Student notes A Brief History of Psychoanalysis in Ireland Being Anxious about Rage (introduction to Melanie Klein) Between Psychiatry and Catholicism J. Hanaghan (the first Analyst in Ireland) R.D. Laing (antipsychiatry) Suicide notes (1) Borderline Personality Acts Bion's Theory Key Concepts in Kleinian Psychoanalysis Notes on the Countertransference Notes on Winnicott     A BRIEF HISTORY OF PSYCHOANALYSIS IN IRELAND. Apart from a small but important group of analysts in Monkstown, South County Dublin, working away in isolation for four decades, psychoanalysis only began to develop and broaden within the Republic during the 1980s, about a century after its inception by Freud.  The disappointing realisation is that psychoanalysis has had little cultural impact here. This may in part by due to the at one time formidable power of the Catholic Church on the one hand and the still powerful influence of organic psychiatry on the other. In a generation, much has changed with the growth in therapies of all kinds. However, psychoanalysis - the “talking cure” which includes the unconscious - is still a rather marginal activity and does not reach the many people who could benefit from it.  Three groups. Broadly speaking, there are three main groupings within the psychoanalytic movement in the Republic.  These groups tend to function autonomously although just a few practitioners are members of more than one group. Two out of the three groups are affiliated to the Irish Council for Psychotherapy (ICP), which is an umbrella group representing the many different strands of psychotherapy (including psychoanalysis) in Ireland and aboard, via the European Association for Psychotherapy (EAP). The first and oldest grouping is called The Irish Psycho-Analytic Association (IPAA). It was formed in 1942 by Jonathan Hanaghan, who had been analysed in England by Douglas Bryan - a leading member of the original London Psychoanalytic Society.  Hanaghan developed an unorthodox, charismatic, radical Christian approach to psychoanalysis. Hanaghan trained a small number of analysts here in Ireland who began working and helping people, often for very low fees. Along with Hanaghan, the founding members were Wilfred Bowell and Rupert Strong, The commitment to their work was very great, and every Saturday night Hanaghan gave an informal talk on psychoanalysis and the New Testament in his house in Monkstown. Anyone could attend and many did during the 1950s and 1960s. This became known locally as the "Monkstown Group” although there were never any formal arrangements or membership lists. The Group, as it was called, was well known for its radical bohemian ethos. Anyone, analysts, patients, trainees and their friends, could attend and participate in the discussion after the talk, over a cup of tea, sandwiches and cakes that people donated. Hanaghan believed that analysis was not enough on its own. People also needed human fellowship, a community of people who would help and support one another through their crises. What he took from Freud was that mental illness arose from a failure in our capacity to love. Hanaghan spoke at every meeting, claiming in, what some referred to, as prophetic terms a profound link between Freud and Jesus. He regarded psychoanalysis as a form of mental and spiritual healing. The so-called "Mounttown experient" began in January 1949, although Hanaghan left the experiment early, it continued in some form or another until 1967, when the house was demolished after the local council had sought a compulsory purchase order on the property. It was an attempt to put into practice Hanaghan’s philosophy. A number of families lived in community sharing everything in a large house in Mounttown, Co. Dublin. It was alleged that the men spent their time discussing important philosophical issues, while the women did the chores. But it did serve as a refuge for the mentally ill, as well as acting as a focal point for artists and writers and visitors came from far and wide to share in the new analytic ideas. For Hanaghan, the analyst is more than a technician, he is a healer. Hanaghan railed against the institutional churches as well as what he regarded as 'academic atheistic psychoanalysis', and the hypocritical “Christian” family. He developed a considerable following which continued up until his death in 1967. The Hanaghan tradition was then carried on by Strong and Bowell, who were joined by Dick and John Cameron, Gordon Fletcher and Mary Miles. The analysts Hanaghan trained were well read in Freud, but the devotional adherence to Hanaghan’s teachings, especially in the decade after his death, became problematic for some, particularly younger aspiring analysts who felt blocked by the founding analysts. It was even said that one of the analysts had on his deathbed suggested that certain aspirants should not be allowed to become analysts of the Association. A suggestion rather hard to refute and which caused some bad feeling, at the time.  Although Hanaghan published a few books (see the Runa Press) and some of his Saturday night talks and lectures to training analysts were typed-up by devotees, he never published in any psychoanalytic journals or exchanged ideas with the wider psychoanalytic world outside Ireland. He believed in organic transmission by word of mouth, the Christian notion of sowing seeds. He did however receive high praise from Anna Freud. She said, ‘the mantle of my father’s work has fallen on your shoulders.’ More recently in 1999, the IPAA became incorporated and has an ongoing study group which attracts new members, who study Hanaghan’s work, but also the work of other analysts. It has applied and been accepted as a member of ICP psychoanalytic section. Although, it remains the smallest of the three groups, it has developed links with the Northern Ireland Institute for Human Relations (NIIHR) and with the Department of Sociology in UCD.  A new beginning was sought in the early 1980s. Study groups formed to read Freud, Melanie Klein, Winnicott and others, that by-passed the Monkstown orthodoxy. Guest analysts were invited from abroad, most notably, Masud Khan, Hanna Segal and R.D. Laing. Younger analysts from Monkstown together with other analysts already trained aboard eventually formed the Irish Forum for Psychoanalytic Psychotherapy (IFPP) in 1986, which, although it was called a Forum, was to distance itself completely from the Monkstown analysts. The remaining senior Monkstown analysts were not invited, nor did they seek to join the new group.  The Forum was intended to be an umbrella grouping for those therapists with broadly psychoanalytically-oriented trainings, open to membership in the 32 counties and abroad, to discuss and develop psychoanalytic ideas and the clinical approaches. The Forum journal first appeared in 1987, publishing a wide range of articles. During the early ‘90s regular publication ceased. The last hard copy of the journal appeared in 2001. There were very well attended clinical meetings and public lectures series in the early years.   This grouping maintained for some time an eclectic mix of psychoanalytic traditions and a free movement of ideas. In August 1994, the IFPP became a registered company, in accordance with developments elsewhere and created a register of practitioners with about 40 members. Trainings were established including those specialising in child and adolescent (IFCAPP) and group analysis (IGAS). The IFPP became affiliated to the ICP when it was founded and for many years IFPP was the only body representing psychoanalysis in Ireland. In 1997, The Columba Press published the first register for psychotherapists in Ireland, including all those IFPP analysts who wanted to be included. This publication is regularly updated. However, a number of analysts within the IFPP were from the outset interested in the work of the revolutionary French analyst, Jacques Lacan, who over more than three decades worked to establish psychoanalysis on firm linguistic foundations and on what he stressed was a  “return to Freud,” especially Freud’s early writings. In keeping with Lacan’s decisive break with what he always dismissed as “ego-psychology,” this new group, believing themselves to be the true heirs to Freud’s legacy, indeed the true psychoanalysts, largely turned their back on the IFPP, just as Lacanians worldwide who endlessly ridiculed the International Psychoanalytic Association (IPA) as a spent force - hopelessly bureaucratic and revisionist. They devoted considerable energy to the exclusive study of the very difficult Lacanian Seminars. New members were rapidly created from the new trainings, who had had virtually no exposure to other psychoanalytic traditions. Lacanian analysts came from France to give seminars in the School of Psychotherapy in St Vincent’s Hospital, Elm Park. An annual congress has been held each November since 1995, with papers on Lacanian psychoanalysis presented by analysts from Ireland and abroad. A Lacanian journal was established in 1994, The Letter, which appears three times a year. The articles collected in these volumes are now a very valuable source of Lacanian ideas, but unfortunately they are so specialised as to be largely impenetrable to non-Lacanian analysts. Although written in English, they often retain a French style as if they have been translated from French, so close is the identification with the Master. More recently a newsletter has been produced, The Review, where shorter articles appear and topics can be discussed. Meanwhile, analysts outside the Lacanian fold feel permanently excluded and there has been little willingness to interact with a wider non-analytic intellectual culture. They believe that no other form of analysis exists. This group of analysts incorporated itself as the Association for Psychoanalysis and Psychotherapy in Ireland (APPI) in 1998, with 60 members. However, it has not affiliated itself to ICP, believing that the interests of its members and the practice of psychoanalysis in Ireland are best served by dealing with the Health Board directly, while continuing to form links with international Lacanian groups. Recently, strains have developed within APPI as some members have sought to resist what they saw as the bureaucratic controls brought about by the strict and exclusive adherence to Lacanian doctrine. This was seen by some as elitist, isolationist and obstructing freedom of thought at a time in Irish society when it seemed more important than ever to try to reach the wider culture. More than two decades on and Irish psychoanalysis has no significant place in Irish cultural life. Psychoanalysts only really have themselves to blame. A new grouping, The College of Psychoanalysis in Ireland (CPI), incorporated in 2005, aspires to be a non-doctrinaire Lacanian group that also recognises the work of the other pioneers of the psychoanalytic movement and wants to reach out to the many people who would benefit from our work and training. But this apparent break from the main APPI grouping angered some of the most senior and founding members of APPI who resigned at a turbulent AGM in 2007. These analysts, few in number, have gone off to found another "more orthodox" secret Lacanian School, which hosts occasional meetings, attendance at which is by invitation only. In the meantime, APPI itself has become rejuvenated and more democratic and the College continues to function with monthly meetings. (Oct 08)  Top Being anxious about rage… Melanie Klien pioneered child psychoanalysis and analysis of disturbed adults. Her investigations led her to the root causes of rage, aggression and destructiveness, something that Freud acknowledged he had overlooked for too long. Klein formulated two very early and intense developmental phases through which all infants pass, the troubling echoes of which remain unconsciously within the child and even adult personality.  We regress towards these residues when under stress or close to breaking point.  The first and most primitive stage is called the paranoid/schizoid. The human newborn is utterly vulnerable and in the beginning needs total care.  It has a very low toleration for anxiety and therefore anything that disrupts its fragile stability beyond a small margin is experienced as terrifying.  Hunger, frustration, pain, anger are all disruptive in this way.  Being unable to contain these intense feelings which are felt to be very bad and threatening, the baby projects them into the outside world (screaming, yelling).  The baby is “split” into a good self (everything good is kept within), and a bad self (full of rage and frustration) which is denied and projected into the outside world.  This radical splitting of the self attempts to ensure that the good is kept separate from the bad.  The good self and all the good things it gets, tend to be idealized as a reassurance against the badness “outside”.  The trouble is that the splitting is only partially successful and the bad things are likely to re-invade at any moment.  These persecutory or paranoid anxieties are the basis for night terrors and paranoia.         The splitting involves the parents as well.  The good mother who gratifies and comforts the child is idealized and retained within, while the frustrating and angry mother appears in dreams and fairy stories as an evil witch. The bad image of the father is the giant or the ogre who has great strength and can inflict great punishment.  Clearly the image of the witch and the giant are far more dangerous and persecuting than the reality of most parents. Klein has shown us that the parental imagoes become massively distorted by the baby's own rage protected into the parents.  Clearly the more angry the baby, the more frightening the parent is felt to be.        If the parents in reality are rejecting, then the paranoid trends within the personality will be greatly enhanced.  The primitive rage-filled fantasies may be confirmed by the reality of the child's experience and it will not have accumulated enough good experience to move onto the next stage. The scene is set for serious mental illness.               The next pase is the depressive position.  If the child during the early stage stored up enough good experiences, then the tendency will be towards integration rather than splitting.  Instead of radically splitting off and disowning the bad parts of himself he will have more confidence to tolerate them, to realise that he can both love and hate.  He is becoming a more whole person now, not so anxiously split into the good self and the projected bad self.  He sees his mother also as a whole person--the good and the bad mother are the one person.  The mother who feeds and gratifies him and the mother who withholds and frustrates are the same person.        The main anxiety during this time is depressive anxiety--the fear that he has destroyed his mother by his destructive and aggressive feelings.  It is the same anxiety that (re)appears in depressive illnesses.  The depressed person or child is frightened by the terrible harm he feels he has done to the person he also loves and needs. He wants to repair the damage, to restore the person to life and wholeness.  Just as his destructive impulses were believed to have caused the damage, so there is the corresponding belief that his loving and creative impulses can make good the damage.  Klein refers to this rebuilding work as reparation.  Reparation  allows the child to rebuild the world allegedly shattered by its own impulses.  If reparation succeeds then the child gains in confidence and maturity.  He acquires the capacity to love, to be concerned about others, to acknowledge that he contains both good and bad feelings.  If reparation fails or is blocked then he is thrown into depressive despair and may regress even further towards the earlier paranoid/schizoid position.        During this phase of development the child is becoming more in touch with external reality.  If the real mother, out there, does survive his magical destructive attacks, then the power of these destructive fantasies is considerably diminished.  If on the other hand the mother retaliates excessively, the feared power of these impulses and their badness is confirmed, reinnforced and the child feels a renewed sense of persecution.  Again if the parents are not available to the child then it is thrown back on its fantastic terrifying inner world.  Of course if the parents do get sick, divorce or die, then the child blames himself and suffers disabling depressive illness. He believes morbidly that has created this catastrophe.        During the depressive phase, the child discovers his extreme dependence on his mother, and goes through intense feelings of fear and loss, mourning, pining and guilt. John Bowlby, working at the same time as Klein, described the grief that very young children go through when separated from their mothers in residential nursery settings.        ‘If a child is taken from his mother's care at this age (1½ to 3yrs), when he is so possessively and passionately attached to her, it is indeed as if his world has been shattered.  His intense need of her is unsatisfied, and frustration and longing may send him frantic with grief.  It takes an exercise of imagination to sense the intensity of his distress.  He is as overwhelmed as any adult who has lost a beloved person by death.  To the child of two with his lack of understanding and inability to tolerate frustration, it is really as if his mother had died.  He does not know death but only absence; and if the only person who can satisfy his imperative need is absent, she might as well be dead, so overwhelming is his sense of loss’.        Such children, experiencing real suffering, cannot deal with the depressive position. Instead they can (indeed must) harden themselves against such suffering, by idealising violence itself, attacking any sources of love or help, invoking the manic defence. At a time of social breakdown, we see more and more of these types of children. It is Kleinian analysis, uniquely, that can help us unpack what has gone wrong.                                                                                                                Top Between Psychiatry and Catholicism Back in the early 1970s, an American friend was renewing his Visa to stay in Ireland for another year, ‘to continue his psychoanalysis’, as he rather naively wrote in the relevant section of the form. The official, looking over his application, straightened up at this point, looked at my friend in disbelief, warned him about quacks and foreign ideas and told him that if he had any problems to see a priest, or even he, the official, could help him if all else failed. Don’t get involved in that kind of stuff.  Even  Monkstown, the home of psychoanalysis in Ireland for over forty years, was regarded with suspicion. A teacher colleague of mine was very anxious for my welfare as he dropped me off at the top of Belgrave Square, but would not elaborate on his concerns.  It was around this time that psychoanalytic books were not generally available in Irish bookshops, either through lack of demand or censorship. Only a few years before, Hanaghan, was still giving his Saturday night talks about, as he saw it, the hypocritical evils of the established churches, the sadistic school system, the severity of parents who beat their children for masturbating, our neurotic relationships locked into Oedipal passions and hatreds. But the official line has become that psychoanalysis started in Ireland as late as about 1980.1 From that point on it was as if Hanaghan never existed.2 Part of the reason for this might have been that there were no specifically Irish analysts trained by Hanaghan. However, during the 1980s a whole plethora of therapies came into vogue in Ireland as elsewhere to meet the burgeoning demand for psychological help. Up until this time, we must presume, many suffered in silence or sought comfort within the institutional confines of the Church and the Asylum. You went to a priest or a psychiatrist, which means as far as the subject was concerned the silence remained, lest your speaking be taken up by either a spiritual or chemical discourse. Furthermore, during the 1980s, more orthodox strands of  psychoanalysis finally became established in Ireland. The key point here is that the specially dominant over-arching position of the Catholic church in the new Republic fended off any foreign “talking cures” and the space left was more than filled by organic psychiatry, experts in the objectification of the subject. Fast forward to 2004 and the situation is complex. Therapy is very popular and the field is dominated by CBT and CAT and clinical and counselling psychology at the medical end of things in the Health Services, and Holistic and New Age therapies at the pan-spiritual end of things. The once dominant Catholic Church has seen fit to embrace holism and feminine theology. Psychiatrists are now required to do modules of psychotherapy as part of their training (although this is largely aspirational at present). Therapy, so long denied and regarded as dangerous, has been rapidly diffused through Irish culture, particularly in the last ten years, affecting virtually every area of life. Joe Duffy, for instance, was trained in Family Therapy. Everywhere the soft focus and soft strategies of intervention have replaced the old antagonisms; everywhere harmonisation and transparency. The dilemma for our small enclave of psychoanalysis is critical. In the clinical field we represent a tiny minority of practitioners, mostly working in private practice, and occasionally on an ad hoc basis within the health boards. Notions such as the unconscious and the divided subject are “poorly understood” (see the APPI Working Group Report, May 2004). Yet students who have invested in training and who are committed to subject and want to be able to work as psychotherapists in the health services feel aggrieved that APPI has not yet affiliated itself to the ICP as have the two other psychoanalytic groupings in Ireland.3 Not only this, but other trainings, clinical psychologists, for instance, are recognised as therapists without having had an adequate training. But this is only one half of the dilemma. The other is that if there is going to be a profession called “psychotherapist” and, let us argue that it is inclusive of psychoanalysis, then how can psychoanalysis retain its distinctive character as something Other, without itself becoming a divided subject? How is the master discourse of the health industry increasingly anxious to police every area of our lives as a potential “health related issue” going to leave psychoanalysis, or any subject for that matter, alone? The drive for transparency, for integration, for consumer rights, freedom of information,  protocols, best practice, empowerment, autonomy, for continuous re-training, ongoing occupational development and so on, in short, the drive for compliance and regulation4 in every area of our lives is unstoppable. This is part of an EU-wide integral reconciliatory vision, where the Other is included in advance.  Furthermore, with the licensing of psychotherapy (both public and private), the secret of the subject will be definitively outed. So a psychoanalysis that opposes notions of “adjustment” per se, that would want to privilege the privacy of the treatment, free association, unfocussed exploration, is presented, let us be clear, one way or another with a threat to its existence. Your notes, your private communications, fee structure, records of dreams, what you said, what they said, your assessments, progress reports, all must be made available for the purposes of clarity and legitimacy. What have you got to hide? So perhaps psychoanalysis has already become two-faced. One face facing the Health Boards, reluctantly and may be already too late, throwing in one’s lot with CBT, CAT and DBT, taking up our place in the Symbolic structure, bound increasing by regulations and outcomes, all to bring about, to foster “healthy functioning.”5 The other face, unseen, operating in a marginal capacity, outside the health model (the Symbolic), making up a kind of black economy of the subject working from safe houses, not in a health system, but in a stealth system.6 Is a compromise possible?  To work within the system, yet to retain the notion of what disrupts the system, the unconscious, which provokes resistance at every moment? Is it possible to think of a psychoanalysis working within the health system, ‘with no need for any kind of reporting back’ (see p10, APPI Working Group Report May 2004), i.e. with our right to work in our own way left in tact? After all, the unconscious appears, the unconscious speaks outside of our special arrangements.  The too close alliance of psychoanalysis and medicine has not had a happy outcome for psychoanalysis in America. To enter the Symbolic is to assume castration. This is the fate of every singularity. Psychoanalysis castrates itself, as its conceptual space becomes crowded out on the multi-disciplinary team bound by outcomes and cost effectiveness; as it becomes one strand of a massive palliative system that picks up the pieces of an atomised culture.7     In the old days, when there was psychiatry and the Church, one could remain outside as these hard strategies that made no pretence at inclusiveness. Hanaghan was there too, with four other analysts, with their highly controversial mix of Freud and Jesus, charging fees sometimes as low as 1d a session, unregulated except for the occasional death threat. Today, however, it seems as if there will soon be no escape from this web of care (and social control), which will include psychoanalysis, which fearing for its very existence, hopped on board just in time before being consigned to oblivion. Notes. 1. There is an article by Dr Michael Fitzgerald, that I have been unable to find, from about 1994 which starts with this statement. 2. Hanaghan wrote a number of books. Society, Evolution and Revelation, 1957. Freud and Jesus, 1966. Saying of Jonathan Hanaghan, 1960. But there has been virtually nothing written about his work, except The Wisdom of Jonty. By Richard Cameron. 1970. All published by The  Runa Press (Monkstown). See also, Ross Skelton, ‘Jonathan Hanaghan. The founder of psychoanalysis in Ireland’. In The Journal of the Irish Forum for Psychoanalytic Psychotherapy, vol 4, no. 1, pp60-78. 1994. Rob Weatherill, Cultural Collapse. Free Association Books, pp25-27, 1994. 3. APPI. has not even made any significant contact, clinical or theoretical,  with other psychoanalytic groupings in Ireland (IFPP, IPAA) let alone ICP. And ICP will not award the European Certificate of Psychotherapy (ECP) to members of organisations outside ICP (See Report of APPI Training Committee, May 2002, p13). This is hardly surprising considering that APPI reserves the title “psychoanalyst” only to Lacanians. 4. The psychotherapy regulatory body in Britain will probably be called Off-Quack. 5. The word “functioning” says it all. It is systems, not subjects, we are talking about when we use this machanical language. A  subject is not dysfunctional. 6. APPI reflects this duality with it practitioners on and off the Register and the non-availability of the Register to members of the public. 7. Redundant steel workers and miners in 1980s Britain were offered not new jobs but therapy to cope with their loss. Top J. HANAGHAN   Founder of psychoanalysis in Ireland in 1930s.  Analysed by Douglas Bryan (a founding member of the British Psychoanalytic Association analysed by Freud).  Founded the Irish Psychoanalytic Assocation in 1942, which exists to this day.  Attempted to bring to Freudian psychoanalysis a radical Christian perspective.  Psychoanalysis is healing, mental healing, that can take place in the PA-setting and in the healing community.  The patient is a lover bitterly entangled and locked in Oedipal conflicts.  The psychoanalyst must be a deeply spiritual and compassionate lover. Hanaghan worked as an analyst until his death in 1967 at the age of 80.  Trained 4 younger analysts.  Kept separate from I.P.A.    Develops the notion of the Ego Ideal, as a 'still small voice' leading us towards our own unique (ethical) ideal, as against, the Superego, which is the harsh voice of the ancestors, of the gang or the herd, who strike fear, dread and terror into the child - castration dread - under the guise of moral training. Castration is an 'engram' in the psyche. Old men send young men to be killed in war (the death wish of the father against the sons).   The ego ideal is the agency of spiritual vision within that can perceive beauty, the good, the true, the spiritual, the moral - often radically against tradition, orthodoxy, especially of the estabished churches.  Man is spirit essentially (as well as mind and body).  'An analyst invites a man to be what he - the man - wants to be, according to his own ego ideal' (WJ, p34).   Imagination is central.  Vision .v. phantasy.  Vision (the ego ideal) leads to evolution (the life drive). Phantasy (id and superego) leads to devolution (the death drive).  We are the site of choice between phantasy and vision, between ultimately barbarism and civilization.  Our choices have cosmic reverberations.  The superego coerces us through fear and under threat (potentially contributing to evil). The ego ideal invites without threat leading to the good. To follow the ego ideal (sublimation) requires courage and a capacity to stand alone.  Hanaghan was a conscientious objector and a pacifist.  The ego (Hanaghan calls it the Actuality-ego) is the pragmatist.  Only the ego ideal calls forth the love (the re-cathecting of objects and the world) which has been locked in the unconscious deeps in pain, hurt and bitterness.  The analyst should be interested in religion (small 'r'), and have developed this capacity for 'simple forth-flowing love' - to give the other unconditional freedom. Forgiveness becomes "forth-givingness".  Against judgement and condemnation.  He was passionately against what he would have called the sterile intellectualism of the universities (you cannot seek God through logical argument (SER, p168)), the rigid orthodoxies of  classical psychoanalysis, the hypocrasies of the traditional churches, brutal punishments by parents, the harshness of the school system.  Believed in New Testament style Christian community and sharing. Freud and Jesus. The Mounttown experiment. The Saturday night "Group", in Hanaghan's house in Monkstown.  Christian fellowship - let go hate!  'In repentance, sadism and masochism are sublimated' (WJ, p7). Acknowledge destructiveness: 'When we greet the madness in us we are safe enough.  I am a most venomous person. It lies in us all: in the Nazi and the Jew.  It is what we do with the venom that is important.  All that lies in evolution lies in us' (WJ, p33).  Build the 'beloved community'. Be undefended, encounter your own deep loneliness and overwhelming.  Become as a little child.  Cry out in dispair (SER, p167).  Analysis offers us this possibility, this opportunity.      Neurosis/Psychosis is blocked passion (affects) leading to psychological even physical illness.  Fixations at various levels.  Oral - leads to destructive gossip, addictions.  Anal - leads to obsessions, meanness, smearing others, sadism, hoarding, intellectual defence.  The European medieval castle - metaphor for the defence of modern men and women. The modern city as dereliction.   Nature herself is fallen.  Animals are fixated - the tiger is fixated at the oral sadistc level.  The self-preservation instinct is initially, the helpless infant-cry calling forth its parent's love -'an utter cry for help and protection' (SER, p19), drawing the baby from his narcissistic depths.   Society, Evolution and Revelation, 1957. (SER) Freud and Jesus, 1966. (FJ) Saying of Jonathan Hanaghan, 1960. The Wisdom of Jonty. By Richard Cameron. 1970.   (WJ)    Top   R.D. LAING (antipsychiatrist).   Making schizophrenia intelligiable from an experiential, existential point of view (as opposed to regarding schizophrenia as rooted in genetics and inheritance).  The rough approximate definition of a psychotic, according to Laing, is the person who has no friends, no conviviality, no connections - someone outsode the social. Laing was a trained psychiatrist and psychoanalyst who was "Anti-psychiatry", anti-classical psychoanalysis and anti the nuclear Family (see also David Cooper, The Death of the Family. Allen Lane the Penguin Press, 1971).  Accused of romanticizing schizophrenia, breakdown, and the "voyage"(into madness).  Denied these charges. Believed one could (or should) move from dull normality of everyday alienation via breakdown into psychosis to a rebirth. Tavistock trained:  Rycroft his analyst.  Milner and Winnicott his supervisors. Adrian Laing's biography (A. Laing, A Biography. R.D. Laing, New York: Thunder's Mouth Press, 1994) suggests that his father was depressed all his life, hence his self-destructive behaviour.  Analysis allegedly did not touch his depression. He was regarded as the "disturbed" psychoanalyst.  Battled with the Tavistock to convince them of the need to focus on existentialism and phenomenology - he failed. Became a psychoanalyst and used acid (LSD) in sessions with some patients and had some sessions that lasted 6 hours!   Influences: communications theory, analytical psychology, family process, mysticism, literature, sociology and theology. His focus: subjectivity and consciousness.  Sartre and Heidegger.  Consciousness is intentional - directed to objects.  In particular, Laing focusses on 'being for others.' Following Hegel: the road of interiority passes through the Other.  Ontological insecurity - insecurity in our very being-in-the-world.  For Sartre man is free (no ucs psychic determinism), yet we defend ourselves against this existential freedom that causes anxiety. Bad faith: being too closely identified with our role or our social situation.  This is inauthentic.  Sartre emphasises existence (extreme subjectivity, criticised by Rollo May and others), whereas Laing emphasises experience (including the other).  Binswanger (Swiss founder of existential analysis) - the despair in schizophrenia - the self needs to be understood. 'don't try to get too close too soon'. Yet critical of the Ellen West case, the scrutiny of her diaries at a distance, and her "authentic suicide".  Menard Boss: Psychoanalysis and Daseinanalysis (New York, Basic Books, 1963).  Against the Freudian understanding of the psychic (mental) apparatus, and reification (treating the other as a thing), the ucs, the intrapsychic.  Yet there is an important emphasis by Laing on the mother and her responsiveness (like Winnicott and the British school).  Harry Stack Sullivan too, emphases the interpersonal, and the 'participant observer.' Laing favoured this approach rather than what he alleged was the aloof and authoritarian analyst with his interpretations.   The connection with Object Relations theory: Laing did not adhere to Freud's tension reduction model: 'Any theory of sexuality which makes the "aim" of the sexual "instinct" the achievement of orgasmic potency alone, while the other, however selectively chosen, is a mere object, a means to this end, ignores the erotic desire to make a difference to the other' (Self and Others,Tavistock,1961, pp84-85). Laing has a close link with Fairbairn and Winnicott without using their terminology.  Clearly approved of the reformulation of PA theory in terms of OR, making it possible to understand a wide range of behaviour in terms of what the subject gives to, and takes from, the human relationship. Human behaviour is predominantly oriented towards making, maintaining and developing relations with others. Especially emphasised empathy, mutuality and 'being-with'. No theory or interpretation must take priority over being engaged with the other.  Interest in Kleinian ideas and Susan Isaacs' work on uns phantasy - splitting, projection, introjection, identification, etc.The "unconscious" is what we do not communicate, to ourselves or to another. We may convey something to another, without communicating it to ourselves.Laing's notion of ucs is clearly an affective ucs, which ties us up in knots.  Also interested in group phantasy systems (Elliott Jacques). Bateson's Double-Bind theory - disjunctive attributions: the difficulty of leaving home in the context of a smiling mother with a tense face, or, soft arms and a harsh voice.  Cling to her, yet the more tense she becomes, the more frightened he becomes, the more he clings. (Bateson, G et al, 1956. "Towards a Theory of Schizophrenia", in Behavioural Science, x, p251)  Induction of the other to embody a projection (technically this projective identification). Forcing the other who is unaware of the projection to become what I disown.  Mystification and denial and the loss of reality testing - all these phenomena are seen in (disturbed) relationships.  The self is provisional and insecure: am I real (schizoid)?  Fears implosion of external reality, engulfment and petrification.  False self - an excess of being good because of fear of loss of love. Increasing shut-upness of the inner self, its isolation and omnipotence.  False self the puppet of others, the possession of others.  Being treated like an object.The person is more than a thing and cannot be adequately formulated in the terminology of natural science. From The Divided Self (R.D. Laing,Penguin, 1959), 'we shall be concerned with people who treat themselves as automata, as robots, as bits of machinery, or even animals.  Such persons are rightly regarded as crazy.  Yet why do we not regard a theory that seeks to transmute persons into automata or animals as equally crazy' (p23).   Against notions of adjustment, adaptation, normality; the schizophrenic is, for instance, 'someone on whom the social lobotomy has not succeeded'.  Laing has been criticised for placing too much emphasis on the present to the neglect of the past. No distinction between neurosis and psychosis and the role of Oedipus Complex.Social phenomenology: Laing generalises from the individual, to the family, to the whole "mad world" (Politics of Experience, Penguin 1967), where the signs to the mental hospitals should be turned around. Laing and some of his colleagues allowed themselves the total proximity of the other with disturbed patients. A colleague of Laing’s testified to ‘his incredible empathy with disturbed patients…being “on the side of the Angels, gentle to the fallen”’ (Laing, A. 1994, p53). Let the psychotic episodes pass and there would be no need for drug therapy of any kind. His first experients in this regard were 1954-5. On Military Service, working in a psychiatric unit in Netley (Oxfordshire) as early as 1951, instead of injecting a raving patient in a padded cell with insulin, as was the routine, Laing goes into the cell with him and spends time talking and listening to him, joining in with his fantasies and there was no need for medication. Gradually after several nights with John, drinking whiskey with him, he says, ‘I felt strangely at home there, lounging on the floor’ (p50). John was later able to be discharged.   Therapeutic centres developed: Kingsley Hall, Villa 21, the Philadelphia Association (meaning “brotherly love”), Ronnie Laing, David Cooper, Aaron Esterson, Sid Briskin, Clancy Sigal, Joan Cunnold, Raymond Blake, were all totally committed to this human way to encounter madness. An article in the British Medical Journal (Dec 1965), claimed 70% recovery rate from schizophrenia after an average stay of 3 months. The therapists were unpaid. Laing summed up their approach to psychotherapy in 1965 thus. ‘Paring away all that stands between us; all the props, all the masks, the roles, the lies, the defences, anxieties, projections,…the transference and countertransference, that we use wittingly or unwittingly as our media for relationships….Existential thought…constantly melts and recasts its own verbal objectifications...offers no security, no home for the homeless...addresses no one except you and me...’ (p97). While on an American trip, Laing was invited to examine a young schizophrenic girl in Chicago. The girl was naked and engaged in no other activity other than rocking back and forth. Ronnie stripped off, sat beside her, rocking in time to her rhythm. After 20 minutes, she started talking to Ronnie, something she had not done for several months. Laing interviewed a paranoid woman from a shelter for the homeless, which seemed just like a conversation, which by the end had achieved such a rapport that she seemed much less troubled and was able to answer questions from the floor. From The New York Times, Laing is quoted as saying, ‘it is as important just to be with someone in deep rapport as it is to try and change them’ (p224). During the '70s,his unpredictable outbursts, drinking, family problems, increasingly marginalised him with his colleagues. In November 1982, he arrived to speak at St. Patrick's Hospital (Dublin). He was drunk. He started by ordering all the psychiatrists present to leave. The scene quickly degenerated into chaos. He appeared that same weekend on RTE's Late Late Show and the host Gay Byrne accused him of being drunk. The audience sided with Laing. Guy Thompson’s book, The Truth about Freud’s Technique (New York University Press, 1994), is a "sane" take on the best of Laing's approach. He refers to the danger of long psychoanalyses born of therapeutic ambition.Thompson has a real commitment to existential analysis. The analytic work transcends “technique” as understood these days too often in very dogmatic terms: Lacanian punctuation; the Kleinian total situation; classical resistance interpretation; etc. Thompson trained with Laing in the Philadelphia Association and he has retained this broad approach which thinks in terms of subjective responsibility, courage and honesty rather than psychopathological processes far removed from the subject.  Yet his approach stays close to Freud, indeed is a “return to Freud” without all the Lacanian ideology. Thompson usefully contradicts so many analytic prejudices: that analyses have to be long; that analysts have to be neutral, reserved, unspontaneous; the analyst’s must have a finely honed technique. None of these attributes belonged to Freud, who seemed to take a real personal interest in his patients, encouraging, supporting, engaging, not bound even by his own guidelines in the technical papers. However, Freud was not a counsellor with unconditional love.  He was rigorous in his search for the truth, which Thompson believes is an existential truth, the truth about our Being.Ironically, this book has not sold well, I was told by a psychoanalytic bookseller, because Thompson is not part of a particular school, and presumably does not appear on the booklists of their ideologically based trainings.The words that come through in this book, very refreshingly, are Freud’s emphasis on tact, candour, honesty, concealment guarding the secret (perhaps Thompson’s word for the unconscious) and the search for truth.  He is reminiscent of Hanaghan, the first analyst in Ireland, when he points up Freud’s emphasis on love.  Psychopathology is a failure to love, or disappointment in love, or betrayal, as in the case of Dora.   Top               SUICIDE NOTES (1)    The question here: can psychoanalysis say anything about suicide? Lacan says that suicide is the only Act that succeeds. It is in that sense a pure act, whereas all other actions are limited and provisional: they have a mixture of success and failure. Suicide is an Act that is complete and final. However suicide, like other human phenomena can be read as a “text” that it might be possible to decipher or to “read”. It is a “statement”, albeit a tragic and a fateful one. Suicide always has a con-text and must be read as part of a context.   It may be (1) a statement addressed to the Other (irrespective of whether or not there is an actual suicide note) which has gross imaginary effects on friends and relatives in terms of sorrow and guilt. (2) A violent passage a l’acte (a psychotic act operating outside any human reality): the subject’s total identification with the object, leftover trash (zero self-esteem).  The subject falls (from the balcony, window, etc) now as pure object and the void that sustains the object closes up. With the psychotic passage a l’acte the symbolic or existential deadlock feels complete, debilitating and impossible. There seems to be no imagining a way out, the only thing the subject can do is to strike blindly in the real. Here the subject exits the scene (of the symbolic/Imaginary social world). The subject becomes a pure object, (technically termed the objet-a). Like Freud’s young homosexual woman patient (Freud, 1920 'The psychogenesis of a case of homosexuality in a woman'S.E.18) who, when spotted by her father walking with her lover, throws herself over a wall onto a railway line. Finding her father’s desire impossible and at the same time being rejected by her lover, she acts in the Real. 3) The Symbolic suicide, where the subject is stripped of “symbolic substance” (the loss of every social connection) and is consequently thrown into the ‘night of the world’. (See Zizek, S [2000]The Fragile Absolute,Verso. p27,28). Here the subject is “written off”.   Moving from the notion of a textual statement that can be “translated”, in particular we should add, by an analyst who is capable of listening to and reading the unconscious, psychoanalysis can also throw light on the psychodynamics of depression and suicide. And here, the  psychical agency known as the superego is of critical importance. Freud questions how the ego, with its immense reserve of self-love (narcissistic libido), can consent to its own destruction in suicide. He explains, ‘The analysis of melancholia now shows that the ego can kill itself only if, owing to the return of the object cathexis, it can treat itself as an object – if it is able to direct against itself the hostility which relates to an object and which represents the ego’s original reaction to objects in the external world. Thus in regression from the narcissistic-object choice, the object has it is true been got rid of, but it has nevertheless proved more powerful than the ego itself’ (Freud, 1917.‘Mourning and melancholia'. S.E. 14:252.) The withdrawal of object cathexis means the withdrawal of love from the other and the consequential re-emergence of (a more primitive) hate which is the ego’s original reaction to objects in the external world. The object has been got rid of “out there”, but ironically, it is now set-up within the psyche itself – the so-called shadow of the object – that hates the ego from inside and in the extreme, wants it eliminated as well.   Hanaghan, following Freud in this respect, used to question the suicidal patient: who is it that you want to murder?  Similarly, Freud refers to the law of the talion. ‘We find that impulses to suicide in a neurotic turn out regularly to be self-punishments for wishes for someone else’s death.’ (Freud, 1913, Totem and Taboo, S.E. 13:154). The great danger comes from the severity of the superego and the sense of guilt it creates. Freud writes about the superego raging against the ego with the destructive component of sadism entrenched in this agency: ‘[w]hat is holding sway in the superego is, as it were, a pure culture of the death instinct’ (Freud, The Ego and the Id, 1923, S.E. 19.53). Speaking of the fear of death in melancholia, Freud suggests, ‘that the ego gives itself up because it feels itself hated and persecuted by the superego, instead of loved.’ In order to live the ego must feel that it is loved in some degree at least by the superego (standing in for parents or the father, providence or destiny). ‘But,’ continues Freud, ‘when the ego finds itself in an excessive real danger when it believes itself unable to overcome by its own strength, it is bound to draw the same conclusion. It sees itself deserted by all protecting forces and lets itself die’ (ibid. p58).    The great danger for the so-called Borderline patient (Borderline personality disorder) is the ever-present risk of murder and/or suicide. Here, the analytic task is to allow their internal bad objects (hated others within the psyche) to be modified through projective mechanisms in a therapeutic environment with staff and psychotherapists and thereby to increase the capacity for containment and thinking before acting. Experience tells us that there is no other way or approach possible with these patients, where subjectivity means little when there is so much unthinking impulsive acting out. However, there is always a subject, who in the final analysis must speak, and speak against those internal objects, against this violent internal environment.    On the level of the community and the social, Robert Putnam's Bowling Alone: The Collapse and Revival of American Community (R. Putnam,2001,Simon and Schuster) is a key work.The contribution made by Robert Putnam is relevant to a psychoanalysis of suicide. T.V. has taken away our involvement in community, so that we lack “social capital”, a feeling of belonging, trust and community.  We increasingly lack social contacts. We are entertainment junkies.  US citizens spend 40% less time socialising than they did back in 1965.  Social isolation make the young unhappy with more suicide, depression and general malaise.  US adolescents spend three and a half hours a day isolated watching T.V. They are increasingly individualistic, disconnected from politics, emphasising the personal and private over the public and collective.  They are perpetual surfers, interactive media specialists.  Urban sprawl and rural isolation have created personal loneliness, lack of purpose and engagement. What he is suggesting here it seems is that the loss or breaking of human affectional bonds, which psychoanalysis tells us “binds” the drives and modifies the superego, is having a hidden but devastating effect on youth in particular. The intensity of these bonds and the sense of betrayal at their (sometimes necessary) disuption is what psychoanalysis has explained very fully.Increasingly without social capital to draw upon, subjective anxieties assume greater and greater intensities with fewer and fewer people around to ameliorate them.    Reterning to Freud, in The Psychopathology of Everyday Life (Freud, 1901 S.E.6), Freud makes it clear that many so-called “accidents” are often suicidal in nature. Like the young married woman who broke her leg by jumping from her carriage. The night before she had danced the can-can in front of many relatives and her very jealous husband, who had whispered to her – Carrying on like a tart again! After a restless night, she went for a drive. When the horses, grew skittish, she needlessly jumped out of the carriage. Freud concludes, ‘we cannot fail to admire the skill which forced chance to mete out such a punishment that fitted the crime so well. For it had now been made impossible for her to dance the can-can for quite a long time.’ (S.E. 6:180). Self destructive impulses are widespread, offset frequently by the power of the life drive. Freud quotes a case from Ferenczi of a 22 year-old journeyman carpenter who had accidentally shot himself while playing with his brother’s revolver. He had thought it wasn’t loaded when he pressed it against his temple and pressed the trigger. He had been out the night before and had taken the revolver with him, with three bullets in the chamber, because he was afraid of brawls. He had just been refused for military service because of varicose veins and felt very embarrassed about this. Furthermore, he explained that he had just been left by his sweetheart, who has emigrated to America and he had wanted to go too, but his parents had prevented him. He had wanted to “forget it all” in the army. In a footnote added in 1924, Freud recounts the tragic story told to him by a young man about a woman, aged 34, who had been engaged before the war, but her fiancé had been killed in action. The young man had befriended this woman and the relationship became intimate. She was a person of very changeable moods. Suddenly, early one Sunday, she telephones the young man, asking him to take her to church straight away. He protests saying he cannot get ready in time. She is disappointed and sets out alone, meeting another friend briefly on the way and she seemed to be in the best of humour, but as she crosses the wide main street in West Berlin, she was run over by a horse drawn cab and killed, on a morning when there was very little traffic as the trams and buses were on strike.   Melanie Klein also understands and agrees with the classical view that suicide is directed at the introjected (superego) object. The suicidal act is an attempt to murder the bad objects, but Klein also states that in her view, that act also aims at saving or preserving its loved objects, both internal and external. ‘To put it shortly: in some cases the phantasies underlying suicide aim at preserving the internalised good objects and that part of the ego which is identified with the good objects, and also at destroying the other part of the ego which is identified with the bad objects and the id. Thus the ego is able to become united with its good objects.’ According to this Kleinian view, the subject hates his bad objects and his id as well. He wants to make a clean break, as it were, with his own sadism directed originally at his mother’s body, i.e. with ‘the uncontrollable dangerous hatred, which is perpetually welling up in him, from which the melancholic by his suicide is in part struggling to preserve his real objects.’ (M. Klein. A Contribution to the Psychogenesis of Manic Depressive States’ in Love, Guilt and Reparation, Delta, 1921-1945, pp276-77.). In an important footnote, which is extremely relevant clinically, Klein says that this desire for a break, a rupture, explains why the melancholic breaks off all relations with the external world, prior to suicide.  Otto Fenichel (The Psychoanalysis of the Neuroses, 1946,Routledge, p400ff) explains that the depressed patient's strong tendency toward suicide reflects the intensity of the struggle between love and hate. In trying to appease the superego by submissiveness, the ego has reckoned incorrectly. The intended forgiveness cannot be achieved because the courted part of the personality, through the regression, has become inordinately cruel and has lost the ability to forgive. The suicide of the depressed patient is, if examined from the standpoint of the superego, a turning of sadism against the person himself, and the thesis nobody kills himself who had not intended to kill somebody else is proved by the depressive suicide. From the standpoint of the ego, suicide is, first of all an expression of the fact that the terrible tension, the pressure of the superego induces, has become unbearable. Frequently the passive thought of giving up any active fighting seems to express itself; the loss of self-esteem is so complete that any hope of regaining it is abandoned. To have a desire to live evidently means to feel a certain self-esteem, to feel supported by the protective forces of the superego. When this feeling vanishes, the original annihilation fears of the deserted hungry baby reappears. Other suicidal acts have a much more active character. They assert themselves as desperate attempts to enforce, at any cost, the cessation of the pressure of the superego. They are the most extreme acts of ingratiatory submission to punishment and to the superego's cruelty; simultaneously they are the most extreme acts of rebellion, that is, murder—murder of the original objects whose incorporation created the superego, murder, it is true, of the kind of Dorian Gray’s murder of his image. This mixture of submission and rebellion is the climax of the accusatory demonstration of misery for the purpose of  coercing forgiveness: "Look what you have done to me; now you have to be good again”. Neurotically depressed children, continues Fenichel, frequently have suicidal fantasies, the love-blackmailing tendency of which is obvious: "When I am dead the parents will regret what they have done to me and will love me again". When melancholic patients try to blackmail their cruel superego in a similar manner, they are worse off than children who court real parents capable of forgiveness and love.   Actual analyses of attempts at suicide frequently show that the idea of being dead or of dying has become connected with hopeful and pleasurable fantasies. This means that suicide may be enacted because hopes, illusions and phantasies of a relaxing gratification are connected with the idea of suicide. Hopes of this kind are more in the foreground in suicides that are not of the melancholic type and in which introjection and struggles between the superego and the ego do not play any part. What is often striven for in suicidal attempts is not "destruction of the ego" but some libidinous aims which, through displacement, have become connected with ideas that objectively bring self-destruction, although they have not been intended as such. Such ideas may be the hope of joining a dead person, a libidinous identification with a dead person, the oceanic longing for a union with the mother, or even simply orgasm itself, the attainment of which, through certain historical events, may have become represented by the idea of dying. The specific fantasies that are connected with the idea of dying can often be surmised from the method by which the suicide is attempted or planned. The hopeful illusions that are connected with the idea of suicide in melancholia are the attainment of forgiveness and reconciliation, which are to be enforced by the simultaneous maximal submission and rebellion, a killing of the punishing superego, and the regaining of union with the protecting superego— a reunion that puts an end to all losses of self-esteem by bringing back the original paradise of oceanic omnipotence. Self-destructive actions during melancholic states, carried out as self-punishment, as an expression of certain delusions or without any rationalization, have been designated "partial suicides". This term is absolutely correct in so far as the underlying unconscious mechanisms are identical with those of suicide. Sometimes, for reasons unknown, the ego's hopes and desperate impulses seem not to have been entirely in vain. A mere change of cathexis frees the ego from the terrible forces within itself. The hopes which are illusionary in the case of suicide are to a certain degree actually achieved in mania. The bad superego is destroyed, and the ego seems united to a purified protective superego in narcissistic love. In still other cases, a depression may end without any mania, as a normal mourning ends after a certain time. The factors, doubtlessly quantitative in nature, to do with quantities of hate, that determine whether or when the result is to be a suicide, a manic attack, or a recovery are still unknown.   Returning to Zizek, he is commenting (S. Zizek, 2001. On Belief. Routledge, p112-113) that under conditions of what he calls “global reflexivization”, one can be "addicted” to anything — not only to alcohol or drugs, but also to food, smoking, sex, work . . . This universalization of addiction points towards the radical uncertainty of any subjective position today: there are no firm predetermined patterns, everything has to be (re-) negotiated, up to and including suicide. Albert Camus in his The Myth of Sisyphus, is right to emphasize that suicide is the only real philosophical problem. Why live? However, when precisely does this question arise? Only in postmodern reflexive society, when life itself no longer "goes by itself," as a "non-marked" feature (to use the term developed by Roman Jakobson), but is "marked," has to be especially motivated (which is why euthanasia is becoming acceptable). Prior to modernity, suicide was simply a sign of some pathological malfunction, despair, misery, and, we should add, suicide was regarded as a sinful act. With reflexivization, however, suicide becomes an existential act, the outcome of a pure decision, according to Zizek. This might mean that life itself becomes an addiction, marked by an excess that no longer fits the simple life process. So instead of a balanced process of living to a natural life cycle, you must get passionately attached or stuck to some excess which involves extreme precariousness.   Top           BORDERLINE PERSONALITY             This condition is a “social construct” a ragbag of multiple symptoms, clusters of patients deemed “difficult” that fall outside the norm, affecting as many as 10% of 18-45 year-old age group.  Characterised by high affect (rage), permanent crises, difficulty maintaining adequate relationships which tend to be intense but short. They have few friends.  Chronic self-esteem problems, will never adopt a position or opinion and therefore never speak the truth.  On every border: neurotic/psychotic; child/adult; male/female; conscious/unconscious; phantasy/reality; full/empty; life/death. Anxiety is key: chronic and diffuse, free-floating.  Organised into quasi-stable life restricting phobias.  Oedipal symptoms persisting (ego-syntonic).  Many conversion symptoms with hypochondriacal trends.  Dissociative reactions (reality denied).  Paranoid trends.  Perversion with pregenital aggressive and eliminatory impulses.  Hypomania and cyclothermic personality organisation. Impulse neuroses and addictions, which give intense pleasure during episodes themselves.  Infantile and narcissistic personality organisation predominates. Failure of integration of good and bad aspects of reality, self and others, due to excessive splitting attacks. No “whole” self.  “Selves” like ‘beads on a string’ with the analyst creating the thread (Andre Green).   Contradictory behaviours that don’t communicate. Shallow relationships: little capacity for realistic evaluation, empathy, intimacy, although these may be well simulated.  Predominance of primitive defences: idealisation, projection, projective identification, as provocation, or, like the anorexic who maintains a calm while others worry themselves to death. Similarly, denial of important areas of concern in the person’s life, or, lack of concerns over a pressing need or danger. Omnipotence, devaluation, contemptuous attitude to others, grandiosity.  Interpretations highlighting “splitting attacks” improve functioning at least temporarily, which is not the case with psychotic organisation. Reality testing: poor capacity to differentiate self from non-self and to assess the effects of one’s behaviour, thoughts, feelings in relation to social norms.  Clinically: no delusions or hallucinations, no gross inappropriate, bizarre, affects, thought content or behaviour (except briefly any of the above under periods of stress). However, tendency to shift to dream-like states with emphasis on primary process thinking (not psychotic). Patient should become puzzled, concerned about such states and work with the therapist in his exploration of them.  Ego weakness: poor tolerance of anxiety, impulse control and sublimation. How much tension can be tolerated? What capacity is there to develop and sustain interests and creative capacities beyond immediate self-interest?  Identity confusion, “as if” personalities, “false selves” with real doubt as to who one is or indeed the identities of others.   Poor Superego integration: neurotics have a relatively severe but integrated superego organisation, while borderline and psychotic personalities are characterised by primitive and sadistic superego precursors (the archaic superego) and their idealised opposites. How far does the patient identify with normal ethical values and abstain from exploitation of others, maintain moral integrity in the absence of external controls?  The degree of superego integration is an important indicator for long term psychotherapy.  Genetically: aggressive pregenital strivings with a condensation of sexual, dependent and aggressive trends.  Early history was demonstrably unreliable, empty, chaotic in proportion to character pathology.  Oedipal conflicts, excessively aggressified so that rivalry becomes terrifying and dangerous, castration and penis envy are grossly exaggerated. Savage SE-prohibitions with masochistic and paranoid projections.  Idealisations of love objects as a defence against primitive rage.  Such idealisations may be frail and prone to rapid reversal and narcissistic withdrawal.  Unreliable parent imagoes involving condensations of both parents which are primitive in character and preoedipal.  Genital strivings are contaminated by pregenital drives: the penis may become a feeding or attacking breast, or an anal/urethral sadistic weapon; the vagina an oral sadistic mouth, polluting anus, etc.  All tinged with rage.  Preoedipal conflicts are prematurely oedipalised.  That is, Oedipal conflicts are used defensively, especially in the transference, where they predominate even after years of treatment.  Intense frustrated dependency needs are shifted from mother to father, which intensifies the positive O-C in girls and the negative O-C in boys.  Also, oral sadism displaced from mother to father increases castration anxiety in boys and penis envy in girls.  Girls, therefore may become defensively masochistic towards men, or excessively seductive, or, severely prohibitive and fearful  in relation to all genital sexuality.  Defensive idealisation of the mother might occur as a reaction formation against rage directed at her. Projection of aggression onto both parents creates excessively violent phantasies of the primal scene, which may lead to hatred of all mutual love offered by others (Kernberg). Further questions.  Brief psychotic regressions versus an acute schizophrenic reaction?  The loss of reality (testing) does not improve when primitive defences are interpreted in the latter case.  The question of schizophrenic patients with remission who present or temporarily “seal-over” as “borderline” or “neurotic.” The structural interview should show up the tendency to psychotic regression even when clinically in remission.  Assessment of the total situation: the quality of object relations generally, internal and external, and the self in relation to others, may be more useful than descriptive diagnosis based on specific symptoms and behaviours. The diagnosis “borderline” sets limits on the value of expressive psychotherapy or psychoanalysis.  Acute episodes will require more direct crisis intervention and temporarily degrees of management of the patient’s external life, possibly.  Treatment may last for many years.  Small interpretations helpful, here and now mental state comments.  Borderline patients have continuous arguments with others. Countertransference feelings may become extreme. Severe conditions: about 2% of borderlines present with low achievement, heightened affectivity, mild psychotic experiences, suicide attempts (to eliminate the archaic superego).  Chronic lability.   Pathological defensive personality organisation (Rosenfeld) which has a life of its own.  For instance, there can be a certain stability and persistence of the splitting processes: of idealisations, on the one hand, and a predictable destructive contempt projected outwards, on the other. There is no integration, no depressive position, no thinking outside these limits, because it works!  It is rigid and resistant to change, but it is adaptation in extreme conditions.  Patients whose background has been one of unremitting maltreatment or violence deal with the threat, not by repressing representations (as in the neurotic), but by stopping key mental processes, such thinking, understanding and making judgements about the other’s motivation, about human intentionality.  Stop thinking!  An absence of thinking thoughts (Bion). Hence, the loss of empathy.           Top   Various ACTS. 1) Hysterical act: the staging of the compromising "solution" of the  trauma she is unable to cope with. Dramatisation, exaggeration - communication to the Other via acts rather than speech (repeating not remembering). 2) Acting-out: repetition, often impulsively, of some element of the (repressed) past without consideration, responsibility or memory, which the subject herself often fails to understand. It is an aspect of transference repetition, a symbolic message addressed to the big Other. The act remains within the Symbolic register (unlike passage a l’act) 3) Parapraxes, bungled actions (acte manque) - “acts” which are successful (only) from the point of view of the unconscious, albeit in a distorted form. To the conscious mind these are meaningless mistakes. 4) The psychoanalytic act: is an intervention in the treatment (into discourse generally) that furthers the desire of the analyst to further the work of analysis. (See Lacan, Seminar: 15. L’acte psychoanalitique. 1967-68). 5) The (often) psychotic passage a l’acte, where the symbolic deadlock feels complete, debilitating and impossible. There seems to be no imagining a way out, the only thing he can do is to strike blindly in the real. Here the subject exits the scene (of the symbolic/Imaginary). The subject becomes a pure object, the objet-a. Like Freud’s young homosexual woman (Freud, 1920) spotted by her father walking with her lover, she immediately throws herself over a wall onto a railway line. Finding her father’s desire impossible, she acts in the Real. 6) The symbolic act is a formal, self-referential, a gesture of self-assertion of one’s subjective position. 7) The ethical act. (Lacan. Seminar 7. The Ethics of Psychoanalysis. 1959-60). Extreme desire. The absolute, not giving ground to desire. Resisting domination. Zizek: ‘the act proper is the only one which re-structures the very symbolic co-ordinates of the agent’s situation’. (On Belief, p85). Its effect then is to ‘traverse the fantasy’ (the way the subject habitually structures the Real) and therefore has great therapeutic implications. Zizek discusses sacrifice, or what he calls, paradoxically, ‘striking at oneself’.  In a number of interesting examples, in a situation of forced choice, the subject makes the mad choice at striking at himself!   This is not aggression turned against the self, but rather, by cutting loose from, sacrificing, the most precious object (objet-a), by means of which the enemy keeps him in check, the whole situation changes and free action becomes a possibility again and the re-birth of subjectivity.  So, Abraham strikes at Isaac, Freud in Moses and Monotheism, strikes at the most precious figure of Moses for the Jews. Lacan’s dissolution of the Ecole freudienne de Paris in 1979, destroys his life’s work.  Medea, who, by killing her children, strikes at her husband’s most precious possession (the ultimate [feminine] ethical act), ‘an act which makes her so unpalatable to decent humanist consciousness’ (The Fragile Absolute, p174).   Similarly, Sethe in Toni Morrison’s Beloved attempts to kill her own children to prevent the greater indignity of their return to slavery.   Apropos this theme, the prisoners of the Gulag who might be put out into the permafrost in order to break them, saying that the only way they could survive (as free subjects) was to renounce their claim to life in advance. In the more traditional ethic, everything is sacrificed for the Cause (like Antigone’s sacrifice of her life, marriage, children, etc., to bury her brother Polynices). Lacan’s view of the ethical act (as feminine) subverts the current clichés about men being political and women being the exception, that is, apolitical-ethical “restraining” men from unlimited power by their ethical stance. Here, in the (feminine) ethical act, even the exception is sacrificed, Sethe killed her children out of her total fidelity to them. And she refuses any relativisation, this is what is monstrous, outrageous, the ultimate ethico-political act, the “authentic” act.  Finally, the Crucifixion: God sacrifices His son, where this sacrifice sublates itself giving birth to a new subject, redeemed of all links - the Holy Spirit.And here is Zizek’s analysis of the WTC “Act” (In Welcome to the Desert of the Real): ‘not simply a symbolic act (in the sense of an act “whose aim is to deliver a message”): it was primarily an explosion of lethal jouissance, a perverse act of making oneself the instrument of the Other’s jouissance’ (p141).  It comes out of a morbid culture of death. There is no ideological agenda, but an attempt to introduce the Hegelian “absolute negativity”.   And this brings us on to the Act itself and the controversial nature of the Act. The Act creates a radical, absolute break - it may be ethical, it may be a monstrosity.  It takes place in a specific context, yet it involves the madness of a decision (Kierkegaard), a step into the open, with no guarantees, but the Act retroactively changes the  symbolic co-ordinates into which it intervenes.  It is without legitimation, undemocratic, Pascalian, an emergency. As was the case in France in 1940, even democracy itself cannot provide a guarantee!  France was defeated as a result of degeneration caused by the liberal (Jewish) influence.  The defeat was a blessing in disguise! Like today, conservatives believe, the threat is from within, permissiveness and lassitude, hence the “war on terror” - ‘What if the true aim of this “war” is ourselves, our own ideological mobilisation against the threat of the Act?’ (p154).     Top   Bion’s Theory. Bion's early original work pioneered group psychoanalysis. Following his analytic training he began analyzing psychotic patients and studied their thought disorders. He drew on this experience to form deep philosophical views on the nature of the mind placing emotional experiences at the centre of mental life. He concluded that the psychotic patient may as an infant have suffered from not having a mother who could contain his potentially catastrophic feelings of dread, coming ultimately from the presence of the death drive within. He further concluded that normal thinking begins in infancy when the infant can tolerate sufficiently the frustration of mother's absence and also have access to a mother as container who is able to hold the infant’s normal or realistic projections of dread, thus fending off a sense of catastrophe.  These normal projections or, more accurately projective identifications, constitute a subliminal/telepathic communication between infant and mother. The containing mother experiences in her reverie, projections which may realistically correspond to what the infant actually feels.     From his analysis of psychotic patients, Bion also concluded that they had a normal as well as a psychotic personality and that the same is true, to lesser degree, of all of us. Furthermore, he distinguished certain features in the psychotic personality such as ‘attacks on linking’ and the emergence of ‘bizarre objects’. Adult patients with a predominantly psychotic structure had probably, he thought, experienced an emotional catastrophe in infancy.    As part of his philosophical investigation into how we come to know things Bion formulated a psychoanalytic theory of epistemology. In this ‘theory of thinking’ he says that the human being is born with inherent preconceptions of, prototypically, the breast. When the infant finds the real breast that corresponds to its personal preconception this Realization generates what he calls a Conception. On the other hand if the infant is frustrated by the breast and the realization is negative, thoughts can evolve in the breast’s absence, and if things go well, these thoughts will also develop into a conception. Through growing processes of abstraction and conceptualisation, such complex thoughts can become systems of knowledge, what Bion calls scientific deductive systems. In addition he postulated the existence of unmentalized (unthought) mental elements of experience termed ‘beta elements’, which normally undergo transformation by ‘alpha function’ - a notion akin to Freud’s  dream work - into alpha elements suitable for mental processing. Originally, it is the mother's empathic alpha function, recruited during a state of reverie, which constitutes her ability to contain. Such empathy is her own emotional approximation to what her infant is experiencing. Mother's capacity for reverie and containment or understanding are then internalized by the infant, who thereby acquires his or her own capacity for emotional experience - learning from experience. Bion designates these functions of self-containment and self-knowledge the psychoanalytic functions of the personality. Without adequate access to these functions, the infant who is intolerant of frustration may experience ‘nameless dread’ and without being able to  use normal projective identification mechanisms, may resort to excessive violent projective identification of un-transformed beta elements (i.e. forceful strong emotions with or without words), thereby creating a ‘beta screen’, evoking strong negative feelings in the (m)other, who rejects and may violently counterprojects.        With the notion of the infant's projective identification mechanisms (the contained) via the receptive mother’s mind (the container), Bion formulates the model of the ‘container-contained’ relationship. Grotstein has referred to this as a universal law (extending beyond psychoanalysis). The emotional relationship between container and its contents can be benevolent or malevolent and Bion designates the emotional links between the containing subject and its contained object as L (loving), H (hating) or K (knowing), and includes their negative counterparts, -L, -H, and -K, which are anti-emotional. These links of L, H, and K,  Bion considers primary in the human being. In this respect he differs from Freud and Klein, who both consider the drive to knowledge (K) or epistemophilia, as secondary to self-preservation and sexuality. Bion’s reading of the Oedipus, Garden of Eden, and Tower of Babel myths shows how the conflict between knowing (K) and anti- knowing (-K) is present in all of them, along with sexuality (L) and aggression (H). Seeking a method of notation for analysts, he also created a ‘grid’ to classify thoughts and emotions according to their genesis for Bion believed that, in the beginning, there were only feeling- thoughts (without a thinker), but that these feeling-thoughts need a mind to think them. This embryonic mind is early alpha function, at first the mother's and then the infant's by identification.      Bion then contemplated how the individual learns from experience, that is, how the mind grows and develops. He reasoned that the mind grows via ‘transformations’ of the Unknowable which he refers to as O. This symbol ‘O’ represents what Kant meant by the noumena or things-in-themselves - his way of referring to the ultimate nature of things beyond the reach of human representability who must be content with the world as it appears to be. In psychoanalysis, O, the unknowable, is experienced as the symptom needing to be understood, and Bion terms this the ‘psychoanalytic object’. As O evolves, the individual sense organs receptive to emotional experiences intersect with it, and the experiencing of O becomes subject to transformations by mother's or psychoanalyst's alpha function into knowledge (K) that is relevant for the infant or, later, analysand.     Mental growth tends to be felt as catastrophic, and thus the mental attitude of the analyst, in order to access his or her intuition about what is happening during the analytic session, must remain without ‘memory, desire, or understanding’, with evenly suspended attention, and the ‘faith’ that something will evolve from the link between the patient and analyst. In this state of mind the paranoid-schizoid (PS) oscillation from dispersed elements into integrated ones (D), via the discovery of  what Bion calls ‘selected fact’ gives some immediate coherence to dispersed elements. Bion emphasizes that the analyst's state of mind, while in session, should move from ‘patience’, a normal paranoid-schizoid position, to ‘security’, a normal depressive position. This will allow the analyst to intuit an experience of ‘O’, that is a momentary at-one-ment with the analysand and then maybe to put into words or ‘publish’ what Bion, following Keats, terms the ‘language of achievement’, which is accessed by negative capability.         Bion also speaks about truth, falsities and lies. At the end of his life he insisted that ultimate reality or absolute Truth, which he equates with the Godhead and O, and in turn with noumena and the ‘thing-in-itself’, are ultimately unknowable. We can only know about them from our transformations of them, from the infinite to the finite domain. In 1976 he introduced the idea of the ‘caesura’, the original pre-natal parts of the personality, which allow us to conjecture about very primitive reactions of our analysands, as well as our own vestigial and as yet unborn aspects.    Reading: Bion, F.  (Ed) (1992)  W.R. Bion Gogitations.  Karnac. Bion, W (1962)  Learning from Experience. Heinemann; Maresfield, 1984. -----------(1963)  Elements of Psychoanalysis.  Heinemann: Maresfield, 1984. ---------- (1965) Transformations. Heinemann. Maresfield, 1984. ---------   (1967) Second Thoughts: Selected Papers on Psychoanalysis.   Heinemann: Maresfield, 1984. Bleandonu, G. (1994) Wilfred Bion his life and his works 1897-1979.  Trans.  Claire Pajaczkowska.  Free Association Books. Hinshelwood, R. (1989)  A Dictionary of Kleinian Thought.  Free Association Books. Meltzer, D.(1978) The Kleinian Development. Clunie Press.  Top         KEY TERMS IN KLEINIAN PSYCHOANALYSIS.   Paranoid-schizoid position (PS): the infantile ego, of the first weeks, oscillates between integration (via the introjection of good objects like the “breast”) and distintegration (caused by bad objects, too many in pouring stimuli). PS is the earliest mental state, where the ego can become fragmented, split/dispersed (as a result of the death drive), via the massive use of psychotic defences which are mobilised to protect the good objects against the danger of the drives. The key psychotic defences - splitting (good from bad), denial (of any bad objects), projection (of faeces, poison, urine to the outside of the ego), lead if excessive to depletion, emptiness and apathy (depersonalization), and difficulties with introjecting and holding onto the good (breast, milk, love) which might already be damaged by aggressive attacks. Hence the terror of loss of/damage to good objects upon which the integrity of the infantile ego depends.  Prior to guilt, paranoia is a fear of persecutory badness. Bad objects inner and outer threaten annihiliation and horror, stemming from pre-genital sadistic raids on the mother’s body. Part objects, the breast, the vagina, the penis are used and attacked. Envious greed and rage and hate are a great danger, potentially escalating. In desperation, the mother is sucked dry, her goodness taken out (greedy introjection) or she is evacuated into (projection). The bad objects are evacuated into the mother for the purposes ridding the ego of dangerous excrement, but also for controlling her and making her into a bad object (see projective identification [PI]). PS is an apparently painless state, without feeling - cold, distant, cut-off, hard, omnipotent. Mind-less because of attacks on the perceptual apparatus and capacity for emotional understanding.  Manic control and omnipotence are more primitive forerunners to and more severe versions of obsessional control. Pathological PI predominates controlling the other, confusion, symmetry (Matte Blanco). PS is extremism, absolutism, psychosis, borderline personality, autism. Phantasy=reality. PS allows little or no subjectivity.  Rosenfeld's negative narcissism. Lacan's imaginary other. Magical, animistic, talion thinking. Potential for murder or suicide (in later episodes of PS functioning) is extreme. Such is the omnipotence of the infantile phantasy life, that the real (m)other out there appears to be insignificant or non-existent. However with Bion’s theory of the container-contained, the functioning of the real (m)other becomes crucial.  PS can be used to describe: splitting in the inchoate infantile ego (as outlined above); splitting processes bordering psychosis at any age; or even the creative chaos involved in making decisions; artistic endeavour and the freedom of creativity; the analytic position (referred to a “patience” by Bion) freely knowingly adopted with disturbed patients. Insofar as it involves the denial of death and suffering, it can also be regarded as the normal (alienated) functioning of everyday life, which cannot bear too much reality.  Depressive position (D): love and hate come closer together after maybe 6 months or a year, when perception allows for a “whole object”. The breast that feeds is also the (bad) breast that frustrates. But when good and bad objects can co-mingle (instead of being split-off), the danger is that the bad objects damage the good. The struggle then is to retain the good by maintaining good object relations, through care, concern and altruism. The object is loved in spite of its bad parts, its imperfections. Hence, the pain of knowing, self and other awareness, poignant sadness, pining, over, or fear of, or fearful responsibility for the maybe damaged or dead whole object (now more integrated and together). Fear of loss of the primal good internal object, upon which mental health depends. Real loss of the breast (weaning and teething).  Persecutory depression and the felt need to sacrifice oneself. Facing, not avoiding loss. Loss of ideal object.  Depressive anxieties. Ambivalent love.  Stage of concern (Winnicott). Loss of omnipotence; beginnings of acceptance of relative dependency on others.  Guilt rather than persecution. Toleration hence tendency towards integration of good and bad, less fearful of bad feelings.  Reparation possible (Klein’s take on sublimation), if it is not a manic defence. Less projection therefore more reality sense, inner and outer.  Normal PI. Fear for the other (as opposed to fear for the self). The capacity to mourn or maybe not (as in depression proper).  Constant rebuilding the inner/outer world, or depressive despair, or paranoid defence against depressive anxieties.  Real potential contact with objects. Better reality testing, objects really do survive my rage – i.e. they are not under my control. In normal development both PS and D and their associated extreme anxiety states are “worked though” in childhood, the ghosts (of those killed in phantasy) are laid to rest and normal development can proceed. Failure of reparative processes to heal the damage wrought by sadism – failure of the baby’s smile to bring an answering smile from the mother’s face may lead to regression to the PS position and to renewed splitting, etc. Badness again cannot be tolerated and so there is a defensive relapse into paranoid anxiety. In D, there is an increasing importance attaching to the qualities of the real (m)other and family out there. Dysfunctional families make progress in working through D very problematic. Bad objects outside multiply the bad objects within via the child’s rage and frustration.    Annihiliation anxiety: the death drive and personal fear of annihilation (in the paranoid-schizoid position), especially in psychotics. Fear of being overpowered by an uncontrollable overwhelming object. Inherited phylogenetic unconscious preditor/prey response (Grotstein). Aphanisis (Jones).  Impingement (Winnicott). Hilflosigkeit (Freud). Primary autism (Tustin). Catastrophic anxiety: a term used by Bion. This anxiety is potentially present throughout life, because life involves (radical) change which can be felt to threaten catastrophe, the movement from D to PS, chaos, fragmentation. The first apprehension of the inchoate ego is of a ‘primitive disaster’ which remains at the core of the unconscious, overlaid by secondary processes. A kind of “big bang” at the heart of things, from which we must always keep a distance. The Lacanian/Kantian Das Ding. Persecutory anxiety:  the fear of being cut through, or cut to pieces, of impending retaliation for sadistic attacks. Klein noted these affecting and paralysing the play of very young children and the speech and affects of adult psychotics.  Main anxiety in the paranoid-schizoid position.  Fear for the self and its integrity, also at the level of the body, prior to Oedipal fears of the cut of castration. Depressive anxiety: main anxiety in the depressive position. Fear of having damaged loved (as well as hated) objects. Fear of the loss of the love an internal object, or an ideal object. The main anxiety that persists in depressive illnesses. Anxiety that re-emerges with the later loss of an object, or any loss. Fragmentation: multiple splitting of the ego and objects to avoid extreme feelings and psychotic anxieties.  Occurs in states of extreme stress, and in schizophrenia. Also, at the other extreme, is part of normal splitting of consciousness. Child analysis: started 1918.  Childrens' play with toys (introduced in 1923) is equivalent to adult free associations with words. Klein developed her play technique in the 1920s.  She believed in answering frankly questions about sexual knowledge and in giving deep and repeated interpretations about ucs sexual and sadistic motivations and symbolisations, representing attacks on the mother’s body, or attacks on siblings, or the parents in coitus, all with the aim of putting into words the real of crippling anxieties. Dramas were played out with toys. Anxiety reduction through interpretation enabling more play and more phantasy production.  Gave a new perception for psychoanalysis generally of the (potentially ‘mad/bad’) infant in the child and the new emotional complexity of the child in the adult. Also created an awareness of the ubiquity of aggression in childhood and human affairs generally and the defences against it. This is the unique Kleinian contribution to psychoanalysis and culture generally. Container-contained: almost a law of the universe within and beyond psychotherapy, where each contained potentially has or had its container. The relatedness of all things. Prototypically, the baby in the womb, mouth/nipple, penis/vagina. The baby is contained by the mother, the child by the family, the school, the community, the worker in the workplace, and so on. Thoughts are contained by language, or thoughts await a thinker to think them, emotions are contained by words. A term developed by Bion, whereby each contained (see beta-element) searches (via projection) for a container to nourish it, to hold it, to link it, connect it to the world (see alpha-element). The analyst and the analytic setting is a container; the patient the contained. The mechanism of the container-contained is via projective identification whereby the mother (in the primary instance) “metabolises” the toxic feelings of the infant in her state of “reverie” – an almost telepathic receptiveness. Her mind mentalises and renders tolerable primitive anxieties. There are 3 forms of container-contained: 1) Commensal – two objects share a third to the advantage of all three. 2) Symbiotic – each object depends on the other to the advantage of both. 3) Parasitic – where one object feeds off the other to the detriment of both, particularly the host. Thus the contained may damage the container, or the container may be too constrictive of the contained which wants and needs to break free. Like the stammerer who cannot contain his feelings in words. Bion was thinking of the individual and the group/ establishment, whereby the creative individual feels too constrained by the rigidity of the establishment. The group may fragment under the impact of the contained, or each might learn from the other. Or the individual may be diminished by the group container.      Early sadism: part of the basic instinctual endowment prior to any enculturation. Klein was struck by the violence of childrens’ phantasies at the oral, anal, urethral, phallic levels, all derived from the death drive. Also the level of cruelty in manic-depressive psychosis and depression with its archaic superego. Klein pointed out the levels of cruelty, mostly unconscious, as part of the human endowment, the criminal acting-out of which is only the tip of the iceberg. Klein pointed up the hidden cruelty that lies behind much normal gestures and behaviour in children and adults. Internal objects: mostly unconscious and multiple internal representations of external objects (incorporated or identified with) but coloured by our own emotional reactions towards them. The more primitive these reactions, the more extreme will be the internal objects in their relating to the ego. Rage can create persecutory internal objects that rage against the ego. In neurosis and psychosis internal and external objects can be confused to a greater or lesser degree. In paranoia, for instance, harmless external objects can be felt to be persecutory. The superego is thus an internal object or an amalgam of internal objects. However, Kleinians understand the internal world to be peopled by good and bad objects that interact in a complex way to each other and to the ego and to “real” external objects. The ego can assimilate an object and become like it, or the object can remain unassimilated and foreign.  Good and bad objects: good objects are helpful and enabling internal objects derived from myriad good experiences by introjection – prototypically the taking in of the “good breast” facilitated by the maternal reverie. This is the foundation of our mental security and stability that will carry us through the bad times of loss and suffering. Bad objects, created by feared drives from within and bad experiences (of violence and abuse for instance) from without, are felt to be endangering to the good objects upon which we depend for our wellbeing. The more primitive the drives, the more enfeebled the ego, the more dangerous these objects can become. The more desperate will become the attempts to eliminate these bad object persecutors. According to Bion, all needed objects are potentially bad objects; they are bad because the are not possessed. Intolerance of frustration can lead even good objects to turn bad. Tolerance of frustration, for Bion, leads to thinking and symbolisation. Part-objects: in PS position, the infant has very limited perception and intense drives, so it “sees” the mother as some many part objects that must satisfy its (particularly oral sucking and biting) needs - nipple, breast, mouth, teeth - not as anatomy but as functionality, as an extention of its omnipotence without a separate existence, to be used and abused, retained, incorporated, or rejected and eliminated. This absolute control precedes, the more integrated whole-object relationships, ushered in by more holistic perception during D. The combined parent object: The phantasy relating to Klein theory of the early Oedipus Complex, of the parents permanently locked together in intercourse to the total exclusion of the child. An added fear is of the parents’ union being of an extremely cruel and sadistic nature, attacking eachother, or together attacking the child, causing devastation. The weapons used are teeth, nails, penises, vaginas, faeces, urine, all mutual destructive, as part of one of the most terrifying imagos of childhood. Moving beyond this primitive figure, Meltzer, felt that parental intercourse can become a source of creativity.   Bizarre objects: in the schizophrenic process, Bion felt that the perceptual apparatus itself is attacked and fragmented and expelled from the personality. Thus parts of the mental apparatus continue an alienated existence as bizarre objects, intruding into an external object to form a particularly persecutory object that has an eerie awareness of the schizophrenic’s own mind. So a gramophone when playing is felt to be watching the patient, or listening, or passing judgement, depending on which mental function has been expelled. This idea is based on the more general observation that individuals brought up in very violent homes will attempt to shut down whole segments of mental functioning, attempting to rid oneself of conscious awareness, becoming in effect neither alive nor dead.  Splitting, denial, projection: primitive defence mechanism of dissociation, where we are in two or more minds one of which may be denied and projected into another. Freud’s example is with the fetishist who both avows and disavows castration at the same time. The fetish object stands in for the missing penis. For Klein however, splitting is at the behest of the death drive and the extreme anxieties it causes. Splitting involves the object, split into good and bad, and the ego which is split by identifying with the objects, or more seriously there can be multiple splitting. The good may be excessively idealised, as a way of keeping it very separate from the bad that is projected, in the way that Freud had already suggest, namely that the death drive must be externalised. The splits are “vertical” and intra-systemic bearing on the expulsion of the death drive, unlike the neurotic’s repression which is “horizontal” and inter-systemic bearing mainly on the libido. With splitting, whole segments of reality can be lost. Borderlines tend to show fairly stable split-off pathological organisation of the death drives, a split-off bad self and the perverse idealisation of violence which holds the total self to ransom and delights in destroying meaning and attachments. Rosenfeld refers to the ‘internal mafia’ and ‘negative narcissism’. Bion referred to a PI-rejecting object – a mother who repeated rejects the infant’s ever more forceful communications via PI. When the ego identifies with this rejecting object, the bad self becomes allied with the death drive and delights in cruelty. What remains of the disavowed good self with its terror of being damaged may end of in the other (of the analyst) via projection. Other associated defences to deal with primitive anxiety states are omnipotence and manic control, violent introjection of the good. Violently taking in, or spitting-out (oral), holding-on or violently eliminating (anal). There are five functions of these primitive defences: 1) relief from anxiety and pain; 2) discharge of the (death) drive from within the organism; 3) the expression of primitive oral and anal impulses including sadistic components; 4) primitive ego development via introjective identification – devouring the good; 5) non-verbal communication of very intense affective states. Projective identification: first defined by Klein quite late in 1946. During PS (Paranoid-schizoid position), part of the ego is forced into the other, voided (anally) into the other in order to take-over its contents, or to control it, leading to a weakening and depletion of self as a consequence. Part of the Id (anal excrements) and part of the ego are projected into the other. The other is then forced to “carry” these projections and experiences this sudden process as being required to play a part in someone else’s phantasy, which feels alien and which has a numbing and disorienting effect in the recipient. One is suddenly and immediately (without the mediation of language) under the omnipotent control of the other, who also feels too close or, in phantasy, fused with the other. Therefore, PI can be a mechanism for denying separation and loss, a means of getting rid of anxiety or pain, dominating the other, invading or damaging the other, taking over certain capacities in the other, making the other feel (beyond words) a version of what he felt as a child/infant in the presence of the parent, or making the other feel like that parent in the presence of the child/infant. PI sets up persecutory anxieties - claustrophobias and panic attacks.       Bion made it clear that PI is a primitive type of affective communication with a normal and an abnormal use, depending on the violence involved.  In the normal use, a fear of dying is split off and is projected into the (m)other where it is allowed introjection, is metabolised (processed mentally by alpha-function) and can then be introjected back into the infant in a relatively benign form where it can link with other psychical contents and add to meaning and what Bion calls learning from experience. When this PI fails and the mother thinks, ‘I don’t know why this baby is crying’ the PI will be more forceful, more violent and repetitive. If the mother continues to fail to introject and metabolise, then the infant is left with what Bion called ‘nameless dread’ the return of the terrifying Thing and a deteriorating developmental process. Massive PI is associated violent splitting and intrusion, omnipotent fusion, leading to an impoverishment of ego and consequent loss of reality awareness and testing. This leads the subject to experience increasing apathy and feelings of emptiness, futility and meaninglessness. There are fears of retaliation by the bad projected objects and the possibility renewed violence against the other because of feelings that part of the self have been stolen or imprisoned by the other.  Variations on the PI theme: the desire to fuse with the other to be forever in union; the desire to live inside the other as an embryo or parasite; identifying with the other for narcissistic aggrandisement; the desire to force an empathic understanding of the other deemed to be too aloof; to repeatedly (ab)use the other who is destroyed in phantasy but (hopefully!) survives in reality (Winnicott) – a clear maturational step – the very difficult child who gives such trouble to others (via PI) eventually comes good when contained in a strong environment. At the most primitive death drive end of the spectrum of PI, the attempt is to get back into an object, to become de-differentiated, mindless and thus to avoid all pain.     For Klein, PI was an evacuative process, for Bion the emphasis was more on "communication" and for Joseph the concern was the pressure on the therapist, being pushed and pulled in different directions in the transference with countertransference implications. Potentially very useful tool in understanding unverbalised, unsymbolised powerfully affective states.     PI is associated with narcissistic personality disorders, particularly, borderline personality disorder (BPD, see above). Rosenfeld distinguished between "thick-skinned" narcissism and "thin-skinned" narcissism. In the former the death drive is more present to humiliate the other via PI by forcing vulnerability into the other, sadistically. Whereas the latter thin-skinned narcissist feels claustrophobically vulnerable to the other's alleged "mocking" of his "weaknesses".      As D (the depressive position) is more nearly achieved, separation becomes more bearable and PI becomes more empathic.      Problems with the concept: danger of blaming the patient: whose feelings are being felt by whom? Danger of remaining in a regressed state - PI is essentially pre-symbolic. Danger of symmetrization - PI and counter-PI, with no insight.       Adhesive identification: Meltzer and Bick noted an identification related to autism, whereby the infant “sticks” to the other, because there is no internal space, no space across which a projection might pass, due to some primary insufficiency of an external object to be a container, or may be the too sudden, too early intrusion of an object as too external, or maybe some genetic factor predisposing to autism. Relationships when they form lack depth. The baby lacks a “skin” which will hold its introjects together and instead he may “leak” uncontainedly into space and fails to perform PI. A “second skin” is formed, as an extreme defence against total diffusion, that holds the body parts rigidly together and creates a persistent adhesion to objects, or mental activities, such as, the precocious development of speech or other isolated mental faculties. Beta and alpha elements: a raw sense data (the body sensations) affective signals, thoughts without a thinker, mute elements that are ‘saturated’  which await the containing effect, the awakening effect, the mind-full-ness, the spirituality, the wisdom of alpha-function to process them into alpha elements which are the ‘furniture for dreams’ and for thinking thoughts, which are unsaturated with meaning and therefore require to link up with other alpha elements in increasingly meaningful ways enabling the mind, as Bion states, to wake up or go to sleep, be conscious or unconscious. With beta elements alone, there is no rest and no thinking, only the reverse, the development of an apparatus for ‘ridding the psyche of accumulations of bad internal objects’, an anti-mind. The beta-elements are like Bion’s concept of ‘innate preconceptions’ (certain inborn predispositions, archetypes, like the mouth anticipating the nipple) which when they meet with a realisation, mate to form a ‘conception’ which in turn can link with other conceptions to form increasingly sophisticated forms of thinking and scientific deductive and philosophical systems. The accumulation of alpha-elements similarly creates an apparatus for thinking thoughts, islands of meaning (protomind) that can interact and augment each other. This movement from beta to alpha parallels the movement from PS to D.      Unconscious phantasy: underlies all human discourse and every mental process and is linked to our biological drives prior to any nurturing in the first instance only. Phantasy is the mental representation of somatic events which become linked to objects and human cultural symbols in infancy and becomes more and more elaborated as mental life develops in contact with the external world. Unlike Freud where phantasy is liked to frustration and the absence of gratification, Klein believes phantasy to be ever present but unconscious. Phantasy is the expression of the drives and also the defences against them. Phantasy expresses the need to transpire the drives, to relieve the tension due to their accumulation. There is always an excess to be expressed, due ultimately to the death drive within. Klein was struck by the extraordinary proclivity for children to act out phantasies in their play, an early simplistic narrative thinking with objects and their manipulation. For Klein, there was no objectless narcissistic phase. From the beginning there are oral and anal phantasies with gross sadistic accompaniments linked to the mother’s body and intercourse. Isaacs believed that there is a certain instinctual “knowing” (biological phylogenetic endowment, an innate knowledge, the the baby’s turning of his head when his cheek is touched). Each somatic sensation is linked to an object that wishes (animistically) to cause that sensation, which is either loved (retained inside) or hated (expelled by projection) according to whether the object is well meaning (causes pleasure) or malevolent (causes unpleasure). The former is a ‘good object’, the latter is a ‘bad object’. The hungry baby literally has a bad object in his stomach that wants to harm him. Without gratification, as his rage increases and his fear of his rage increases, he believes this bad object to be more and more threatening and wishing him harm. Primitive defences against this very threatening situation (if the mother does not intervene to help) involve the magical omnipotent projection of bad objects (via the sensations of the anus and urethra) and introjection (via the mouth) and idealisation of good objects in the PS position. In D, the phantasy narrative become a little more realistic, but reality is always underpinned/interpreted by unconscious phantasy. The symbolic brings something from the “outside” to bear on omnipotent phantasy. So the movement from PS to D involves some loss of omnipotent control of objects and the ability to symbolise in the absence of the object – a considerable developmental step.  In the “Controversial discussions” there was much dispute about Klein/Isaacs’ assertion of such intense narrative sophistication in the first year of life. Cannabilistic phantasies, undoubtedly present later in childhood are no more than a retrospective attribution to infancy perhaps. But as Jones points out, oral sadistic phantasies later on, also point to or imply that there are already oral phantasies at the actual time of the oral phase to regress back to. There was also a problem that Klein’s ucs was not Freud’s ucs, with displacement, condensation, absence of negation, etc. Klein’s ucs seems to have secondary process elements in it too. But it was argued that there is never such a thing as an ucs on it own. Klein was criticised for muddling objective psychical mechanisms (introjection/projection, etc) with subjective content. Furthermore, she has altered the significance of other Freudian concepts. Of regression and fixation, for instance, if ucs phantasy is permanently present, then the drives no longer assert their influence as a result of frustration, repression and regression to fixation points. Similarly, the genetic stages of the libidinal development and the Oedipus Complex are now conflated and confused in favour of what Glover termed an “enclave” of primitive functioning. With Klein, we seem to be locked into a stage of permanent fixation-regression to the early oral and pregenital  stages!           Archaic superego: a more primitive, earlier (in the second year) and more severe superego than the Freudian precipitate that arises at the time of the Oedipus Complex, by introjection of the lost loved and hated object. The archaic superego is almost indistinguishable from the (oral and anal) drives from which it arises. Klein was uniquely placed to observe and describe its destructive effects. It is primarily oral sadistic in nature and amounts to the sum total of bad internal objects that operate as death squads against the immature infantile ego, which in the child is constantly required to behave badly and get itself punished to appease the unconscious sense of guilt arising from this “internal saboteur” (Fairbairn). This superego cuts, bites, devours. Klein was clear that children (‘criminals’) look for punishment to relieve a persecutory sense of guilt, which arises in turn from the infant’s oral rage and sadism against the mother body. It bears little relation to the actual chastisement that the child receives from its parents. Only later can this superego be updated as the child has access increasingly to reality testing. Greed: based on a form of introjection carried out in anger. The violence of the oral incorporation, involving biting, leads in phantasy to the destruction of the object. The end state is that there has been no oral satisfaction, since the introjected object is worthless; or, worse, it has turned into a retaliatory persecutor in reaction to the oral sadistic attack carried out in the process of incorporation. In the paranoid-schizoid position, the internal world may accumulate more and more persecutory and retaliatory objects that threaten the subject; this gives rise to a greater and greater hunger for 'good' objects to alleviate the internal state of dominance by 'bad' objects and by hatred and destructive impulses. This creates an insatiable situation of anxiety and 'destructive introjection'. Hunger in the context of persecutory anxiety leads, in phantasy, to violent forms of introjection and the fear of destroyed objects inside -destroyed by the bad objects and 'bad' impulses mobilized. Hunger giving rise to more hunger is greed.  The end result may be an inhibition of oral impulses and a restriction of introjection, intended to spare the objects that are so hungered for; this may therefore lead to an anorexic state and a depleted internal world. This introjective violence is a counterpart of the projective attack in envy in which the desired object is invaded, in phantasy, in a fit of destructive violence, and spoiled or poisoned. Envy:  the secular version of Original Sin. Worst still than greed, envy is destruction of the object because it is good and because it is separate, not just because it frustrates. Envy creates hostile relations with good objects and is the main motor/instigator of paranoid-schizoid phenomena. Normal splitting is disrupted, so that not just the bad object is attacked, but the good also, tending to cut off supplies of life sustaining love at source, because now the good object cannot be safely introjected. In fact the good object will change under the impact of envy into a terrifying persecutor. Vicious circles are set up, whereby a good object is destroyed by the immediacy of envy which rushes still more urgently to gratification, leading to even more envious attacks and greater destruction of the good, and so on. Envy is the desire to eat into the mother’s body (oral sadism and spoil its contents, anal sadism), to become fused in a very destructive way. The object is attacked and destroyed. This is not just secondary envy arising from frustration and deprivation, Klein envisages a primary envy arising from within, due to the death drive and doubtless constitutional factors (leaving the door open for a genetic causation of schizophrenia). No other school of psychoanalysis or psychotherapy, takes things quite so far, although Klein was consistent with Freud in his elaboration of the death drive. All analyses, she stresses, should strive to reach and analyse envious impulses. Here is a malignancy at the heart of the subject that is capable to destroying any goodness, any good objects maintained by the life drive. For Bion, it was a cancer, it is an anti-mind, the destroyer of alpha-function, meaning, knowledge and love. It must therefore be deflected outwards and must be the main motive for projective identification, otherwise it multiplies within. It is also the violence behind an omnipotent introjection, a denial of separation, and a desperate desire to take in something good against a background of emptiness as the good objects are continually damaged. Object-relations therefore are very problematic and temporary being infused with too much impossible demand. Envy is the root of schizophrenia and the most severe forms of mental illness. For Rosenfeld, Meltzer, it is the nucleus around which the pathological personality disorder forms which holds the sane part of the personality as a hostage threatening it with deadly consequences. Negative narcissism arises by siding with the envious destructiveness, leading to perverse and autistic states. The defences against envy are splitting (to avoid ambivalence – good and bad) and fragmentation (to avoid the mental pain of loss), denial, omnipotence (narcissistic compensation) and idealisation of self. Other similar defences are described: devaluation of the other, contempt (which clinically can mask itself as an elitist superiority), apathy (as the ego is emptied by PI and not able to be nourished by II), indifference (as a way of in-discrimination). Winnicott and the ego-psychology school found the Kleinian emphasis on envy too pessimistic. For Winnicott, such negativity might on occasion be a sign of life-resisting domination. For Lacan, envy arising ab initio, without a context is meaningless.   Reparation: the Kleinian equivalent of sublimation, whereby destructive impulses are used in the service of repairing the damage done by the sadistic attacks on the mother’s body. Reparation sublimates aggression, whereas sublimation bers more on the libido. Reparation is the main defence in the depressive position. Initially, it may be the infant’s smiling gesture towards the mother he feels he has damaged, an attempt to project the good. Later, it becomes a source of creativity. It is the ethical act of Christian forgiveness, whereby myself (internal objects) and the other (external objects) are healed from the splitting fragmenting processes that dominated the PS-position. Instead of splitting, denial and projection, there is awareness of ambivalence and integration. Klien uses the example of the boy who feels pity for the wounded squirrel and comes to its aid and the hostile world changes to a friendly one. It is via reparation that the inner destructiveness, with its magical omnipotent power, is lessened and becomes increasingly realistically oriented. Obsessional reparation can be rather repetitive and placatory. Likewise manic reparation is based more on triumph over disaster and veers back towards PS. Bowlby credits Klein with being the first to show that children grieve their losses and want to make good via repeated acts of reparation. Repeated act of reparation enable the maturing of the personality and lead to altruism and social action.     Manic defences: part of the bi-polar personality, whereby excessive activity serves to triumph over depression and concern. At a relatively normal level: the woman who cleans excessively after a row – the attempt is to restore the good objects back to wholeness after the damage that the row caused. However, hypomania and mania are characterised by omnipotence based on absolute denial. Denial of the object’s importance to us and denial of our dependence on it may lead to an attempt to forget the object’s importance, or, conversely, to idealise it excessively. For a while (in the late 1930s) Klein even refers to a ‘manic-position’. However, as failed reparation, the denied objects can return to haunt the ego with depressive or persecutory anxieties.  Nameless dread: arises when the containing mother fails (in her state of reverie) to contain the infant’s terrors communicated via projective identification (PI) that it is dying and the infant is left with a meaningless nameless fear derived from the death drive and incremental failures to develop mindfulness (alpha-function).  The feminine phase:  As the early PS relation to the “breast” is very difficult and fraught with anxieties, both boys and girls adopt a “feminine” position in relation to the father’s penis. (Freud had already acknowledged the shift in love object from mother to father in the Oedipal girl). However, Klein (unlike Freud) understands that the little girl has early vaginal sensations that facilitate this turn to the father.  The girl can fear that her mother will destroy her body, abolish its contents and damage her babies, as a retaliation for the girl’s attacks on her mother’s body and (during the early Oedipus) the girl’s attack on the penis inside the vagina. All these phantasies underly the woman’s later problems with her mother and anxieties over her fertility and her appearance. These anxieties are the forerunners of the classical “penis envy” and greatly amplify it; feelings that there are multiple things wrong with her body, that her body is deformed and that her babies will be deformed. Similarly, the boy can fear that he will be punished for his envy of pregnancy, breast feeding and the generative power of the mother’s body, and also the attacks that he has made on the penis inside the mother. Similarly he fears for his own organ lest it will have been damaged or destroyed by the mother. Heterosexuality depends upon overcoming these early persecutory and paranoid anxieties and not succumbing to a rebuff from the opposite-sexed parent, which may lead  to homosexuality, if it is not subsequently overcome by belief in and identification with the same-sexed parent.      Countertransference: Freud came to learn from and understand the transference. Similarly, during the ‘50s, the Kleinians (not Klein herself) came to learn from and use the countertransference, that is the analyst’s spontaneous, yet unacted upon, feelings towards the patient, based on his/her past (neurosis). In conjunction with this reference to the analyst’s past figures triggered by the patient, the CT feeling may at the same time be the registration of a reaction to the patient’s unconscious use of PI. Here the analyst is put in touch with a part of the patient’s unmetabolised past, re-enacted in the present, frequently without words, because these unmetabolised feelings arose at a time when there were no words, no language. So the analyst’s feelings may register an unconscious state of mind of the patient in the session. The CT can then be used as a specific instrument of empathy to the translate by the analyst of heretofore mute feelings into words and feelings. Instead of a defensive CT-reaction, the analyst will be able to use his own (self)analysis to maintain the rhythm of introjection (of the patient) and re-projection back to the patient, without becoming too disturbed himself. However, in this very intuitive situation, patients can become very adept at projecting parts of themelves into similar part functioning of the analyst. For instance, the analyst’s wish to be mother, or to be all-knowing, to be sadistic, in a sense telling him what he wants to hear. Similarly, the CT can be misused to ‘blame the patient’ for unresolved neurotic trends in the analyst, restimulated by the patient – the male patient who reminds the female analyst to much of her father/brother, etc.     Omnipotence: the irony of the most vulnerable, isolated, creature who defends himself by a whole range of omnipotent phantasies to do with attacking, controlling and gauging-out and sucking-out, etc. He is God! For a time he may be treated like a god by his loving parents and for a time his omnipotence is a necessary bridge (Winnicott’s “primary illusionment”) to a more reality-tested separation, the so-called “transitional object” is a kind of half-way house between omnipotent phantasy and the really real which non of us every quite attain (Lacan’s Real). However, omnipotence may remain as a very narcissistic feature which dominates object relations in the borderline personality, intimidating dependant parts of the self and others. The cause of this might have to do with a too early impingement of otherness and externality, by for instance a violent family situation. The psychotic core: the Kleinians believe that everyone has a psychotic core (unlike the Lacanians who undertand psychosis structurally – as a specific failure of the “paternal metaphor”). In neurotic or normal persons, the psychotic core is well overlaid by solid good experience which accumulates a fundamental primary good object that acts a guarantor throughout normal life and enables us to withstand loss without undue damage to our internal objects who can be healed via reparation. Klein discovered that children could at least potentially (given a combination of constitutional factors and/or an uncontaining environment) suffer from psychotic illness due an excess of the death drive and its derivatives and paranoid suspiciousness of good as well as bad objects. Feelings of going to pieces, of falling forever, of leaking away, of being radically uncontained, of breakdown and depersonalisation, of being overwhelmed or flooded, and rigid defences against these, can all be regarded as psychotic phenomena. Klein’s little patient, Dick, was withdrawn from reality, showed a complete absence of affect, was inaccessible and lacked emotional rapport. Was alternatively negative and automatically obedient and indifferent to pain – all sign of infantile psychosis. He was locked into a non-symbolic world, where sadism, omnipotence and vicious circles dominated. Kleinians had had some success in understanding primitive psychotic mechanisms in children and adults and have lead the way in the treatment of schizophrenia via psychoanalysis.   Epistomophilia: the desire to know linked to the drives, firstly about sexuality, linked to scopophilia/voyeurism – the sexual theories of children. All “knowing” is first sexual knowing.  But desire too closely linked to sadism can cause inhibition in learning, loss of curiosity and intellectual development. There are also innate preconceptions to do with the nipple in the mouth, the penis in the vagina, pre-patterned. Bion, working with inhibitions created in schizophrenic thinking, developed the “K-link” which arises from preconceptions “mating” with realisations to form new conceptions developing slowly into a mind that can think, a process severely disrupted in mental disturbance. When PI works, the K-link is enhanced (via the containing other) and ideas can be linked together (like chains of signifiers), or not when PI fails and meaning is stripped from the mind (-K), leading to ‘attacks on linking’ and zero-K in fragmentation, where the ego’s capacity for emotional knowing or ‘learning from experience’ is severely impaired. K is central to analyst’s therapeutic effect.   KLEINIAN PSYCHOANALYSIS. (Selected readings). Bion, W. (1962)  Learning from Experience.  Karnac. ---------  (1967)  Second Thoughts: Selected Papers on Psycho-Analysis.  Karnac. *Bleandonu, G. (1994)  Wilfred Bion: His Life and Works, 1897-1979. Free Association Books. Burgoyne, B. & Sullivan, M. (1997)  The Klein-Lacan Dialogues.  Rebus Press. Cohen, M and Hahn, A. Ed. (1999) Exploring the Work of Donald Meltzer: A Festschrift.   Karnac. Eigen, M (1985) 'Towards Bion's starting point: between catastrophe and faith'. IJPA 66, 321-32. --------- (1986)  The Psychotic Core.  New Jersey: Aronson. --------- (1998)  Toxic Nourishment. Karnac books. *Grinberg, L (1992)  (New) Introduction to the Work of Bion. U.K. Robert Harris Educational Trust, 1975. *Grosskurth, P. (1985)  Melanie Klein.  Maresfield. Grotstein. J. (1981)  Ed.   Do I Dare Disturb the Universe?  Beverly Hills: Caesura. *Hinchelwood, R. (1989)  A Dictionary of Kleinian Thought.  Free Associaton Books. *----------------   (1994) Clinical Klein.  Free Association Books. *Isaacs, S. (1948)  'On the nature and function of phantasy'.  IJPA 29: 73-97; republished (1952) in M Klein, P Heimann, J Riviere, Developments in Psycho-Analysis.  Hogarth. pp67-121. Klein, M. (1921-63)  The Writings of Melanie Klein.  4 Vols.  (1) Love, Guilt and Reparation and Other Works, 1921-45.  (2) The Psychoanalysis of Children.  (3) *Envy and Gratitude and Other Works 1946-63. (4) Narrative of a Child Analysis.  Karnac books and the Institute of Psycho-Analysis. Klein, M. Heinmann, P. and Riviere, J. (1989)  Developments in Psycho-Analysis.  Hogarth. Klein, M. Heinmann, P. and Money Kyrle, R.  (1977)  New Directions in Psycho-Analysis:  The Significance of Infant Conflict in the Pattern of Adult Behaviour. Hogarth. Kristeva, J.  Melanie Klein.  New York: Columbia University Press. 2001. Likierman, M.  Melanie Klein: her Work in Context.  London and New York: Continuum. 2001. *Meltzer, D.  (1978)  The Kleinian Development.  Perth: Clunie. -----------   (1967)  'Terror, persecution and dread', IJPA, 49: 396-400. Also in, Sexual States of Mind.  Perth: Clunie. *Mitchell, J. (Ed.)(1986) The Selected Melanie Klein. Peregrine. Money-Kyrle, R. (1978)  The Collected Papers of Roger Money-Kyrle.  Perth: Clunie. *---------  (1973)  Introduction to the Work of Melanie Klein.  Hogarth. *Racker, H. (1968) Transference and Countertransference.  Maresfield, 1982. Rosenfeld, H. (1965)  Psychotic States. Hogarth. *-------------  (1971) 'A clinical approach to the psychoanalytic theory of the life and death instincts: an investigation into the aggressive aspects of narcissism'. IJPA: 52,169-178. -------------  (1987)  Impasse and Interpretation. Maresfield. Ruszczynski, S and Johnson, S. Ed. (1999)  Psychoanalytic Psychotherapy in the Kleinian Tradition.   Karnac *Rycroft, C  (1968)  A Critical Dictionary of Psychoanalysis.  Penguin. *Sayers, J.  (1998) The Kleinians.   The Polity Press. *Segal, H. (1982)  Klein.  Fontana Modern Masters. Spillius, E. (1988)  Melanie Klein Today, Vols 1 and 2. Hogarth Weatherill, R.  (1992) 'Are the Kleinians really psychoanalysts at all?' In The Journal of the Irish Forum for Psychoanalytic Psychotherapy, Vol 2, No.2, 1-12. *-------------   (1998)  The Sovereignty of Death.   Rebus Press.   *Key and/or more accessible works.       Top NOTES ON COUNTERTRANSFERENCE In the Journal of the Irish Forum for Psychoanalytic Psychotherapy. Vol 3. No. 2. 1993. pp7-20.                    I remember a brief discussion with an experienced colleague, some ten years ago, in which she expressed horror at my interest in noting and using the countertransference as a crucially important datum in analytic exploration. Here I will try to discuss and justify my interest.       This question has been addressed in the literature since the '30s, but very little addressed on training courses in psychotherapy, being dominated as they are in this country either by a Lacanian position or a classical one. Both of these approaches view the countertransference with a negative sign, thereby missing a whole range of phenomena that are crucially important in psychoanalytic psychotherapy. The countertransference is defined in two ways: 1) Broadly, the total of the therapist's feeling responses towards the patient including certain invariants in the analyst's personality. 2) More narrowly, the counterpart of the patient's transference i.e.  the therapist's unconscious projection of unresolved conflicts towards figures in his past on to the patient in the analytic setting (see Sandier, Dare and Holder, 1973).       Freud said that the analyst should "recognise this countertransference in himself and overcome it" (letter to Ferenczi in 1910). Freud regarded the analyst's mind as an instrument, and its effective functioning was impeded by countertransference. However, retrospectively we might see his position as ambiguous. For when in 1912 Freud talks about the analyst turning "his own unconscious like a receptive organ towards the transmitting unconscious of the patient" (p. 115), he is not implicitly barring the use of countertransference. However, Freud was a Newtonian. He wanted to observe things from the outside, without contamination. He didn't come explicitly to regard the countertransference as he later did the transference — as a useful tool in psychoanalytic work. However, naturally enough the analyst does have feelings and conflicts, "blind spots" he frequently called them, in relation to his patients and what they do and say. These are not in themselves a problem, only when they get in the way of his functioning like a mirror. So to eliminate this problem and to keep the mind clear and unruffled, Freud encouraged: 1) continuous self-analysis; 2) a training analysis; and 3) periodic re-entry into analysis, every five years.       Let us move on to look at the broad conflicting approaches in psychoanalysis today to see what position they take in relation to the countertransference. Space will not permit me to include the Jungian, Sullivanian, and Kohutian perspectives.                    Analytic approaches             1. Classical: Firstly we should consider briefly what are the hallmarks of the classical technique (see Greenson, 1967). From the beginning, it was the patient's resistance to forgotten or defended material which initiated the analyst's interpretation, with the aim of making the  unconscious  conscious.  But  as  long  as  the  flow of associations remained, there was no need for interpretation. Also timing was emphasised. Premature interpretation was to be avoided. Depth interpretations commence only when resistance is encountered. The therapeutic alliance is distinguished from the transference-neurosis. Apart from  transference-interpretations,  there  were  other  non-transference interpretations, as well as reconstruction and working through.       With the coining of the tripartite model of the mind in 1923 the emphasis shifted from interpreting unconscious material which is resisted against, to ideas of strengthening the ego and the exploration of various resistances, for instance: transference resistance; ego-resistance (secondary gains from the illness); id-resistance (habitual modes of drive satisfaction); superego-resistance (need for punishment). This approach is known as defence-analysis. Generally speaking, the classical mode was to abstain from transference-interpretations until transference was manifesting itself as a resistance.       These clinicians recognise the countertransference, but view it as largely negative, as something that if it cannot be overcome will block good analytic work. It is not seen to be essentially of use in contributing to a knowledge of the patient.       2. Kleinian: As early as the 1920s, British analysts were tending to   interpret   the   transference   before  it   emerged   as   a  resistance, particularly noting the aggressiveness of the patient's transference (this is long before it became a hallmark of the Kleinian approach), that is, very early in the treatment making interpretations about unconscious hostility to the analyst. The Kleinian approach aims at the continuous revelation of unconscious phantasy as it emerges in the transference, with the emphasis always on the most archaic oral destructiveness, and terrifying internal objects arising therefrom. Analysis of these impulses brings the analysand to the "depressive position" - the working through of loss, the reluctant and forever anguished acceptance of the loss of the beloved object. Although Klein herself rejected the notion of the countertransference as a tool of therapeutic understanding of the patient, later Kleinians exploited it to the full, particularly following on Klein's analysis of schizoid mechanisms (1946) and the concept of projective identification, as elaborated by Bion (1959), and his belief that the analyst acts as a maternal container to receive, de-toxify and metabolise the patient/child's emotional distress arising from primitive drives, projected of dire necessity into the other.       3. Lacanian: Here, the emphasis is on the silence of the analyst and the speech of the analysand, and the transition from empty speech to full speech (Lacan, 1953). Even the transference is not interpreted here, but intervened upon rarely, as when the patient makes a slip in his speech, or in his reporting of a dream, or the use he makes of specific signifiers that keep returning, and in other so-called "formations of the unconscious". The transference can never be resolved. It remains open and always insisting, demanding, wanting something, wanting love - the "object a", the lost object of desire. To interpret the transference, according to Lacan, only sponsors a narcissistic illusion of knowing, which impedes the subject's access to desire. Instead, the knowing ego is displaced in favour of the subject, which is never, can never be precisely. It is only in speech that the subject comes fleetingly and ephemerally into being.       Analysis is conceived of as being endlessly de-centring, because of the nature of the unconscious to decentre. To interpret the tranference, or to use countertransference in furthering our understanding of the patient and the patient's understanding of himself, would amount to being sidetracked — being caught in an imaginary completeness and unity — i.e. a further alienating strengthening of the ego. This of course was the view of my colleague.  This Lacanian position is valuable insofar as it emphasises and preserves an irreducible Otherness in the analytic encounter, but it may be radically misleading and clinically traumatising in its exclusive ideological emphasis on the signifier. Lacan's view is extreme. There is not one reference to him in valuable sources like Wolstein (1988).       4. Independents: The Independents (see Rayner, 1990) would be nearest to the classical model in facilitating the development of the therapeutic alliance, and only making interpretations about unconscious hostility when the patient seems ready to hear them. They have a more benign view of human desire than either the Kleinians or the Lacanians, emphasising the unconscious ego's capacity to become enriched and more deeply centred, emphasising the synthetic powers of the mind to work on unconscious discontinuities and archaisms. They enjoy the analytic situation, the essential playfulness of the "news from within", the spontaneous creativity/difference or otherness of the unconscious. True, the unconscious is there as radical otherness, but this is not such a bad thing. In fact it can be seen as a source of endless discovery.       Whereas the other schools have emphasised the primacy of unconscious factors, over and against the real world of others (both Lacan and Klein centre their theses around a great loss or a lack), the Independents have underlined the importance of the early and fateful environment of the infant, stressing the interaction of the environment on unconscious phantasy. Their strength has been in delineating exactly how the mother manages her baby, and how the mother/baby interaction structures, lays down, core unconscious propensities destined to be repeated in the subject's life. Independents seek to unpack this early unconscious mutual experiencing, especially and crucially through the medium of the transference/ countertransference dialectic as it is endlessly replayed in the analytic setting. This is the approach that is favoured by the author.       Now we shall turn our attention to a few of the key papers on the countertransference.       B. Key Papers       As early as 1930, Ella Sharpe envisaged the psychoanalytic relationship as an unfolding of a serious dramatic play in which the analyst enters into a profound dialogue with his own feelings, in the session, having them available therefore for possible use. This is about two decades before the general espousal of the use of the countertransference, when analytic neutrality imposed an adherence to a self-denial of emotionality. She felt spontaneity was essential, and she felt the task of analysis was the freeing of the patient's ordinary creativity — related by her to the Kleinian notion of reparation of damaged internal objects.       In the '20s Ferenczi was working with patients who seemed unable to respond to the classical technique, and he tried to be open with his feelings about them, as he expected them to be with him. This was leading naturally to the investigations of the analyst's emotional reactions to his patients.       His pupil Michael Balint was to follow this up. His paper (1939) with his first wife, Alice, understands countertransference as the analyst's normal non-pathological transference to the patient. We react emotionally to the expression of emotion (by the patient). It is true, as Freud said, the analyst must be a mirror, but not by behaving passively as in inanimate object. They felt that the more clearly the patient can see himself, the better the analyst's technique; and if this has been achieved, it does not matter greatly how much of the analyst's personality has been revealed by his activity or passivity, his severity or lenience, his methods of interpretation, and so on. This was the beginning of the move towards the Independents' understanding of the place of emotional responsiveness in psychoanalytic technique.   Winnicott (1947) emphasises the need for the analyst to be quite at home with his hatred if he is going to tackle the treatment of borderline psychotic patients, where hate, he says, is always present. He will not only experience it, but need to use it constructively. Not only this, but the analyst's hate will be justified in terms of self-preservation, just as a mother's is with her baby. In the case of those patients with very fragile self-esteem, it may not be possible to tell the patient about it, but the analyst must never deny to himself the hatred he feels. He goes on to affirm somewhat enigmatically, "It seems to me doubtful whether a human child as he develops is capable of tolerating the full extent of his own hate in a sentimental environment. He needs hate to hate". And similarly, "A psychotic patient in analysis cannot be expected to tolerate his hate of the analyst unless the analyst can hate him" (p. 202).       A leap forward was to take place when it was realised that the countertransference could be used in helping analysts to understand the hidden meanings in the material brought by the patient. Heimann (1950) is generally regarded as the starting point of interest in the use that the analyst can make of his countertransference as a tool in understanding the patient. She drew attention to the aspect of countertransference that is a specific response to the patient, and distinguished it from the intrusion of the analyst's own neurotic transference. She went so far as to say that the countertransference is "the patient's creation... part of the patient's personality". The countertransference, properly used, therefore could become a precise instrument for probing the patient. This is a more restricted and focused  use of the countertransference than Balint and Winnicott had in mind. She, however, cautioned students against making interpretations based on their feeling responses without giving due weight to what the patient actually said to them.       Margaret Little (1951, 1957), Girtleson (1952), and others went so far as to indicate that the analyst should on occasion analyse his own feelings with the patient, but Heimann and others pointed out that this might be more of a burden than a help to the patient. Like Searles (1958), Little emphasises the vulnerability of the disturbed patient to the analyst's real but unacknowledged feelings. Such patients can indeed often make very good countertransference interpretations to the analyst.       Annie Reich (1951, I960), from a classical position, sharply rejected the notion that the countertransference can be used as a therapeutic tool. She feels it is a substitute for empathy and true analysis and therefore must be overcome.       Kernberg (1965), while worrying about the too general use of the term countertransference, was equally worried that the view of countertransference as only a blind spot, or a resistance, encourages a phobic attitude in the analyst towards his own feelings, thus restricting his understanding of the patient. And this becomes particularly important when considering borderline patients. Here he was in agreement with Winnicott, Little and others.       As Sharpe (1947) stresses: "To say that an analyst will still have complexes, blind spots, limitations is only to say that he remains a human being. When he ceases to be an ordinary human being, he ceases to be a good analyst... We deceive ourselves if we think that we have no countertransference. It is its nature that matters" (p. 4). Many would go along with this view that countertransference is inevitable, and without it there would be no empathy, no interest, no analysis (Spitz 1956, Little 1960, Money-Kyrle 1956).       Racker (1953) goes so far as to speak of the "countertransference-neurosis" which, like transference, we must assume always reveals its presence. So for the analyst (parallelling the mainly oedipal transference in the patient), every male patient represents the father, and every female the mother, at some unconscious level at least. A very ill patient, who remain ill, can become a terrifying persecutory internal object for the analyst. If the analyst's need for love is thwarted, his perception of his patient may be disturbed by the interference of hated archaic images, or by reactive defences against them. He goes on to speak of the great resistance among analysts towards recognising countertransference, except as a theoretical proposition. Racker cautions: "We must begin by revision of our feelings about our own countertransference, and try to overcome our own infantile ideals more thoroughly, accepting more fully the fact that we are still children and neurotics, even when we are adults and analysts" (1957, p.130). Racker’s (1968) paper represents perhaps the most valuable collection on this topic. Blake-Cohen (1952) notes that the common factor in the very wide field of countertransference responses is "the presence of anxiety in the therapist - whether recognised in awareness or defended against and kept out of awareness" (p. 69). Later in this paper she produces a list of  situations of anxiety or hidden anxiety that are indicators of the analyst's countertransference.       Pearl King (1978) has argued about the all-important analysis of affects which have accompanied traumata in the pre-verbal period. These can be uncovered from the analyst's careful monitoring of his own affects, being careful to distinguish his own pathological countertransference which must be self-analysed. She stresses the analyst‘s attitude of neutrality or non-attachment. She is envisaging here a parallel split in the analyst as optimally occurs in the patient. Freedom to move from different positions of affective appraisal on the one hand, and then to think about them - bring them together in new constellations.       Money-Kyrle (1956) sounded a general word of caution, however. The central problem is: what is the status of the analyst's feelings — the feelings that arise spontaneously in response to the patient? Are they indeed the analyst's own neurotic conflicts to be cleared through further analysis, or are they also some register of the patient's problems which it would he essential to capture and use?    In what he calls the "normal-countertransference", the patient speaks and the analyst empathises easily because he sees in the patient "a former ill part of himself, including his damaged objects, which he can now understand and therefore treat by interpretation" (p. 331-2). Here, Money-Kyrle was describing the familiar feeling of realising that the interpretation made could, one realises with a little amusement perhaps, easily be made of oneself. And he also recognised the equally familiar possibility that "by discovering new patterns in the patient, the analyst can make 'post-graduate' progress in his own analysis" (p. 341). But the problems come when the patient's material "corresponds too closely with an aspect of himself which he has not yet learned to understand" (p.322) Comprehension fails, strain ensues, a vicious circle sets in, the analyst feels persecuted or guilty or projects this into the patient. Money-Kryle gives an example of his own. He describes a patient who responded to the analyst's mistake by attacking what this patient immediately believed was the analyst's hopeless impotence. "I had to do a silent piece of self-analysis invoking the discrimination of two things which can be felt as very similar: my own sense of impotence at having lost the thread, and my patient's contempt for his [projected] impotent self, which he felt to be in me. Having made this interpretation to myself, I was eventually able to pass the second half of it on to my patient, and, by doing so, restored the normal analytic situation" (p. 336-7).       Sandier, Dare and Holder (1973) make quite a useful summary of our understanding of the term countertransference, and its usage, under three headings: 1. General features of the analyst's personality which will colour or affect his work with all his patients throughout every analysis; 2. More specifically, countertransference can lead to difficulties in the analysis if the analyst fails to recognise and cope with his countertransference-reactions; 3. Scrutiny by the analyst of variations in his feelings and attitudes towards his patients can lead to increased understanding of the patient's history. It is on this third usage that we will now concentrate.       C. Modern theorists       What we have been noting is really a "democratising" of the analytic process (see Epstein and Feiner, 1979, and Wolstein, 1983). We will limit our focus to the Independents and their emphasis on the mutuality of the analytic encounter that has been the strongest thrust of the Independents in the last two decades since Balint and Winnicott died. The torch has been carried by Khan, Klauber, Enid Balint, Limentani, Little, Stewart, Coltart, Symington, Casement, Bollas, Pedder and Parsons.       For instance, Klauber (1981) says: "It is from this mutual participation in analytic understanding that the patient derives the substantial part of his cure and the analyst his deepest confidence and satisfaction" (p. 46).       The analyst must therefore be open to deep emotional contact with his patient — made at the Paranoid Schizoid level. In line with classical theory, he agreed that a mild positive transference is the agent of continuity of an analysis and should not be analysed. What the patient seeks is a gratifying object relationship, but through interpretation this desire is frustrated. Instead the patient receives understanding and a relationship based upon the use of identification with this understanding. Identification puts boundaries on the analytic relationship and defines its role. Symington in Klauber (1987) uses a metaphor. It is like a man who buys a plot of land to build a house on. The plot must have boundaries for it to be acquired in the first place, but the house is built on the land not on the boundary. Emotional contact must be made, but Klauber warns against impulsiveness from the analyst. He advises careful spontaneity only after mastering a rigorous technique. Impulsiveness, he indicates, is likely to come from the id rebelling against the superego.   Klauber   talked   more   freely   in   the   analysis   than   would   be customary: indeed, he felt that while silence could reveal the original trauma, it also tends to repeat the experience of a too-distant parent who in silent on emotional matters. He notes that the beginning of an analysis is traumatic, and de-traumatisation begins with the first interpretations and the patient's partial identification with them.  This requires sounds, intonations and words from the analyst — not the silent repetition of the trauma. The analyst's spontaneity facilitates the patient's maximum expression  and  freedom,  and  although  this  may  at  times  lead  to omnipotent behaviour, it is better this be given its head rather than stamped on.   Coltart suggests that every analysis starts as a mystery in which (paraphrasing Yeats) "something vital in the patient slouches towards Bethlehem waiting to be born". Taking her cue from Bion, she stresses the inadvisability of communicating certainty about a patient to a patient. The appreciation of uncertainty is very typical of the Independent idiom. Sometimes, she says, one does not think at all during analytic sessions. However, Coltart has been criticised for what some have called emotional impulsiveness. In this 1989 paper, she describes an impasse with a patient. She had sat with him (he wouldn't lie down) day after day. his gaze shifty, evil and terrified. He was as if possessed. She felt she carried his dark and heavy projections which she tried in vain to decode until, despairing, she suddenly became furious and bawled him out for his prolonged lethal attacks on the analysis and herself. This outburst changed the whole course of the analysis because, as they came to see, this patient had needed to act out, live out and have experienced and endured by another person, without retaliation, his primary hatred of a genuinely powerful mother. She says:    I had given up trying to "understand" this patient, given up theorising, and just sat day after day without memory or desire, in a state of suspension, attending only with an empty mind to him and the unknowable truth about himself which had shaped his life, until such a moment that I was so at one with it that 1 knew it for the murderous hatred it was, and had to make a jump for freedom — his as well as   mine — by shouting. These acts of faith can feel dangerous (in Kohon, 1986, p. 195).       Symington, in the same collection of writing, also considered these "acts of freedom" of the analyst and how they can bring about therapeutic change. We can slip into assumptions about a patient, become a prisoner of illusions about a patient, become lassoed into a patient's self-perceptions, and this can become an illusory stranglehold. He concludes that the inner act of freedom in the analyst causes a therapeutic shift in the patient and new insight, learning and development in the analyst. The interpretation is essential in that it gives expression to what has occurred and makes it available to consciousness.       Bollas asserts that the psychoanalyst must develop and use his own true self, his own idiom, his own way of working. "Personal idiom always mediates the unconscious and its laws. Analysts make interpretations, they invent meanings; they do not discover the meaning conveyed by the patient. No two analysts would say the same thing to a patient" (1989, p. 73). The analyst, however, must be aware of his idiom, and therefore must treat himself as one of the objects of scrutiny in the process. At the same time, he is an object being used by the patient, and he must be aware of the patient's use of him. So the analyst must be aware of his own self-idiom and the patient's use of him.       Bollas (1987) believes that the analyst is compelled to re-live elements of the patient's infantile history through his countertransference. He asserts the need for a "counter-transference readiness", a mental neutrality akin to the creation of an internal potential space (Winnicott, 1972), which functions as a frame (Milner, 1952), allowing for a more complete and articulate expression of the patient's self-experience. Bollas takes the example of the hysteric.       The hysteric, as Freud noted, enjoys the possession of the analyst. The analyst is confronted with many others and a forceful language of imagery that does not lend itself to reflection. Masud Khan (1975) speaks of the hysterical reenactment compelling the other to become a "witness accomplice", i.e. the analyst is compelled to observe her introjects by means of a kind of performance art. Why does the hysteric transform herself into an event or spectacle, holding the other captive in a drama, or a comedy? And how can this be transformed into analytic reflection?       In a case that Bollas describes, an elegant, well-informed girl (Jane) came to him for analysis because of a restless depression. Bollas finds himself caught by the vivid descriptions of her life. She would recount some very distressing event, and then look at him coyly, laugh and bite her lip. She quickly used interpretations, grabbing them, he tells us, before she could become engaged by their meaning. Bollas had various countertransference reactions. He found that he was reluctant to take her seriously, and was even tempted to laugh at some of the stories she related. She was not affecting him in any lasting way. Bollas says that he found her attractive and sensually appealing, and he began to realise thnl he was looking forward to the sessions for that reason alone. She would occasionally get enraged at his not understanding her, and he would indeed feel guilty as he felt he had not been taking her seriously, but consoled himself with the thought that he was proceeding analytically and that there was nothing more that he could have done. She was attractive and knew it, she was communicating through the senses, and luring him away from reflection on her internal life. But this sensational discourse undermines true communication. The language of the body is a substitute for emotional thinking. Bollas sensed that he was dreading her intense need, refusing her access to his internal world. He wanted rid of her. Why had this happened? She began to talk about her mother who was an enormously self-preoccupied woman wanting very much a social recognition, wanting her daughter to appear respectable. Jane could only make contact with her when Jane was acutely distressed or very angry, or when she could entertain her mother or amuse her. Otherwise her mother would not listen, and she recalled her often walking away when Jane was about to say something important about how she was feeling. In the transference, Bollas says he was being coerced into a maternal outline, being forced or nearly forced into being her maternal introject. She procured her mother by being a spectacle, by relating through coercion. It is this aspect of Jane's relationship to her mother that Bollas was registering in his countertransference feelings. Therefore, it is the analyst’s capacity to think and reflect on his countertransference that introduces into the analytic space, for potential use, an ego function that transforms raw sense data and affect into reflective thought.      Then there is the controversial question of the direct use of the countertransference. Should the analyst describe his own experience as an object in the session, should he communicate this to the patient? Bollas gives an example of a patient whose long pauses in her discourse had the eventual effect of making the analyst bored, tired, irritable and sleepy. He felt now that some aspect of the patient's mental life was in him. Her previous analyst had made frequent interpretations, and he wondered for some time whether or not this was the cause of her long pauses. She was waiting for him to interpret? He proceeded to communicate his countertransference feelings, telling her that her pauses left him in a curious state, in which he lost track of her, and it seemed as if she was trying to create some sort of absence that he was meant to experience; she seemed to disappear and reappear without announcement. The patient was relieved when he spoke up for his subjective state. By presenting this "subjective scrap" into the analytic space, he had given this patient back something of herself, and she was later able to go on and report how other-worldly and distracted her mother had been — only ever relating to a small part of her during childhood, leaving her to live through her childhood in secrecy and in dread of her true self (Bollas, 1987, pp. 211-213).       Bollas sees the analytic interaction as something which is half known but not properly thought about. He calls this the "unthought-known". The analyst's communication of the countertransference can be helpful, provided that it is not a direct expression of affect. He says the analyst's relation to the unthought-known must be thoughtful, waiting in uncertainty for the core significance of the material to be discovered.       D. Summary       What has been advanced here is the value and the risk of the analyst's being open to the full range of feelings evoked in the analytic setting. She more often than not will remain silent, not communicating these feelings, but holding them, containing them to be thought about, during and after the session, and in supervision. To repress, deny or ignore these feelings can only impoverish the psychoanalytic process.       The question is, whose feelings are these? And of course they are our feelings, part of our own history, and must be scrutinised as such. But instead of becoming anxious and phobic about this realisation and withdrawing, and becoming defensive with the patient, and so on, we must also realise that these feelings might be hidden communications from the patient, and that to miss these (because we are caught in our own anxieties) is to repeat for the patient her own unempathic early object relationships.       In this way of thinking, the analyst is continually monitoring her own spontaneous feelings and phantasies in relation to the total presentation of the patient, and through her own freely associating thinking (amidst confusion) may be able to offer some formulations, something Other, something new and different from the patient's "unthought known".       References: Balint, M and Balint, A. (1939) "On Transference and Countertransference" in Balint (1965), Primary Love and Psychoanalytic Technique. Tavistock Bion, W. (1959) "Attacks on Linking", in Second Thoughts (1967), Maresfield, 1987. Blake-Cohen, M. (1952)  "Countertransference and Anxiety", in Wolstein, 1968, pp 64-83. Bollas, C. (1987) The Shadow of the Object, London: Free Association Books (FAB). Bollas, C. (1989) The Forces of Destiny, London: FAB. Coltart, N. (1986) "Slouching towards Bethlehem... or thinking the unthinkable in psychoanalysis", in Kohon, ed., The British School of Psychoanalysis: The Independent Tradition, FAB. Epstein, L. and Feiner, A. (1979): "Countertransference: The Therapist's Contribution to Treatment", in Wolstein (1988). Freud, S. (1912-1916) Papers on Technique, in S.E. 12. Hogarth. Greenson, R. (1967) The Technique and Practice of Psychoanalysis, Hogarth. Heimann, P.  (1950) "On Countertransference", in Heimann (1989) About Children and Children No Longer. Routledge. Kernburg, O. (1965) "Notes on Countertransference", Journal of the Am PA Assn. 13: pp. 38-56. Kahn, M (1974) The Privacy of the Self.  Hogarth King, P. (1978) "Affective responses of the analyst to the patient's communication", IJPA 37: pp. 360-66. Klauber, J (1981) Difficulties in the Analytic Encounter, F.AB. Klauber, J. (1987) Illusion and Spontaneity in Psychoanalysis, FAB. Klein. M. (1946) "Notes on some Schizoid Mechanisms", in Melanie Klein: Envy and Gratitude & Other Works 1946-1963, pp 1-24, Delta, 1977. Lacan, J. (1953) "The Function and Field of Speech and Language in Psychoanalysis", in Ecrits, pp.30-113, Editions du Seuil, 1966. Trans by Alan Sheridan, Tavistock, 1977. Little. M. (1951) "Countertransference and the Patient's Response to it", in Little, 1986. Little, M. (1957) "The Analyst's Total Response to his Patient's Needs", in Little, 1986. Little, M. (1960) "On Basic Unity", in Little, 1986. Little, M. (1986) Towards Basic Unity, FAB. Milner, M. (1952) "The Role of Illusion in Symbol Formation", in The Suppressed Madness of Sane Men, Routledge Money-Kyrle, R. (1956) "Normal Countertransference and some of its Deviations”. IJPA. 37: 360-366. Racker, H (1953) "The Countertransference Neurosis", in Racker 1968, pp. 105-126 Racker, H. (1957) "The Meaning and Uses of Countertransference", in Racker 1968, pp. 127-173 Racker. H.  (1968) Transference and Countertransference, Maresfield Library. Karnac, 1985. Rayner, E. (1990) The Independent Mind in British Psychoanalysis, FAB. Reich, A. (1951) (1960): "On Countertransference", IJPA 32: pp. 25-31. Reich, A, (1960) "Further Remarks on Countertransference", IJPA. 41: pp. 389-395. Sandier, J., Dare, C., Holder A. (1973) The Patient and the Analyst, Karnac (1979). Searles,H. (1958)"The Schizophrenic's Vulnerability to the Analyst's Unconscious Processes", in Wolstein 1988, pp.202-224 Sharpe, E. (1930) "Certain Aspects of Sublimation and Delusion", in Sharpe (1950), Collected Papers, Hogarth. Sharpe, E. (1947) "The Psychoanalyst", IJPA 28: pp. 1-6. Spitz, R. (1956) "Countertransference: comments on its varying role in the analytic situation", in Journal of Am PA Assn. 4: pp. 256-265. Winnicott, D. (1947) "Hate in the Countertransference", in Through Paediatrics to Psychoanalysis, Hogarth (1958). Winnicott, D. (1969) "The Use of an Object", in Playing and Reality, Tavistock (1958). Wolstein, B. (1983) "Observations of Countertransference", in Wolstein 1988, pp. 225-261. Wolstein, B. (1988) Essential Papers on Countertransference, New York University Press. Top            Notes on WINNICOTT.   ‘There is no such thing as an infant’ (M, p39n, derived from Freud comment, SE. 12:220). Analysed by James Strachey and Joan Riviere. Supervised by Melanie Klein. Paediatrician and child psychoanalyst. Independent group analyst. Psychosis and neurosis are “environmental deficiency diseases”. Illness is inhibition of potential spontaneity and bodily aliveness, of feeling real, all this belonging to the “true self” but the true self is ultimately unknowable and incommunicado (M, p179). O-R theorist: it is not so much pure instinctual satisfaction that makes a baby feel real, but the enrichment of the drives provided by maternal care that counts. (see PR, p116). During the analysis of the psychotic, the analyst is in the position of the mother of the newborn infant, feeling love and hate, not so  much “representing” the mother but actually being her, so that development can re-start, having been put on hold during infancy and maximal dependence. Similar, the couch does not represent the mother’s lap, but rather is the mother’s lap. This is not a sentimental theory as Winnicott understands the importance of the negative, for instance, “hating objectively” (P, p200) in response to ruthless demand (primitive love) of the infant (Winnicott give a long list of reasons why a mother hates her baby), as well as the analyst’s hating of the patient in the countertransference with borderline and psychotic patients. ‘It seems to me doubtful whether a human child as he develops is capable of tolerating the full extent of his own hate in a sentimental environment. He needs hate to hate. If this is true a psychotic patient in analysis cannot be expected to tolerate his hate of the analyst unless the analyst can hate him’ (p, p202). Even, Winnicott suggests that, ‘adaptation failures [during early development] have value in so far as the infant can hate the object’ (M, p181).   Analysis is not just about sexual desire, it is also about emotional nurture. The child of the depressed mother, perhaps un-nurtured, lives “reactively”, because the mother uses the child to sustain something in herself. After WW2 and the evacuation, British psychoanalysis was concerned with, a return to mother (perhaps, not so much a return to Freud!). Aim of analysis: vast extended history-taking with therapeutics as a by-product! (M, p132); towards a richly alive experiencing (protecting privacy of self), re-establishing continuity of being, being able to live in one’s own unique non-compliant way, with the ‘capacity to be alone’ (M, p29), being able to make an environment ‘one’s own’. Winnicott was against analysis as, an impinging mother/indoctrinating-technique-oriented (Kleinian) analyst. Analysis is only facilitating a natural developmental process towards life (FID, p107). If a prospective patient interests the analyst in some way, he can be helped, no matter how great the pathology (see Masud Khan, in HI, p1). All depends on the analyst’s commitment/engagement. ‘I represent the reality principle…I am nevertheless a subjective object for the patient’ (M, p166). The analyst always learns from the adult psychotic. Where the infant id was; there must mother's ego be. This is a question of ego-relatedness. Fear of breakdown in maturity is fear of what has already happened in infancy (M, p139) – psychic death (“primitive agony”), the intolerable absence of the mother beyond a certain point (PR, 115) (see also International Review of Psan. Vol(1), 1974).    Three post-natal developments. See: ‘Primitive emotional development’ (P, p145f and HN, Part 4, p99f). ‘Baby as an immature being all the time on the brink of unthinkable anxiety’ (M, p57) 1) Integration: unintegration with unconnected feeling states and maternal holding in body and mind. (see M, p49).  ‘Primary maternal preoccupation’ (P, p300-305), the potential for intimacy with her infant (like an illness) prepared for during pregnancy with total adaptation at first to absolute need.  Baby is swaddled, held, kept warm, bathed, rocked and named leading to integration – at times the baby comes together and feels something. Spontaneous gesturing and the primary illusion of omnipotence. The infant is God (in Lacanian terms the infant is the special object of desire - Phallus). The infant hallucinates the breast and the mother presents, at the same moment! ‘The breast is created by the infant over and over again out of the infant’s capacity to love or (one can say) out of need. A subjective phenomenon develops in the baby, which we call the mother’s breast. The mother places the actual breast just there where the infant is ready to create, and at the right moment’ (PR, p11). Leads gradually over time to a localising the self in the body – psycho-somatic partnership – sense of aliveness (P, p244) and coordination.  Phantasy is prior to reality. Also, at the other extreme from illusionment, are the acute id-experiences. Without “ego-relatedness”, intimate rapport, the infant experiences his desire as an overwhelming assault. Rapport makes (urgent) desire bearable. The infant discovers the world by first creating it. The mother makes what is in fact a dialogue between her and her infant appear to him as a monologue born of his own desire.  Phantasy is progressively enriched by the world’s riches, which create in turn the desire to anticipate through increasingly sophisticated hallucination that new reality. Next time, the phantasy will include details of smell, taste, touch, etc., leading to greater enrichment. ‘In this way he starts to build up a capacity to conjure up what is actually available. The mother has to go on giving the infant this type of experience. The process is immensely simplified if the infant is cared for by one person and one technique…not by several nurses’ (P, p153). If there are different mothers, reparative gestures are inhibited and ‘the destructiveness that is basic in human relationships’ becomes inhibited (HN, p72).  What this amounts to is the notion of a “Primary psychical creativity”.  Opposite to Freud’s theory of creativity via sublimation of  repressed sexuality, and Klein’s reparation in the depressive position.   The mother is split into the “Environmental mother” (caring activities) .v.  “object mother” (exciting/erotic to be attacked). In pathology, the object mother is split: to one half the infant “relates” in a false compliant way; to the other half the infant relates to a subjective object, ‘being scarcely influenced by an objectively perceived world. Clinically, do we not see this in autistic rocking movements?’ (M, p183).      Unintegration as relaxation (a resource) .v. disintegration (a terror) as active chaos (PS), as a primitive defence against failure of care (M, p61). Reactivity (literally hyperactivity, figiting, excessive motility) to impingement can be so great as to interrupt continuity of Being.  Mother must be able to contain primitive ruthlessness (see “pre-ruth” below). Mother does not require infant, at the beginning, to distinguish between “me” and “not-me” experiences. The “transitional object” is the first not-me possession. Reality, on the other hand, as radical “not-me” (Other), is referred to by Winnicott, as an “insult”. Therefore, reality must be dosed. 2) Personalisation:  instinctual experience plus continued quiet experiences of body-care, enables the coming into being of a person, via the aggregation of “ego-nuclei” (Glover), psyche-soma integration, the being in the body.  The breast is fit for attack and the mutually lived (erotic) experience (See FID, p152) which enriches both mother and baby, both feeling fully alive. One’s person is located in one’s body, “in-dwelling”. Projective and introjective interaction continues with the not-me (M, p61. useful diagram, HN, p73). De-personalisation is a possibility, in deep sleep, in a “prostration attack” – “She’s miles away” (P, p151). Dissociations are common: between dreams and awakening; between enjoyment and screaming; between sanity and madness. 3) Realisation:  Time and space and the properties of reality. The transition from 'object-relating' (fusion, subject as isolate) to 'object-usage' (differentiation, involving a real object).  Progressive failure and the benefits of frustration.  Mother's failure can lead to regression to temporary fusion.  Forsaking omnipotence .v. impingement - narrow dividing line between the two.  With optimal frustration objects become real!  Two types of aggression: a) vigorous muscular movements and feeling real; b) rage at impingement – the protecting the true self.  Good destructive rage and the object (analyst) survives (object-usage).  Reality (out-there) is different from phantasy (inside) if the object survives.  Here there is a shared reality born of continuous destruction (in fantasy). ‘The point is that in fantasy thing work by magic: there are no brakes on fantasy, and love and hate cause alarming effects. External reality has brakes on it, and can be studied and known, and, in fact, fantasy is only tolerable at full blast when objective reality is appreciated as well’ (P, p153). From here to ‘the stage of concern’ (D-position), defended against by the manic defence (P, p129f), which is life as it is often lived without depth!   Winnicott is opposite to the classical view where reality is established by repression of impulse.     False self organisation – possibility of trauma and  disintegration and the psychotic defences. The protest against false self development is irritability, excessive motility, agitation, feeding and other disturbances. The false self (shell) protects the true self (core) at all costs. Compliance is the main characteristic, imitation, feelings of not existing. The false self is a collector of impingements to react to, and enables the individual to exist without being found.  The true self  is an essentialist notion without an essence! The true self cannot be described. It is only what the false self is not. The true self  ‘does no more than collect together the details of the experience of aliveness’ (M, p148), of spontaneous gestures, met repeatedly by the mother (M, p145). The true self feels real, alive in the body tissues and organs.  Analysis is about this: finding a way to exist as oneself, and have a self to retreat into for relaxation.  The mother as mirror: giving back to the child his own self (opposite to Lacan's misrecognition).   Three functions of the false self: in a restricted way it attends to (appears to complies with) the (m)other; conceals the true self; “caretakes” in place of the environment that failed.   Degrees of false-selfness:  1) At the most extreme: feeling unreal and futile, depersonalised. 2) False self replaces true self and seems real, but lacks in essentials. 3) False self tries to find the conditions (analysis perhaps) whereby the true self can safely emerge more.  4) Compromise between true and false self while knowing about the private self, not wearing one’s heart on one’s sleeve. Mannered social attitude, omnipotence foregone. (M, p140f). In intelligent/academic people, the false self can link with intellectualisation, dissociating the potentially unified psycho-somatic existence.   How does a child in the clinical situation use, play with, manipulate, rather than merely (falsely) adapt to his environment? How does the patient use his analysis? Some patient have to be taught how to use the analytic situation. The spatula game (P, p49) is emblematic (like Freud’s grandson: fort/da). Stage 1) The baby thinks about picking up spatula, there is a ‘period of hesitation’ which continues for a time, then 2) active desire for the spatula, plus salivation, puts it in mouth, chews pleasurably, bangs it on the table, confident and alive, plays at feeding, 3) drops spatula, as if by mistake, enjoys dropping it. Eventually loses interest. Key point: forcing the spatula in stage (1) leads to screaming. The period of hesitation is crucial. Transitional space (and time). ‘We experience life in the area of transitional phenomena, in the existing interweave of subjectivity and objective observation, and in the area that is intermediate between the inner reality of the individual and the shared reality of the world that is external to individuals’ (PR, p64).  Dream and fantasy: fantasy is an omnipotent dead end, whereas the dream, ‘ha[s] poetry in it…layer upon layer of meaning related to the past, present and future, and to inner and outer…’ (PR, p35). The transitional object stands in for the breast; it antedates reality-testing; infant relinquishes to some degree omnipotent control to manipulation involving muscle erotism and ‘cordination pleasure’; must never change unless changed by the infant; survives intense loving and hating; may develop later into a fetish; may stand for faeces remaining smelly and unwashed; derives from an internal object that is alive and good enough and therefore must continue to seem to be alive and give warmth. (see PR, p9).   The antisocial tendency is present in all character disorders concealed in various ways.  It arises as a result of a break in the infants on-going beingness – de-privation. (P, p306). More generally, Winnicott does not see aggression as necessarily pathological. Rather he see it positively, as ‘evidence of life’(M, p127), especially when it is fused with the erotic life. Unfused, left outside, it appears as destructiveness, non-relational and senseless, maybe erotized aggression – sadism, masochism. ‘Many infants have a massive aggressive potential that belongs to reaction to impingement’ (P, p217). The erotic needs aggression (unlike Freud and Klein with their notion of an eternal clash between life and death drives). Oral sadism is not “meant” as cruelty, it is part of pre-ruth aggressive primitive loving (P, p210). No hate intended, it is more like careless loving, a stage of unconcern. Later (during integration) hate (one can use this term now), anger and the “stage of concern” or ruth (D, see HN, pp69-83).  The erotic seeks the object, as merged, not necessarily experienced as other (subjective object), whereas as the aggressive component attacks the object and requires opposition and otherness (objective object), in order to feel real, different, to feel really alive, to feel creative (M, p26). Not Klein’s reparation, which might be a flight from creativity. Moving from pure subjectivity (primary illusionment) to virtual objectivity (disillusionment), whilst in between is the transitional space (me/not me) which will become the locus of all cultural experience. In relation to the superego, it is at its fiercest in early infancy (as per Klein). The mother figure must be present during the time that the infant/child ‘is accommodating the destructiveness that is part of  his make-up’ (up to 2 years), ‘she is repeatedly destroyed and damaged’ (M, p102) in fantasy, and loved in reality.   Mirror different to Lacan’s mirror. Not to be seen by the mother at the moment of spontaneous gesture is not to exist. She is the guarantor of his true self emergence, his being. ‘After being – doing and being done to. But first being’ (PR, p85). If she violates his initial omnipotence and forces him to see “her”, then he goes into hiding (false-self).   Psychoanalysis is understood as the play of interpretation and the provision of an environment conducive to growth, enjoyment and aliveness, sometimes beyond words, over and beyond the (rather limited) translation of the repressed unconscious. For the neurotic, psychoanalysis is making the unconscious conscious via the transference. For the psychotic, psychoanalysis is not so much about awareness, but ‘they do gradually come to hope to be enabled to feel real’ (HN, p60)…a struggle to reach a life…to begin to live (HN, p80). Here Winnicott is speaking to a patient, but it sums up his approach to analysis: ‘All sorts of things happen and they wither. This is the myriad deaths you have died. But if someone is there, someone who can give you back what happened, then the details dealt with in this way become part of you, and do not die’ (PR, p61). Masud Khan refers to the analyst as a witness. Sociability predates language. Rapport, meeting, merging, relating, attending, but not impinging. Ego-support may be essential early on in the analysis. Not too much silence, because that could signal omniscience, i.e. ‘I retain some outside quality, by not being quite on the mark – or even being wrong’. (M, p167). Maybe one interpretative theme per session if the patient’s unconscious has provided the material. Aim to be just “good-enough”. Playing stops when one of the participants becomes dogmatic/coercive – the analyst, for instance, knowing too much (adhering to closely to a taught technique). Playing is the process of finding through pleasure what interests you. To the analyst, he says: ‘If only we can wait, the patient arrives at understanding creatively and with immense joy, and I now enjoy this joy more than I used to enjoy the sense of having been clever’ (PR, p86). Winnicott privileges privacy and reticence against interpretation and ‘we can understand the hatred people have of psychoanalysis that has penetrated a long way into the human personality, and which provides a threat to the human individual in his need to be secretly isolated’ (M, p187). The danger comes when the analyst changes from being a subjective object to becoming an objective object. Winnicott lists three types of communication: forever silent but connected to being alive and very personal (involving subjective objects); explicit indirect and pleasurable communication (via language) protecting the privacy of the self; finally, an intermediate form that slides out of playing into cultural experience (M, p188). How to remain isolated without being insulated (autistic). Hide AND seek (‘a joy to be hidden, but a disaster not to be found’). One task is (in adolescence, in particular), is ‘the establishment of a personal technique for communicating which does not lead to violation of the central self’ (M, p190). ‘[W]e are always starting again, and the less we expect the better’ (PR, p37) After talking about having a depressed mother, Winnicott says the task is: ‘to be alive and to look alive and to communicate being alive…the enjoyment of what life and living may bring. To be alive is all. It is a constant struggle to get to the starting point and to keep there’. (M, p192).   References. M…The Maturational Processes and the Facilitating Environment. Studies in the Theory of Emotional development. London. The Hogarth Press and the Institute of Psycho-Analysis. 1965. P….Collected Papers.Through Paediatrics to Psycho-analysis. London. Tavistock. 1958. PR...Playing and Reality. London. Tavistock. 1971. HI…Holding and Interpretation. Fragment of an Analysis. The Hogarth Press and the Institute of Psycho-Analysis. 1986 FID..The Family and Individual Development. London. Tavistock. 1954. HN...Human Nature. London. Free Association Books. 1988. See also Adam Phillips. Winnicott. London. Fontana Modern Masters. 1988.