But at the Same Time and on Another Level

Psychoanalytic Theory and Technique in the Kleinian/Bionian Mode

James S. Grotstein

• Editorial: Routledge
• Año: 2018
• ISBN:
  9780429911651
• Edición: 1
• Categoría: Psychologie
• Categoría: Geschichte & Theorie in der Psychologie

This book is organized as a handbook, a "beginning", to elucidate general principles on how the psychoanalyst or psychoanalytically informed psychotherapist may optimally provide and maintain the setting for the psychoanalysis, and ultimately intervene with interpretations.

Chapter 1
Bridges to other schools and to psychotherapy

The evolution of psychoanalytic technique

Freud’s (1896d) first theory of psychoanalysis was a reality-oriented one that was characterized by the notion that neurotic symptoms were caused by buried traumatic sexual memories. His second theory emphasized the effects of inherent infantile psycho-sexuality, resultant unconscious phantasies, and the organizing importance of the Oedipus complex. However, the pivotal change in the second theory was that of psychic determinism: that is, the psychic ownership of agency (Freud, 1950 [1887–1902], 1905d). The third theory of psychoanalysis was that of ego psychology (A. Freud, 1936; Hartmann, 1939). Klein’s concepts of psychoanalysis, however, despite the bitter criticism she suffered at the hands of contemporaneous Freudians—that is, that she was a heretic—were very closely related to Freud’s orthodox analytic principles—and arguably a faithful continuation of them, even with their retrospective extensions into the early oral stage. It is an extraordinary irony that Klein’s work was—and continues, in my opinion, to be—the most authentic continuation of orthodox Freudian thinking, now at a time when many of those orthodox principles have been all but discarded by Freud’s direct, legitimate successors. David Rapaport (1959) once stated: “Melanie Klein’s psychology is not an ego psychology but an id mythology” (p. 11). Although he meant this to be a dismissive and sarcastic criticism, he had no idea how right he really was and what high praise he was bestowing on Klein. It took a long time for classical Freudians to appreciate the critical importance of the Kleinian emphasis on unconscious phantasy.

Ego psychology became the first reaction to orthodox Freudian analysis; it came to be known in the United States as “classical analysis”. The school of self-psychology then emerged, in turn, as a reaction to ego psychology. Simultaneously, Sullivan’s School of Interpersonal Relations was developing and gave birth to its reactive descendant, relationism, which became intermingled with followers of intersubjectivity from many differing schools. One of the common denominators of these new schools was the emergence of the two-person intersubjective conception of the analytic relationship, thereby abrogating the alleged authority, objectivity, and neutrality of the analyst, and its corollary, the importance of the analytic focus on the solitude of the analysand’s experience.¹ Another characteristic was the elevation and enfranchisement of archival reality to psychoanalytic prominence—at the expense of the importance once given to unconscious phantasy. Yet there seems to have been another trend in recent times, one that is often associated with the post-modern trend of relativity, uncertainty, and probability theory: current intersubjective writers seem to emphasize phenomenology (conscious experience) over putative unconscious experience (unconscious phantasies). I deal with the evolution of techniques in greater detail in later chapters.

To which types of patients does Kleinian/Bionian technique apply?

Recently, while presenting a paper at a psychoanalytic society in another city, I was asked the above question—one that has many implications. After much consideration, this is the harvest of my reflections: Kleinian/Bionian technique is, for me, the fundamental technique, atop which other techniques may usefully “come on line” once the patient/analysand has attained the depressive position, at which time he has become sufficiently individuated and separated from his part-object parent (mother as breast-mother and father as penis-father) so as to experience them in their own right realistically as a bad mother or father as well as a good-enough mother or father—that is, achieve integrative ambivalence now about mother and father as whole objects. I welcome clarification from members from other schools on this matter. Kleinian/Bionian analysis has been and continues to be more interested in how the infant—and the infantile portion of the adult personality—imaginatively and solipsistically creates (re-creates?) phantasmal internal objects and part-objects from their model of experiences with their external objects (experienced at first as part-objects—that is, functions) and how these part-object creations organize all subsequent whole-object relations.

”Innocence” versus “original sin”

I see the conflict between the different analytic schools as a manifestation of the myth of the Tower of Babel. Each school has considerable merit and offers many hitherto unrealized advantages to the others. I think one of the principal conflicts between some of the schools is that of the dialectic between infantile innocence (in the Wordsworth/Blake tradition) and original sin (in the Biblical tradition) (Grotstein, 2008a, 2008b). Orthodox/classical Freud and Klein view the infant as having been born from and with the “original sin” of his instinctual drives as “first cause”. Oedipus was condemned by fate to commit parricide and incest even before he was born. Fairbairn, Winnicott, Sullivan, intersubjectivists, self-psychologists, and relationists espouse the infant’s primal innocence. (In justice to Fairbairn, however, he ultimately relies on the doctrine of “original sin” when he states that the schizoid patient is given to believe that even his love was bad: Fairbairn, 1940). Bion characteristically takes a stand on both sides, as do I.

Tausk (1919) and Federn (1952), unlike Freud, believed that the infant was born as a psyche, discovered his body and emotions initially as alien to him, and only slowly accepted them as his own. Bion’s (1962a, 1962b) concept of the container ↔ contained seems to presume the same. The containing mother introduces the infant to his bodily urges and his emotions for him to claim. Furthermore, as I listen to Kleinians—whether London post-Kleinians or Kleinians generally—I seem to hear their implicit—though not explicit—inclusion of the analysand’s sense of innocence. Take, for instance, the following brief vignette: After listening to an analysand reporting his self-destructive activities over a weekend break, a Kleinian analyst (of note) interpreted: “It seems that you began to feel increasingly more anxious as you entered your weekend aloneness. You tried to hold on to our relationship, but your mounting anxiety got the better of you and of us. Before you knew it, demons came on the scene: the sounds of menacing voices you heard in the hallway of your apartment. Those demons were me—what your angry, destructive feelings did to me for my having left you.” What is implicit in this example is that, although the analysand is laden with his inherent quota of destructiveness (death instinct), it had been in suspension until it was recruited by his anxiety over the weekend break.

Innocence and putative (phantasied) and justified guilt constitute a paradoxical binary-oppositional structure. The infant’s awareness of his innocence may not credibly appear, however, until the achievement of the depressive position, at which time the infant becomes sufficiently separate from his object that he can distinguish the location of fault and blame. Life constitutes a continuous challenge to our character in terms of our being able to resist the temptation to become petty! Put another way, innocence must temper the surges of our Dionysian self or become co-opted by it.

Implications of innocence in technique

The idea of innocence often lurks as a silent background consideration for Kleinian/Bionians in those clinical situations when they are predisposed to interpret the analysand’s maximum unconscious anxiety before the defence against that anxiety. In this situation the anxiety is believed to be first cause as the aetiology for the defences against it and for the secondary anxieties that develop in the wake of the defences. The analysand experiences this procedure as being empathic in so far as it reveals that the analyst understands the helplessness at the time when the anxiety began, which has putatively authorized the analysand to act upon it on his own. Yet there are many times when this should not be done. Narcissistic personality disorders that are characterized by a chronic manic defence (Klein, 1935, 1940) will often use these early anxiety interpretations as if they are being let off the hook, so to speak. In these and many other cases one must be sure that interpretations of anxiety do not fall into the hands of the wrong personality, one that holds the “innocent” personality as a hostage. The point is that the analyst should facilitate the analysand’s rendezvous with the depressive position, where the guilt that he has long been evading with his symptoms can at last be authentically experienced (Albert Mason, personal communication).

Having stated the above, however, it is my opinion that the specific maximum anxiety rather than the drives should always lurk in the analyst’s mind and be recognized as the principal aetiology (first cause) of the analysand’s disorder. In other words, as Bion (1965, 1970) informs us, the ultimate content of the repressed is un-”alpha-betized O”.

Autochthony (solipsistic creativity) versus archival past

The analytic problem devolves into the dilemma of the difference, strictly from the analytic point of view, between what archivally actually happened to the infant as a result of its nurturing environment, as against how the infant autochthonously—self-creatively, solipsistically, omnipotently—believed he was the agent of first cause and thus created the event he had encountered (Grotstein, 2000; Winnicott, 1971). The autochthonous principle seems to be the predominant one in working through the paranoid-schizoid position and much of the depressive position. During the later phases of the depressive position, however, the erstwhile putatively “guilty” infant becomes sufficiently separate from his objects and sufficiently individuated that he is then able to consider the separateness and individuality of his mother (and father). This maturation enables him to consider to what extent his mother—and/or father—had themselves been guilty in their defaulting on the covenant of the infant/child ↔ parent relationship by mistreating the infant.

Some Kleinians may question my conception of autochthony. I find in many seminars Kleinians speaking as if the infant’s hate, greed, envy, and the like were in fact actually involved in altering mother’s (and father’s) behaviour. This may have been true, but, as Bion (personal communication) often stated, “We can never really know, because history is rumour.” Joseph’s (1959) presentation of a patient with repetition compulsion arguably demonstrates an inconsistency between undeniable infantile and childhood neglect on the one hand, and Joseph’s ascribing her problems to her infantile rivalry and envy on the other (Joseph, 1989, pp. 16–33). I, personally, believe that clinically we must think of psychic causation from four perspectives, all of which inseparably interpenetrate and are embedded in each other: (a) autochthony, the unconscious -phantasy of creation (as in Genesis); (b) the actual effect on the object of one’s drives; (c) the impinging factors of external reality; and (d) the inexorable and ever-present intersections of O.

Consequently, I believe that virtually all psychoanalytic schools achieve great measures of validity when the infantile portion of the personality has achieved and worked through the depressive position.

Psychopathology, like mental health, is co-constructed in the crucible of ongoing experience within a bipersonal and multi-personal field—in actuality but solitarily in unconscious phantasy in the patient’s unconscious belief because of self-organization—that is, according to the rules of his own unique nature. At any given moment, however, no one can tell the “dancer from the dance” because of the endless iterations of the effects of their multiple influences on the other in each successive engagement and response. This is the Weltanschauung [world view] of intersubjectivity from the psycho-historical vertex (which I like to call the “war correspondent” vertex). This point of view may be accurate archival history. The psychoanalytic vertex represents the world view in which the patient had felt compelled to compose an unconscious creative novel to give personal meaning to his emotions when he was caught unawares in the cauldron of unpredictable circumstance, O. [O is Bion’s 1965, 1970 arbitrary term for the ever-evolving ontological moment, generally between two—or more—individuals. It represents the raw, unprocessed experience of the Absolute Truth about and infinite and ineffable Ultimate Reality. More simply, it is the unrepresentable universe—a Reality without the representation or presence of objects. It is the constantly evolving unknown and unknowable of the analytic session and of life itself as it inexorably and unpredictably unfolds and intersects—impinging on—our emotional frontier.]

In other words, psychoanalysis consists of “script analysis” with attempts at “rewriting one’s novel” so as to mitigate O’s lingering presence. Put another way, psychopathology ineluctably emerges from a bi-personal/multi-personal field (intersubjective)-context but with an autochthonous, personal ownership. But psychoanalytic treatment, although performed in an intersubjective manner, addresses mainly the intra-psychic field of the analysand. Such is the paradox of psychoanalysis.

Important concepts from other schools: adaptation

In the following I try to establish bridges between Kleinians, Bionians, and the other schools when I am able to. (I use the term “bridges” rather than “integration” because of the hegemony of one view over another that often occurs when “integration” takes place—that is, something valuable from one or another of the differing points of view may become lost.) To give just one example out of many: Melanie Klein (1957), in her epochal uncovering of the phenomenon of envy in the young infant, considered it to be a mental manifestation of the death instinct. She had not been familiar with the ego psychologist, Heinz Hartmann (1939), and his theory of adaptation—a concept that owes its origin to Darwin’s (1859, 1871) theory of evolution and of the survival of the fit-test. If we were to conflate adaptation with envy, for instance, we might hypothesize that the infant who becomes envious of his mother (mother’s goodness) does so not only because of the putative activity of the death instinct, but also perhaps because of a signal anxiety of danger due to his phantasy that the more he appreciates his mother’s goodness, the greater mother becomes in his eyes and the lesser the infant becomes; a situation of critical danger therefore becomes imminent: that is, the infant may fear the development of increasing abject shame, helplessness, impotence, ultimate vulnerability, and so on. In other words, the very acknowledgment of mother’s goodness ultimately devolves into a phantasied state of a putative danger of survival. Thus, the infant adaptively (but actually mal-adaptively) diminishes his assessment of mother’s goodness in order to guarantee emotional survival. Having said that, however, I still believe that the phenomenon of envy is primal and defining for every individual, and, correspondingly, every individual must keep his rendezvous with his recognition and ownership of it. If not an instinctual drive in its own right, then envy must certainly be an inherent pre-conception or Ideal Form awaiting activation in experience with any and all object relations.

The long and short of the problem that adaptation addresses is as follows: Do we adapt to our instinctual drives (Kleinian view), or do our drives help us to adapt to our internal and external realities—that is, O? I choose both. Put another way, all psychopathology represents thwarted attempts at adaptation. Another consideration is the nature of the death instinct itself. When viewed through the lens of adaptation, one does not see it as a peremptory discharge of destructiveness. One would see it instead as a putatively protective function that anticipates death or danger and helps to protect the anguished emotional links to needed ...