issues related to how patients do not allow the analyst to have his mind and work with evenly suspended attention. Instead, Winnicott is interested in what the analyst carries inside that interferes with the use of free-floating attention in order to better know the patient’s internal objects.

Winnicott is suggesting that in order for the analyst to be able to experience and understand the patient’s internal object mother’s depression that is being projected into the analyst, the analyst must have enough purchase on his own depression that arises from sources independent of his unconscious identification with his patient’s depressed internal object. Otherwise, the patient cannot find in the analyst his internal objects that he is controlled by, attached to, and trying to integrate in some way with his relationship with his analyst. The analyst cannot create a “psychic base” (Money-Kyrle, 1968) or a “home for the mind” (Spezzano, 2007) for the patient. In turn, the patient cannot experience the analyst’s mind as a source of containment and safe base from which to explore what the patient is communicating about that he cannot understand on his own.

The analyst’s capacity to bear the impact of the patient’s internal pain and attachment to painful objects also involves the demands that his love may have on the patient. He must not be so worried about the patient’s concerns, demands and anger about the analyst’s failure to love and gratify that the patient is unable to find a home for his familiar experiences of conflict and ...