Attention and Interpretation

A scientific approach to insight in psycho-analysis and groups

W. R. Bion

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781136440489
• Topic: Medicine
• Subtopic: Health Care Delivery

Tavistock Press was established as a co-operative venture between the Tavistock Institute and Routledge & Kegan Paul (RKP) in the 1950s to produce a series of major contributions across the social sciences.
This volume is part of a 2001 reissue of a selection of those important works which have since gone out of print, or are difficult to locate. Published by Routledge, 112 volumes in total are being brought together under the name The International Behavioural and Social Sciences Library: Classics from the Tavistock Press.
Reproduced here in facsimile, this volume was originally published in 1970 and is available individually. The collection is also available in a number of themed mini-sets of between 5 and 13 volumes, or as a complete collection.

1. Introduction

I doubt if anyone but a practising psycho-analyst can understand this book although I have done my best to make it simple. Any psycho-analyst who is practising can grasp my meaning because he, unlike those who only read or hear about psycho-analysis, has the opportunity to experience for himself what I in this book can only represent by words and verbal formulations designed for a different task. They were developed from a background of sensuous experience. Reason is emotion's slave and exists to rationalize emotional experience. Sometimes the function of speech is to communicate experience to another; sometimes it is to miscommunicate experience to another. Sometimes the object is to achieve access to, and permit access from, a good spirit; conversely, to deny access to a bad spirit. The vocabulary forged from such material serves, though inadequately, when, as in psycho-analytic practice, the object being studied is present. In mathematics, calculations can be made without the presence of the objects about which calculation is necessary, but in psycho-analytic practice it is essential for the psycho-analyst to be able to demonstrate as he formulates. This is not possible the moment the conditions for psycho-analysis, in the narrow technical sense, do not exist. Some of us have sought to extend psycho-analytic method so that it can be employed in a group setting. Such a development, if it can be done without mutilation of the fundamental character of psycho-analytic method, would initiate the change from private to public communication. Language does just that in the domain of sensible experience. Poetic and religious expressions have made possible a degree of 'public-ation' in that formulations exist which have achieved durability and extensibility. To say the same thing differently, the carrying power of the statement has been extended in time and in space. Vixere fortes ante Agamemnona multi and Not marble, nor the guilded monuments / Of princes, shall outlive this powerful rhyme' are expressions of that belief; they are interpretations of human experience. In his sphere the psycho-analyst's attention is arrested by a particular experience to which he would draw the attention of the analysand. To do this he must employ the Language of Achievement. That is to say, he must employ methods which have the counterpart of durability or extension in a domain where there is no time or space as those terms are used in the world of sense.

What I have said with regard to this book also applies to the psycho-analytic session; it is certainly my impression that the experience of psycho-analysis is supposed or intended to have an enduring effect. Unlike this book the session affords me and others an opportunity for drawing attention to the actual phenomena to which I think the analysand should attend and this might reinforce the effect of my communication. A similar advantage seems to me to be available in a psycho-analytic approach to groups; it is possible to hope that the capacity of the artist, though useful, may not be essential to the psycho-analyst. Indeed, it may be a disadvantage in so far as the artist's capacity may enable him to provide, as Plato feared, a substitute for the truth.

In this book I have made a few tentative approaches to a matter which I think has not received proper attention in psycho-analysis, namely, lying. The disposition to lie may be regarded as a sympton of a severely disordered personality. It certainly contributes many difficulties to any attempt at a psycho-analytic approach, but on the other hand my experience of psycho-analysis makes me feel that the aptitude for lying, so universal that only a liar could disregard its all-prevading nature, has its own place as an object for study and is ignored at a dangerous cost to analyst and analysand. In short, I agree that it is often a symptom of a disordered personality but submit that it is not necessarily a contraindication for analysis. Here I can only indicate one or two aspects.

It is too often forgotten that the gift of speech, so centrally employed, has been elaborated as much for the purpose of concealing thought by dissimulation and lying as for the purpose of elucidating or communicating thought. Therefore, the Language of Achievement, if it is to be employed for elucidating the truth, must be recognized as deriving not only from sensuous experience but also from impulses and dispositions far from those ordinarily associated with scientific discussion. Freud, like others before him, felt the need to isolate himself - insulate himself? - from the group in order to work. This would mean insulating ourselves against the very material we should study. We should, therefore, reorientate our views on such matters as rationalization and the employment of reason generally. The patient says, 'Suddenly, just as I finished lunch he threw a mug of beer in my face without any warning. I kept my head and showed no resentment at all remembering what you had said about psycho-analysis. So it passed off without anyone noticing.' Is he lying? Is he verbalizing a present hallucination? Matters of this kind are occurring throughout a psycho-analysis and demand correct assessment by the psycho-analyst. Yet we have not elaborated instruments - I have tried to do so with the grid¹ — for making the assessment. I am not speaking of making the interpretation or of the many theories that facilitate the making of an interpretation; the grid is of a different category altogether, analogous to a ruler in physical science, formed from a matrix of theories to aid observation and not as a substitute for observation. I commend to others a proper study of the lie and its differential diagnosis from phenomena which appear similar. The psycho-analyst must employ the Language of Achievement, but he must remember that the language was elaborated as much for the achievement of deception and evasion as for truth. This aspect is particularly clear when the prevalent emotional field is one of rivalry and hostility such as I have described, in group situations, as peculiar to the fight-flight basic assumption (Bion, 1961). The individual is similarly affected by the group emotional situation. It is, therefore, impossible to give correct interpretations, save by accident, unless that situation is assessed. For example, drug addiction is exploited as a cover for psychosis, lying is often excused as an aspect of drug addiction, and vice versa.

Psycho-analysts should determine whether they are talking of means of communication, including verbal communications, as things-in-themselves or whether they are talking of other things-in-themselves which these communication elements, gestures, actions, silences, and verbal formulations, are being used to represent. The grid is intended to remind the psycho-analyst that it is necessary to discriminate one element in his psycho-analytic experience from another and, in particular, to recognize that what matters is both the communication and the use to which it is being put. He must observe whether the presenting feature (or the feature to the obtrusion of which he wants to draw attention) is intended to further illumination or deception, and where in the genetic spectrum it belongs (primitive communication or sophisticated).

Although the grid is unsatisfactory in its present form, it will not, I hope, mislead but lead to an improved version. I have used the following signs:¹

T   — transformation

Tα — the point from which the transformation starts

Tβ — the point at which the transformation is presumed to be
        complete

Ta — the psycho-anaiyst's transformation

Tp — the analysand's transformation

O   — the experience (thing-in-itself)

Analogies are frequently used. The things used and what those things represent are dissimilar. It is supposed that a rifle and a penis are similar. But what should be exact is the relationship between the particular objects in the particular analogy and not the objects themselves. Thus: as the breast is to the baby's mouth so the surgeon's knife is to the X. In any particular instance the inexactitude of the relationship merits criticism and appraisal. The objects are faulty and to be condemned if they are similar. For example, 'The knife is to the fork as the knife is to the fork' is a 'non-analogy'. 'The eyes are to the mind as the mouth is to the food' is a correct analogy and draws attention to the matter that is to be observed, namely, the relationship between the two.

¹ See frontispiece, and Elements of psycho-analysis (Bion, 1963), where the grid system is more fully discussed.

¹ Originally in Transformations (Bion, 1965).

2. Medicine as a Model

Most people think of psycho-analysis, as Freud did, as a method of treatment for a complaint. The complaint was regarded as similar to a physical ailment which, when you know what it is, has to be treated in accordance with the rules of medicine. The parallel with medicine was, and still is, useful. But as psycho-analysis has grown so it has been seen to differ from physical medicine until the gap between them has passed from the obvious to the unbridgeable. For most purposes the similarity yields illuminating comparisons and models that facilitate discussion. But the more we see of psycho-analysis the more the models become inadequate to define, report, or apply psycho-analysis. Differentiation has meant that models which were illuminating have become opaque and often misleading even to psychoanalysts. Let us see why. We may start by discussing the obvious and simple reasons, though they will not remain either for long.

In physical medicine the patient may have a pain in his chest for which he can go to his doctor. To him he can explain its nature and its history and from him he can receive instructions to undergo further examination, say, by X-rays or microscopy, or certain forms of treatment. Or so it appears; later we may have reason to question this account. For the present it will serve to point the divergence of physical medicine and psycho-analysis.

Suppose the patient complained not of physical but of mental pain; no one doubts the existence of anxiety or sees any incongruity in seeking help to cure it. We find it necessary to differentiate between the pain of a broken leg and the pain, say, of bereavement; sometimes we prefer not to, but exchange mental for physical pain and vice versa. Physician and psycho-analyst are alike in considering that the disease should be recognized by the physician; in psycho-analysis recognition must be by the sufferer too. The physician considers recognition of the pain subordinate to its cure; the psycho-analyst's view is expressed by Doctor Johnson's letter to Bennet Langton: 'Whether to see life as it is, will give us much consolation, I know not; but the consolation which is drawn from truth, if any there be, is solid and durable; that which may be derived from errour must be, like its original, fallacious and fugitive.'

The point that demonstrates the divergence most clearly is that the physician is dependent on realization of sensuous experience in contrast with the psycho-analyst whose dependence is on experience that is not sensuous. The physician can see and touch and smell. The realizations with which a psycho-analyst deals cannot be seen or touched; anxiety has no shape or colour, smell or sound. For convenience, I propose to use the term 'intuit' as a parallel in the psychoanalyst's domain to the physician's use of 'see', 'touch', 'smell', and 'hear'.

I shall now give three different formulations of the same episode occurring in the psycho-analysis of a woman. More could easily be given to demonstrate the problem of communication and publication that faces the psycho-analyst.

The patient produced an association to express, though in a disguised manner, her hostility to parents whose relationship to each other she represented as that between pander and whore. She intended also to evoke a response from the analyst such that he would be wrong whatever facet of a multi-dimensional association he selected for interpretation. Choice of dimension and interpretation could be 'proved' to reflect the analyst, not the analysand; he could hesitate impotently before the wealth of alternatives presented to him.

A version employing more analytically recondite Kleinian intuitional formulations: the patient was directing an attack on the analyst's psycho-analytic potency; the 'missile' was the association - which therefore is to be regarded as an object of grid category A6. The characteristics of the association are either that it subjects the analyst's intuition to splitting because of his inability to formulate simultaneous expressions of diverse and possibly incompatible interpretations, or that it has the ability to compel the analyst, through the need to act, to adopt a moral standpoint for interpretation because the scientific standpoint involves being 'split' between alternative interpretations. The close relationship between moral attitudes and action, as contrasted with thought or meditation, will be investigated later. The first problem is to choose what interpretation to give. Any one of many facets of the patient's statement may be noticed rather than any other. It can be considered as a statement or as a transformation; as multidimensional or multi-faceted; it could be represented by a visual image of a figure in which many planes meet or lines pass through a common point. I can represent it to myself by a visual image of a geometric solid with an infinite number of surfaces. It depends on a realization, derived from space, of sensuous experience. The attempt to externalize the visual image is restricted as if the representation by points and lines was itself a 'space' too restricted to 'contain' the visual image; thus, — has breadth whereas the mental visual image of a line or a point has not.

Projective identification has hitherto been formulated in terms derived from a realization of the ordinary man's (or woman's) idea of three-dimensional space. The usual Kleinian formulations depend on a visual image of a space containing all kinds of objects. Into these objects in this space it is supposed that the patients project parts of their personality that they have split off. Melanie Klein, who discovered this mechanism, considered it to be observable in psychotic and borderline psychotic patients. Later, she and her co-workers considered that the theory had a more extended application and that realizations approximating to it could be detected in neurotic and normal personalities. She stressed the degree of fragmentation and the distance to which the fragments were projected as a determining factor in the degree of mental disturbance the patient displayed in his contact with reality. With this view I agree; as my practice with disturbed patients increased it became evident that more rigorous formulation of the theory was needed if the gap between representation and realization was to be bridged by the analyst's interpretation. This was brought home to me in circumstances adumbrated in Learning from experience and Elements of psycho-analysis. I shall recapitulate briefly some of what I wrote then and later in Transformations.

There are patients whose contact with reality presents most difficulty when that reality is their own mental state. For example, a baby discovers its hand; it might as well have discovered its stomach-ache, or its feeling of dread or anxiety, or mental pain. In most ordinary personalities this is true, but people exist who are so intolerant of pain or frustration (or in whom pain or frustration is so intolerable) that they feel the pain but will not suffer it and so cannot be said to discover it. What it is that they will not suffer or discover we have to conjecture from what we learn from patients who do allow themselves to suffer. The patient who will not suffer pain fails to 'suffer' pleasure and this denies the patient the encouragement he might otherwise receive from accidental or intrinsic relief. Where one patient would understand a word to mark a constant conjunction this patient experiences it as a thing that is not there, and the thing that is not there, like the thing that is there, is indistinguishable from an hallucination. Since the term 'hallucination' has a penumbra of associations which would be inappropriate I have named these objects beta-elements.

These descriptions of how these objects appear to the patient and how they appear to me are intended to aid the reader's understanding, but are not sufficiently rigorous for use in practice. The formulations have the status of elements in grid category C.

Suppose the patient is capable of tolerating frustration and pain: his story will differ in important respects from the above. To him the name represents a 'no-thing', but his capacity for toleration enables him to observe a constant conjunction, to bind it with a name or to use it when it has already been named. Patient A, for I shall now call the intolerant patient so, has then at his disposal beta-elements or bizarre objects and his case differs in this respect from patient B, as I now designate the second patient, who can tolerate and therefore name (even if the name is no more than a grunt or a yell) a constant conjunction and so investigate its meaning. Whether the beta-element or the bizarre object is to be classified as thought or not is a matter of scientific convenience which may be determined later. I suggest provisionally that all beta-elements are distinguished from elements that pervade the mental processes of patient B by considering the latter to be thoughts and the former not. The most genetically primitive elements of thought I shall group together as alpha-elements, in distinction to betaelements.

I shall now use the geometrical concepts of lines, points, and space (as derived originally not from a realization of three-d...

Table of contents

• Cover
• Title
• Copyright
• Original Title
• Original Copyright
• Contents
• 1 Introduction
• 2 Medicine as a Model
• 3 Reality Sensuous and Psychic
• 4 Opacity of Memory and Desire
• 5 Theories: Particular Instance or General Configuration
• 6 The Mystic and the Group
• 7 Container and Contained
• 8 Vertices: Evolution
• 9 Ultimate Reality
• 10 Visual Images and Invariants
• 11 Lies and the Thinker
• 12 Container and Contained Transformed
• 13 Prelude to or Substitute for Achievement
• References
• Index