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Playing at Work
Clinical Essays in a Contemporary Winnicottian Perspective on Technique
Vincenzo Bonaminio
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eBook - ePub
Playing at Work
Clinical Essays in a Contemporary Winnicottian Perspective on Technique
Vincenzo Bonaminio
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About This Book
Playing at Work offers a thorough guide to the innovative psychoanalytic practices of Vincenzo Bonaminio, as he draws on the work of Winnicott, Bollas, and Tustin to demonstrate an effective method for working with adults, adolescents, and children in clinical settings.
Using several clinical cases, the book explores central psychoanalytic concepts such as transference and countertransference, identity and self, embodiment, anxiety, and the role of parental influence on psychic development. By providing extended commentary on his case material, Bonaminio illustrates the significance of writing about clinical practice to the development of techniques that address patients' varying needs. Simultaneously, this text offers a method that cultivates each patient's capacity for intuition and the use of metaphor to form their own interpretations, and thereby invests a sense of freedom into the analytic situation.
By its deeply reflective insights, and its emphasis on the contribution made by the analyst as an active participant in the therapeutic situation, Playing at Work forms essential reading for all practicing psychoanalysts and psychoanalytic psychotherapists who wish to improve their clinical practice with patients of any age.
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1Transference Before Transference
DOI: 10.4324/9781003228332-2
Scene 1. Paola. A Tuesday in March, not long after 6:30 pm, some years ago
Paola arrives on time as usual. It is the first session of the week. She is 38 years old, an only daughter, and has an elder brother. She has recently separated on a trial basis from her boyfriend, with whom she had a son who is now a year and a half old. The child is mostly cared for by her parents, who retired early. She is a teacher in a middle school.
Paola begins to speak softly of “the most important thing” that happened to her and bothered her over the weekend. Her child, Luca, with whom she could finally spend some time (she also feels like an inadequate, immature mother), “moved into the background … it was as though he didn't exist. I behaved like I was in a trance, and only now and then was a little bit there.”
She told me she had felt great discomfort in regard to Luigi, a school colleague of hers, with whom she seemed to be able to “construct a sentimental story.” The principal chose her to accompany the students to a school camp in Northern Italy for almost the whole week. “By the way,” she said hurriedly, “next week I won't be here for at least three sessions … unless you might be nice enough to move my session from Friday to Saturday.”
She felt bad, she said, because Luigi would have been the obvious choice to go to the school camp, given that he is a male and the physical education teacher, and without a doubt he is nicer in the boys’ eyes. But the principal, “on one of her whims,” seemed to have thought it would be better for Paola, a woman, to spend “especially the nights – in the hotel,” with the children. “You know how parents are … Maybe something would happen, and we'd be in the middle of it … A woman is more attentive to certain things … and then with these stories of molestations … the principal will have thought of that.”
But this wasn't what tormented Paola. It was the look Luigi fixed on her, amazed, waiting for her to say it was his turn, that in any case he was more suited. And in contrast, she remained silent and tried to avoid Luigi's gaze. She nodded obediently to the principal, like a schoolgirl, but inside she felt happy: happy to be free for a week, free of Luigi, who was a “bit of a bore,” free from her parents and from Luca, too. She imagined the joy, the relaxation, of being able to smoke in peace, without being judged by Luigi, the health fanatic, or by her parents. But afterwards she felt like a worm for having “stolen” Luigi's place, for not having uttered a single word, for having rejoiced at what the principal said. She had also felt guilty in relation to me, because of the skipped analysis, but then she thought that wasn't really so serious, and of course I would understand her need.
Many characters and themes (Bollas, 1995; Ferro, 1996; 1999) presented themselves in my mind: the principal, the children, the parents, adolescent sexuality, molestations, phallic competition, the need to be alone (a withdrawal from the transference?). Inevitably, I could not be anything other than selective (the selected facts of which Britton and Steiner [1994] speak), about what I feel to be most meaningful to me, partly based on previous themes that I cannot specify here for brevity's sake.
Consequently, after listening to her words, I began to formulate an initial comment about what she had told me, then said, “certainly, you are using the analyst, supposing that he is on your side, in order to mitigate your sense of guilt, because you think he is ‘understanding your needs,’ but of course this is what you like to think … in order to keep him on your side, an ally.” Then I was interrupted by a loud, unexpected, and annoying ringing at the main entrance to the building.
That certainly doesn't concern me, I thought immediately. It might be a mistake, or the patient who sees my colleague with whom I share the office. But as far as I know there is no patient whom she sees at this hour. Besides, I continued to myself, we have staggered hours precisely to avoid overlapping each other … it must be the janitor … that creep who, since we're getting close to Easter is being especially accommodating. He delivers books that arrive for me instead of leaving them with my colleague, as he has been told, because he knows I will definitely be in the office and thinks he'll pocket a more generous tip. He thinks he's clever, he does! He's like the mayors of the Christian Democrat party, who repair the streets on the eve of the election so they will gain more votes. He thinks that he will extract some big bills, much higher than customary. But he's a pain, let's face it. I'll reduce his tip rather than increasing it! People like him understand only through actions.
These were my free associations, or countertransference thoughts, those that, in an illusion, we would like to think of as always focused on the patient but have an “evocative resonance once disentangled from the analyst's accumulated thoughts”1 (Fabozzi, 2002).
The janitor was not only the real janitor, the man of flesh and blood, but also my ‘internal janitor,’ who was having some difficulty filtering all this psychic material coming from the patient and the annoying and unexpected doorbell. This internal janitor certainly corresponded to the character in an unconscious script who doesn't do his duty and represented a deficit or a failure in my capacity to contain and give a preliminary meaning to the material.
While I was preoccupied with these thoughts, the famed evenly hovering attention, the much-exalted reverie of the analyst, was lost.
Listening, as Smith (2000) clearly says, is like every other psychic formation, a compromise. The analyst's listening certainly cannot escape the inexorable work of the unconscious, and at times – one could say ironically – the compromise is more in the analyst's favor than in the patient's!
I tried to get back on the same wavelength as the patient. I said, “Certainly, it is difficult to tolerate the feeling of having taken something away from Luigi … also to have done it without intending to, but maybe you feel so guilty because, deep down, you rejoiced a little: the principal preferred you to Luigi. Luigi is always in the middle of things and believes he is ‘the cool one,’ as you say … an athlete, a health nut, an ecologist, one who is always kind to children … and then there is the possibility of your taking a vacation from the analysis, well protected by the excuse of the greater necessity of work …”
Just as I was concluding my comment there was a second, then a third, loud ringing of the bell downstairs. I became irritated. Who the hell is it? I thought. Is it possible that he doesn't understand? If someone doesn't answer a bell, they're not in, right? It's not rocket science. Then it occurred to me that it could be the priest who wants to bless the house for the coming Easter festivities. He carries on with his duties … and is a pain in the neck to people who are working … for heaven's sake! … He can ring for as long as he wants… he'll figure out that some atheists live here … I'm not going to open the door … he'll get tired in the end.
All this went through my mind, while my irritation increased together with my inevitable distancing of myself from Paola's narrative.
“Maybe it's someone who wants you,” Paola said. “I wonder … a messenger, the janitor … maybe something serious has happened to your children.” (She wants to reassure me and instead makes me more anxious, I thought.) “… maybe it's a mistake – maybe you made an appointment that got forgotten. Go answer it, don't worry about me.”
In a falsely calm way, I answered: “there's no need, it must be an error, nothing to worry about, it will stop sooner or later.” But then, after only a few seconds, given that the bell continued to ring, I contradicted myself. I became disorganized, just as Paola's narration was getting progressively more disorganized. Standing up from my chair, I said: “I'm very sorry, perhaps you are right. It's better to answer … otherwise we risk having our eardrums perforated. It must be an error … it's better to go and see.”
I went to the intercom and said, “Yes?” clearly irritated, though I tried to control my tone. From the other end of the line a very loud masculine voice said, “I am Stampeder, Massimo Stampeder2… I have an appointment with Dr Bonaminio for 6:30. Excuse me, Doctor, I couldn't find the correct main door, will you let me in? Shall I come up? What floor are you on?”
“No, no!” I said. “The appointment is for 6:30 p.m. tomorrow, Wednesday. Wednesday at 6:30, I had told you … Do you remember? Wednesday at 6:30.” I felt like a boring old professor or an office clerk. I over-articulated the syllables: Wed-nes-day.
I did not even have time to finish my sentence before I noticed that Stampeder had already gone away. Perhaps he left with his tail between his legs, full of shame, or perhaps was furious at me, which became apparent in his own tortured analysis.
When I sat down once again, and attempted to resume our interrupted conversation, Paola said she understood my irritation and tried to console me. “It can happen, what do you expect?” she said. “Mistakes can be made … at any rate, it didn't bother me … don't worry about it.”
She spoke in a manic way, as though she were responsible for the event and wanted to placate the “furious mother.” Then she added, and here really infuriated me: “Poor guy, he felt excluded, who knows how bad he feels about it … I have nothing to do with it, I know; this is my hour … but I feel guilty, as though I had taken his place … but look here – this is my hour, and I'm thinking I've done something wrong to him! … I'm strange, aren't I?”
I thought to myself, but look here at you, worrying so much about the poor guy, after you've just told me that you treated that other poor fellow, Luigi, like an old rag.
Contact with the patient was recovered, despite my ‘hate in the countertransference’ (Winnicott, 1947), which I recognized as objective, felt towards Paola and the unknown ‘Stampeder.’ This was not something one or the other of them made me feel, like the projection of their anger or aggression; however, a few minutes passed before I felt that the strong emotions were quietening down, so I was able to speak to her in a tone that seemed coherent and calm.
“Well, it is as though that person were Luigi, from whom you felt you had stolen a place even though you didn't want to. But profiting from a situation that was to his disadvantage made you feel guilty … a little like now, when you feel guilty because of the person you imagine pacing around furiously downstairs, like a beaten wolf.3 It is your hour, certainly, and this mistake has nothing to do with you; just as the principal's decision had nothing to do with you. But it is difficult for you to tolerate being the ‘privileged one,’ the ‘chosen one’ … and who among us would not like to be ‘that chosen one,’ without, however, feeling the guilt of having taken away that place from someone else, perhaps a brother? It seems to me that this may be a plausible motivation for your otherwise incomprehensible sense of guilt. Your sense of commonality with Luigi, who remained excluded, and with that ‘poor guy,’ that you imagine wandering around downstairs.”
Thus, I based my interpretation, like a ‘selected fact,’ on sibling rivalry for the mother. Is there an explanation for this? I mean: is there an explanation for the fact that I chose an interpretation to do with sibling rivalry, which had never appeared in her history or in her relationship with me up to that point? I commented on rivalry with a brother whom I knew nothing about. Is there an explanation for the fact that I chose precisely that complex link in Paola's narration in response to the intrusions of Massimo Stampeder? It was as if the analyst were unconsciously acting as a bridge between two patients who of course didn't know each other.
The fact that countertransference may precede transference, pre-organize and structure it, is a notion that was put forward a long time ago in psychoanalytic literature by some, although not many psychoanalysts. But more extreme is to say that understanding a patient's transference may be guided, ...