This book began with a study, shown in Chapter 4, originating from my observation of phenomena relating to patients’ relationships with the consulting room, where they project into the room, at times seemingly unrelated to the transference to me. Current theories do not completely address this, including an assumption that for the patient everything in the room is related to the transference. I consider that the role of the consulting room in the therapeutic process is both primitive (pre-transferential) and transferential and my discovery is that the former has not been noted before and the latter has not been adequately understood. Sigmund Freud invented the psychoanalytic consulting room as well as the concept of transference. However, despite his fascination with spatiality, and, as I show in his work, his projection of maternal and paternal figures into room spaces, including his consulting room, this remains untheorized. In addition, Freud made spatial diagrams to illustrate his theoretical concepts and many of those concepts have an implicit spatial concern. A neglected area of Psychoanalysis is the extent to which Freud was interested in space and objects to understand the psyche and also the psychoanalytic process in the consulting room. Freud was deeply immersed in spatiality in culture but this has not received much attention in literature. My formulation of spatialisation simultaneously involves a psychological projection of meaning and physically acting upon the environment, utilised to master the undifferentiated, relentless, internal pressure of instinct. I suggest that spatialisation is a distinctive feature of mental life and therapeutic work. Spatialisation is part of normal development and people retreat into it when under stress or when they are insecure. I suggest that the less thinking takes place, the more spatialising happens. Richard Wollheim (1969) wrote that in the mind's primitive state thoughts become, as I suggest, spatial, and they are projected outward as a way of dealing with the emotions so that instead of thinking actions occur in space. Linked directly with Freud's theory of projection this means that thinking primitively means thinking spatially. Object-relations theory is inadequate without spatialisation in that Object-relations are dimensional. It fits with it, and does not replace Object-relations theories; it adds another aspect, the spatialised aspect. The Room-object Spatial Matrix offers a missing way of understanding people's relationship with the consulting room. A fundamental feature of Object-relations is transference, transference is built on spatialisation, spatialisation is the foundation of mental functioning. You don’t have an object to transfer until you have spatialisation. There is no object without spatialisation, Spatialising - leads to - Object-relations - leads to - transference. The more primitive the levels of mental functioning, the more spatial it is. I am now going to analyse spatialisation in this study.

I utilise Freud's theory of instinct (1915, p. 120) as being unformed internal pressure of instinct put into spatial form, as well as; historical and cultural examples of space use and spatialising examples (here in Chapter 1); Sigmund Freud's writings and diagrams of spatial usage and spatialising (in Chapter 2), as well the perspectives of Richard Wollheim on thinking and Object Relations and Winnicottian theories (in Chapter 3) to formulate my hypothetical addition to the theory of transference to explain the phenomena better: The Room-object Spatial Matrix. I suggest that this can take place within a matrix of stages, the first of which, Primal Spatialisation, takes place into mother/parts of mother to create the object, this is pre-object and therefore pre-transferential. I suggest that a difficulty in utilising mother as the first object of spatialisation, can lead to Stage 2 of the Matrix, Room-object, where spatialising into the spatial array of room spaces and the objects within them replaces or supplements the mother function, topping up the object usage of parts of mother including the insides and parts of the insides of mother, the outsides of mother and parts thereof, including mothers skin, which can be spatialised in the outside and inside of the room walls and room contents. Stage 3 – Consulting Room-object, is where the consulting room is used as other rooms were used before as a direct displacement from one room to the other separate from transference to the therapist. Stage 4 – Consulting Room-object + Transference, is like stage 3 but includes the transference to the therapist. Stage 5 – Consulting Room-object + Transference, outside the Consulting room, includes the spatialising of original spatialised room, the object, the therapist in the transference and the therapist's consulting room. These stages can be moved in and out of, the stages representing a regressive, defensive function (re-enacting the spatialising to re-create the object and defend against its loss), as well as a maturational one as a form of rudimentary containing mind. I suggest that spatialised room transference into rooms (Room-objects) can fulfil the role of an external auxiliary thinking/mind space as a replacement for and an addition to mother's or, in the case of the consulting room, the therapist's containing mind. My claim is that part of this hypothetical Room-object Spatial Matrix is pre-object and therefore pre-transferential. My methodology in the original study (shown in Chapter 4), was an attempt to magnify the primitive spatial level of thinking. I utilise clinical material in Chapter 4, from this study, relating to room moves, to demonstrate where the formulation of the Room-object Spatial Matrix stages can and cannot be seen, in order to demonstrate the matrix stages, in particular the pre-transferential aspects. In Chapter 5 there is a discussion of findings of the clinical study and implications for practice.

In Chapter 6 on The Room-object Spatial Matrix in the Virtual consulting room space, I show clinical work relating to a different room move; one to the Virtual consulting room, relating to the Covid-19 pandemic. This was also a global room move, creating the greatest spatial change on masse relating to the psychotherapy consulting room space, since Sigmund Freud first created it (as discussed in Chapter 2) and heralding, for all therapists (including those who had not worked virtually beforehand), a new potentially ‘blended delivery’ and we could say ‘blended rooms’ (physical and virtual) psychotherapy age. I explore patients' spatialising activities in the virtual Consulting room and their attempts at the Stage 5 – Consulting Room-object + Transference, outside the Consulting room, having had to be creative in their spatialising outside the consulting room space; forming their own couchs, chairs, and spaces. For those who have never been in the physical consulting room space, they have also been able to utilise parts of the virtual space to formulate the Stage 5, something of which is necessitated in the Virtual consulting room space as patients. Whether patients have been in a physical consulting room space or not, they have had to make something of a room space to create a room for themselves to do the psychotherapy work in, to be part of the virtual consulting room. This chapter looks beyond the Consulting Room at psychosocial applications of the Room-object Spatial Matrix to the novels of E.M. Forster. Forster's language of expression is spatial, concerning people's relationships to the interiors of rooms, spaces, houses, street, cities, and countryside, including colonial, post-colonial, capitalist (pre-neoliberal), and queer perspective spaces, often as a spatialisation. This chapter also considers both the social themes he explored in his novels and the rooms and spaces within them and how applying the Room-object Spatial Matrix can bring out psychosocial thinking on these themes and spaces allowing for an additional layer to be considered. The final end Chapter, Chapter 9, concerns endings and goes backwards through the chapters of the book looking at clinical examples, Freud's room spaces, and cultural examples back to the beginning. It concerns people's final rooms in which they spend their final days, which I suggest can be thought of as an additional stage of the Room-object Spatial Matrix; Stage 6 – The End Room-object space. I include a clinical example, with that of Andre Gide's mother and Sigmund Freud's own End Room-object space; his consulting room, including the last book he was reading at the end in that space, Balzac's ‘La Peau de Chagrin’, where the magic skin on the wall is reminiscent of the Room-object and its illustration in Chapter 3, of the walls as mother's skin. Beyond the Room-object Spatial Matrix I suggest that there are Post Room-object spaces exemplified by examples from Westminster Abbey, which are first discussed here in Chapter 1. Finally, there are conclusions on the physical and virtual consulting room space in relation to the Room-object spatial matrix and implications for practice through the book.

As part of the background and rationale for my formulation of the Room-object spatial matrix, I will now look at spatial thinking applied to the psychoanalytic discipline, in particular concerning the consulting room. Robert Tally discussed Michel Foucault's characterisation of this ‘epoch of space’:

Robert Tally identifies this ‘spatial turn’ as relating to post-war perspectives in the latter half of the twentieth century; ‘progress of history in the wake of such destruction, and a changing view of temporal movement may have opened the way to those who demanded that greater attention be paid to spatial concerns.’ (Tally, 2013, p. 12) Perspectives on space have developed in some disciplines in this ‘spatial turn’. However, psychoanalytic perspectives on spatial meaning from an unconscious perspective remain relatively underdeveloped theoretically. Harold Searles began to look at human's relationship with the non-human world and the ‘matter of regression to a primitive level of thinking, comparable with that found in children and in members of so-called primitive cultures, a level of thinking in which there is a lack of differentiation between the concrete and the metaphorical.’ (Searles, 1962, p. 23). He also wrote that:

I consider, that in this book, I am continuing this opening up that Searles writes of, thinking about the non-human environment and the concrete and the metaphorical in relation to the role of the consulting room. In relation to the space of the consulting room, Gary Winship and Shelley MacDonald wrote that: