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PSY71 - Transference & Countertransference 2

PSY71 - Transference & Countertransference 2 -...

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Unformatted text preview: mmmmmnmnnmamnmsw t - (1935) int. J. Paycha—Anal., 76595-709 Analysing Forms Of Allure-noes And Deadnnss Of The Tranaferance-Countertranafcrnncc Thomas H. Ogden ‘33 The same of alivertess and deadness ofthe transference—cotmtertrahsference represents a critical dimensieri of the anahitic experience and may he the single most important measure ofthe mament-lO-«mflmdflf stems ofthe analytic process. In this paper the author presents four clinical discussions that illustrate the importance of analysing the experience ofaiiueness and deadness in (oil the tramfirenceconntertransference. In each vignette particular emphasis is placed on the use oftransfirence interpretation derivedfi'om experience in the coflntertrartsfierence to address the defensive and expressive role of the obliterate movement ofali‘veness and deadhess at a given juncture in an analysis. The role pirated by the experience ofaliveness and clearances in the structure ofthe patients internal object workload quality of object relatedness is examined. We 'll hunt for a third tiger now, but like The others this one too will be aform Ofwltat I dream, a structure ofwords. and not The flash and bone tiger that beyond all myths Paces the earth. 1 know these things qaite well, Yet nonetheless some force keeps driving me In this vague, unreasonable, and ancient guest. and I go on pursuing through the hours Another tiger, the beast hotfouncl in verse. The Other Tiger. l. L. Borges, 1960. I have become mamasingly aware over the past several years that the sense of alivcness and dcadness of tho nansfcrencc-conntcrn‘ansfcrcncc is, for me, perhaps the single most important measure of the moment—to-monlcnt status of'thc analytic process. In the course of four clinical discussions, I shall explore the idea that an essential element of analytic technique involves the analyst‘s making use of his cchricncc in the oountcrn'ansfcrcncc to addrcss specific expressive and defensive roles of the sense of alivcncas and dcadness of the analysis as wall as the particular function ofthcse qualities of experience in the landscape of the patience internal object world and object relationships. From this. perspectiVe, the problems of central concern to analyst and analysand tend to focus increasingly On such questions as: when Was the last time the analysis felt slim to both participants; is there a disguiacd vitality that cannot be acknowledged by analyst andlor analysaud for fear ofthe consequences of its recognition; what sorts of substitute formations might be masking the lifelessncss of the analysis, tag. manic excitement, perverse pleasure, hysterical acting in and acting out, ins-if constructions. parasitic dependence on the inner life of the analyst, and so on? The ideas that I shall Present are based in large part on Winnicott‘s (1971) conception of the ‘placa whcrc We WARNING! This text is printed for the personal use of the oWncr ofthc PEP Archive CD and is copyright to the loomal in which it originally appearcd. It is illegal to copy, distribute or circulate it in any form whatsoever. livo’ (a third area of experiencing between reality and fantasy [195 1}) and the problems invoiVed in generating such a ‘place’ (intetsubjcctive state of mind) in the analysis. I am also drawing heavily upon Bion‘s (1959) when that the analyst/mother keeps alive, and in a sense brings to life, the analysand‘s/infant's projected aspects of self through the saccessfiil containment of projective (MS. received June 1995) Copyright fl Institute of Psycho—Analysis, London, 1995 -695« identifications. Symiugton's (1983) and Coltart's (1936) discussions of the analyst‘s freedom to think represent important applications to analytic technique of the work of Bion and Winnicott. Green (1983) has made a pivotal contribution to the analytic understanding oftho experience of deadness as an early internalisation of the unconscious state of the depressed mother. A great deal has been written in recent years about the importance of the analyst‘s ‘reainess‘, i.e. his capacity for spontaneity and freedom to respond to the analysand from his own experience in the analytic situation in a way that is not strangulated by stilted caricatures of analytic neutrality (see for example, Bollas, 1987; Casement, 1985; Meares, 1993; Mitchell, 1993; Stewart, 1977). As will be clinically illustrated, my own technique rarely includes discussing the countertransference with the patient dirscrhi. Instead, the countertransferencel is implicitly presented in the Way I conduct myself as an analyst, for example, in the management of the analytic frame, the tone, wording and content of interpretations and other interventions, in the premium that is placed on symbolisation as opposed to tension-dissipating action, and so on. i shall attempt to develop several ideas having to do with technical problems involved in recognising, ‘symbolising and interpreting the sense of aliveness and deadness of the analytic experience. I believe that every form of psychopathology represents a specific type of limitation of the individual‘s capacity to be fully alive as a human being. The goal of analysis from this point of view is larger than that of the resolution of unconscious intrapsychic conflict, the diminution of symptomatology, the enhancement of reflective subjectivity and Self—understanding, and the morease of sense of personal agency. Although one‘s sense ofheing aliVe is intimately intertwined with each of the above—mentioned capacities, I believe that the experience of aliveness is a quality that is superordinate to these capacities and must be considered as an aspect of the analytic experience in its own terms. The focus of this paper is clinical. My effort will not he to define psychological aliVeness and deadness or even to attempt to describe how we determine whether, or to what extent, a giVen experience has the quality of aliveness or of deadness. It is not that these questions are unimportant. Rather, the host way I new of addressing these questions is to discuss clinical situations that I believe centrally involve these qualities of experience and to hope that the descriptions themselves convey something of a sense of the ways in which aliVeness and deadness are consciously and unconsciously experienced by analyst and analysand. In the four clinioal discussions of forms of psychological aliveness and deadness that follow, particular attention is paid to the ways in which countertransference experience is utilised in the process of creating analytic meaning, i.e. in the process of recognising, symbolising, understanding and interpreting the'leading h'ansference-countern'ansference anxiety. In the first clinical discussion, I will present {pigments ofan analysis in which the patients sense of deadness could not initially be symbolise-d and instead Was enacted (entombcd) in the lifelessness of the analytic eitperience WARNING! This text is printed for the personal use of the owner of the PEP Archive CD and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever. itself. The focus of this discussion will be on the use of the counter-transference to generate verbal symbols that are eventually offered to the patient in the form of interpretations. Ms N, a highly successfirl civic leader, began analysis because she felt intense, but diffuse anxiety and believed that something was seriously wrong in her life, but did not know what it was. In the initial meetings the patient did not seem to consciously eXperience feelings of emptiness, futility or stagiation. She said that she felt at a loss for wards, which was 1 I use the term counterrmnrrerencs to refer to the analyst's espedence of and contribution to the transference-counterb'ansference. The latter term retars to an unconscious lntersubjectiVe construction generated by the analytic pair. i do not view transference and countertransference as separable entities that arise in response to one another; rather, I understand these terms to refer to aspects ofa single hitersubjective totality experienced separately (and individually) by analyst and analysand. v 696i - something that: was highly uncharacteristic of her. The first year and a half of analysis in many ways had the appearance of a satisfactory beginning. The patient was able to see more clearly the specific ways in which she kept people (including me) at a great psychological distance. There was also some decrease in anxiety, which was reflected in the patient‘s increasingly less rigid body posture on the couch. (For ahnost a year, Ms N had lain completely still on the couch with her hands folded on her stomach. At the end of the meeting, thepatient would bolt fiom the couch and briskly leave the room without looking at me.) The language the patient used was initially equally stiff and often sounded textrblookish. Her speech pattern became somewhat more natural in the course of the initial year of work. However, the patient throughout this period had profound doubts about whether the analysis was of ‘any real value’ to her. Ms N felt that she was developing no greater understanding of either the source of her anxiety or of her sense that things were not right in her life. In the course of the first half of the second year of Work, I gradually developed an awareness of the way in which the patient Would fill the hours with apparently introspective talk that did not seem to develop into elements from which further understanding or interpretation could be generated. A pattern developed in the hours in which Ms N would describe events in her life in minute detail. It Was not at all clear what the point of the lengthy descriptions was. At times, lwould say to the patient that I thought that she must be very anxious that I Would learn too much about her if she helped me to understand the significance of what she had just said. I found that I esperienced increasingly less curiosity about thepatient, which absence had quite a disturbing effect on me. It felt equivalent to losing the use of my mind. I euperienced a form of claustrophobia during the hours and on occasion defended against this anxiety by obsessionally counting the minutes until the hour would be over. At other times, I fantasised ending the hour prematurely by telling the patient that I was ill and needed to end the session. I Would sometimes ‘pass the time’ by connting the beats per minute of my radial pulse. I was initially unaware that there was anything odd about my taking my pulse despite the fact that this is a practice that has never occurred with any other patient. As the thoughts, feelings, and sensations associated with this activity Were occurring, they did not feel like ‘analytic data’. Instead, I eXperienced them as an almost invisible, private background experience. WARNING! This text is printed for the personal use of the comer of the PEP Archive CD and is copyright to the Journal in which it originally appeared. It is illegal to COPY, diatribute or circulate it in any form whatsoever. During the period of weeks that followed, I gradually became more able to near the taking of my pulse, as well as the associated feelings and sensations, as ‘analytic objects‘ (Bion, 1962; Green, 1975; Ogden, 1994a, d), in. as a reflection of an unconscious consn-uction being generated by the patient and myself, or more accurately being generated by the ‘intersubjective analytic Ihird'- I have discussed my conception of the ‘intersuhjective analytic third’ (or ‘the analytic third’) in a recent series of publications (Ogden, 1992a, b, 1994a, b, c, d). To summarise briefly the ideas presented in these publications, the inter-subjective analytic third is understood as a third subject created by the unconscious interplay of analyst and analysand; at the same tirne, the analyst and analysand qua analyst and analysand are generated in the act of creating the analytic third. (There is no analyst no analysand, no analysis, aside from the process through which the analytic third is generated.) The new subjectivity (the analytic third) stands in dialectical tension with the individual subjectivities of analyst and analysand. The intersubjcctive analytic third is not conceived of as a static entity; rather, it is understood as an evolving esperience that is continually in a state of flux as the intersubj activity of the analytic process is transformed by the understandings generated by the analytic pair. The analytic third is eXperieneed tluougli the individual personality systems of analyst and analysaud and is therefore not an identical experience for each. The creation of the analytic third reflects the asymmetry of the analytic situation in that it is created in the context of the analytic setting, which is structured by the relationship of roles of analyst and analysand. The unconscious experience of the analyst 459’?- is privileged in the analytic relationship: it is the experience of the analyssnd (past and present) that is taken by the analyst and analysand as the principal (although not fiXClUSiVB) subject of the analytic dialogue. I began to be able to link the experience of holding my own Wrist (in the act of taking my pulse) with what I. now suspected to be a need literally to feel human warmth in an effort to reassure myself that I was alive and healthy. This realisation brought with it a profound shift in my understanding of a great many aspects of my caperience with Ms N. I felt moved by the patients tenacity in telling me seemingly pointless stories for more than 18 months. It occurred to me that these stories had been offered with the unconscious hope that I might find (or create) a point to the stories thereby creating a point (a feeling of coherence, direction, value and authenticity) for the patient's life. I had previously been conscious of my own fantasy of feigning illness in order to escape the stagnant deadness ot‘ the sessions, but I had not understood that this ‘excuse’ reflected an unconscious fantasy that I was being made ill by prolonged exposure to the lifelessnsss of the analysis. It was through this and similar lines of thought and feeling (associated with my own experience in the analytic third) that l began to develop a sense of the meaning of the patient's diffuse anxiety and her sense that she was caught in something awful that she could not identify. I said to Ms N that I thought I understood better now some of the reasons for her telling me in great detail about events in her life in a way that made it confilsing to both of us why she was telling the story. I said that I felt that she had giVeu up on being able to create a life for herself. Instead, she was giving me the forms with which she had filled her time in the hope that I could create a life for her from these pieces. The patient responded by describing the way in which her life at work and at home consisted ahnoat entirely of organising other people‘s activities while neVer actually making anything herself. It now seemed to her that she used other people's lives and the things that they made (the lives of her employees, of her husband, her au pair, and her two children) as a substitute for her own WAMWGI This text is printed for the personal use of the owner of the PEP Archive CD and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoever. ability to create something that felt lflce a life of her own. Later in the sessiOn, she said that she had for a long time imagined that a paperweight on a table next to my chair had been a gift flour a patient. She said that she had never told me that she had even noticed the object, but that she had for a long time wished that she had given it to me. It was not until that moment that she realised that she had not imagined giving me a gift of her own, and instead had wished that she had given me that grfi. She could not envision herself as a person who could select, and in that sense create, a gift for me, so she imagined being someone else, the person who had given me the gift. I thought, but did not interpret at this juncture, that underlying this thought Was the fantasy that it would never be possible for her to create a life of her own so the only alternative available to her was that of stealing the life of another person. It seemed important that I should not usurp the patients opportunity to create life in the analysis (create interpretations) that she was now just beginning to be able to do. Several months later, Ms N presented a dreamt}: which she was in a cab inert in a kitchen that was not her own kitchen. It was as ifshe had been poured into the cabinet' and had become a rectangular cube the shape ofthe inside ofthe wooden from The dream was presented in conjunction with the patient‘s telling me about a fiend who lived with continual psychological pain in connection with the death of her 5—year—old daughter. The friend‘s child had been killed before the patient began analysis, in an accident that had resulted from the negligence of a baby-sitter. Afier telling me the dream, Ms N fell silent. This silence stood in marked contrast to the way in which she had in the past obscured feeling with excessive verbiage. After a few minutes, I said to Ms N that I thought that she was describing to me her sense thatshe lacked a shape of her onn. I went on to say that her friend's pain, however terrible, was a human feeling that I thought the patient feared she was incapable of experiencing. I told her that although she had never said so directly, I felt that she Was afraid that she might never » {598 - be able to feel anything, even the pain that others might feel about the death of their child. In a voice so faint that I could barely hear her, Ms N said that this had for a long time been a fear of hers about which she felt enormous shame. She had stayed awake many nights worrying that she would be unable to grieve if one of her own children were to die and that this felt to her to be the most odious failure of which any mother could be guilty. She said that she felt that she had not been able to love and be with her children in the way that she wished she could have been. In fact, she now knew that she had neglected them quite badly and that they had suffered greatly for it. The patient again fell silent for the remaining few minutes of the hour. To summarise, I View the portion of the analysis just discussed as representing the begirmings of a process in which the patient‘s experience of deadness (both in her imagined inability to grieVe and in her identification with her friend‘s dead child) was being u'ansformed from an unthinkable thing—in—itself (a fact eXpetiBnce-d by both the patient and myself as a non—verbally symbolised sense of deadness of the analysis) into a living, Verbally symbolised experience of the patients (and my own) deadness in the analysis. An intersubjective analytic space had begun to be generated in which the deadness could be felt, viewed, experienced and spoken about by the two of us. Deadness had become a feeling as opposed to a fact. WARNING! This text is printed for the personal use of the owner of the PEP Archive CD and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form whatsoeVer. .In this second clinical discussion, I shall describe an analytic encounter which illustrates technical challenges arising in conjunction with a patient's unconscious insistence that the analyst serVe as the repository for his psychic life and hope. I Mr D, in the initial interview, informed me that he had been in analysis six times and each time ‘had been terminated’ by the analyst. The most recent unilateral termination had occurred three months prior to Mr D's first meeting with me. The patient carried himself and spoke in a way that conveyed a sense of arro...
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