Feelings – Inside Out – Exploring the Life of the Mind

The Shape of Fear: on psychic voids and perilous black holes

This column also appears in the May/June, 2011; Volume 23, Issue 3 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT). Abstract page 74.

Abstract:

The capacity to use words and language as symbols of communication is a developmental achievement borne of the elegant and mutually regulating mother-infant dyad. This paper examines what occurs when emotional catastrophe compromises this sensitive process, and speech and words come to be used instead to defend against annihilation anxiety, dread and psychic “black holes” associated with primitive mental states. The perspectives of Bion, Ogden, Grotstein and Tustin are used in conjunction with case material to explore these early modes of self-other experience that might be construed as pre-object relations, as they are primarily sensory in nature. Consideration is given to the ways speech is used as an autistic object/shape engendering isolation rather than as a symbolic mode of communication promoting enhanced relationality and subjective meaning.

Language was the conjurer, indeed the philosopher’s stone, language was a form of alchemy. It was language that elevated meanness to the heights of art. Like the irritating particle that bred the nacre of the pearl, language ameliorated the gnawing irritant of existence; it interceded between the wound and the dream. Henry Roth

Laurie’s uninterrupted speech knocked me about like a strong wave slamming into an unwitting swimmer who has unwisely turned her back on the sea to gaze anxiously toward the safety of shore. She would commence speaking the moment she arrived in my consulting room and, if I didn’t intervene or attempt to interject a comment during the ensuing forty-five minutes, would continue until she departed. I felt intrusive if I intervened, invisible if I didn’t.

For months I looked for meaning in this verbal splatter, something elemental in her eruptions that I might transform and return as both useful and usable. I struggled to know her, tried to like her. Feeling superfluous, I was ashamed to find myself looking at the clock repeatedly during sessions and exceedingly relieved when they ended.

Conceptual imagery and word shapes

Taking shape in my mind, her speech appeared as meaningless glyphs, disenfranchised words comprised of loosely formed letters, their varied sizes and shapes barging forward or receding. Oblivious of the time frame, Laurie’s sessions began to seem endless, requiring gentle reminders to allow her ample preparatory time to reorganize herself and leave. Any specific reference to the separation anxiety associated with endings would evoke another gush of speech that was almost impossible to interrupt. I looked for the needy baby behind the noise.

Our sessions had no discernible beginning or ending, just an ongoing flood of speech. There were few thoughtful troughs between waves, just endless sets rolling toward shore across the surface of a vast sea of words flooding the room. For a long time, she and I were lost at sea. When she wasn’t speaking to me (or at me), she was talking on her phone, filling the waiting room with sounds that made me wince, and I felt violated by her incessant vacuity.

Collapsed psychological space

When we spoke on the phone, her compulsive speech would begin the moment I greeted her, regardless of the purpose of the call. Unable to differentiate between a formal phone session and a simple business-related call, she leaked words in a manner that suggested her inability to sustain any sense of foundational boundedness. She experienced words, thoughts and actual bodily contents as equivalencies and was unable to plug holes in her still rudimentary sense of self. As Odgen described, she was “creating a substitute for the space between mother and infant in which the infant ordinarily finds a place to live between self and other (Ogden 1989, p.66).

Desperate verbiage filled any potential space in which we might have engaged one another meaningfully. I felt like a theatrical prop that existed simply to absorb her bizarre recitation of the loosely associated and circuitous events of her life daily life, her errands and shopping excursions, her family irritations and interactions.

She would frequently wander through time leaving me to find links in the massive holes in her narrative. A present time reference to her sister in once sentence would shift decades in the next, the pronoun “she” no longer representing her sibling but her aunt. Why are you telling me this? I wondered. What are you really trying to tell me?

She buried me with words, and any attempt to proffer an empathic interpretation or comment was bulldozed with a quick nod and continuation of her monologue.

Any pause in her continuous production of words seemed to provoke terrible dread and annihilation anxiety. I began to dread her sessions with equal intensity. No psychological space (Heller 2010) existed in which she and I might engage. I frequently felt useless and unnoticed. Who failed to acknowledge you? I wondered. Who left you alone? Who couldn’t or wouldn’t speak your language?

Her capacity to utilize the creative potential of psychological space had collapsed like a weak lung, or perhaps a lung that had never filled. For many months, there was no space for me to offer anything other than my presence and willingness to be used as a container, an exogenous lung. I felt suffocated, as if the air were being sucked from the room and experienced uncomfortably deliberate urges to fill my lungs to capacity and inhale great breaths of air.

I was to learn eventually that she had sustained a collapsed lung following a childhood accident, so the lung imagery that arose in the analytic third (Ogden 1994) during moments of reverie* were salient and permitted me to begin to comprehend and decode what she was broadcasting unconsciously.

Behind this blinding white water spew of distraction, I found that for a moment, I could grasp the sand with my toes and withstand the currents. I listened and attended to her pressured and compulsive speech as if I were caring for a screaming infant. Using a soothing and modulated tone of voice and carefully paced speech as swaddling, I began to open a small space in which we might initiate and share a relational exchange.

The importance of learning from experience

The repetitious nature of her narratives signified her inability to build upon her own ideas and thoughts or upon the co-constructed foundations of shared interpersonal moments. She would repeat what appeared to be almost scripted sequences again and again, as if she’d never spoken them and I’d never heard them. Each narration was isolated and unlinked to any other. She could not make use of earlier versions to work through, learn from or adapt subsequent renditions.

From a Bionian object relations perspective, Laurie could not think with her thoughts (Bion 1962.) They functioned as impulses to speak, nothing more.

Her proto-thoughts existed as beta elements (Bion 1962), sensory bits that had yet to be symbolized and transformed by alpha function and language into meaningful ideas upon which she and I could build. Paradoxically, Laurie used words not as symbols of communication but as protective amulets to avoid a dark psychic void, a whirling vortex of nonbeing from which she feared she might never return. As her word waves crashed in, I felt the concomitant pull of dangerous rip tides.

Into the void

Psychic voids represent gaps and fissures in the emotional floor of an infant’s foundational and rudimentary sense of being that expand into gaping and engulfing black holes (Grotstein 1990). They signify the reverberations of an emotional catastrophe (Tustin 1981) between mother and infant, precipitating what the young child experiences as an endless free-fall in unbounded space.

Despite her mother’s actual presence, Laurie’s needs exceeded what her distracted mother was able to provide. Lacking adequate maternal protection and containment, Laurie was left to manage confusing and frightening sensory experiences without the aid of her mother, the one person who could symbolize, interpret and transform them into meaningful psychic structure. Instead, Laurie’s inner landscape was filled with dangerous sensory-affective potholes into which she feared she might trip and fall forever. She defended against these terrifying threats of annihilating engulfment by filling the holes with meaningless noise and word-spackle.

The autistic-contiguous mode of experience

Evidence of this ancient catastrophe was manifest in Laurie’s default defenses and select mode of experience that reflected presymbolic and sensory rather than more fully mentalized object relations, consistent with what Ogden (Ogden 1989) designated the autistic-contiguous mode of experience.

Lacking a psychological skin (Tustin 1994), Laurie used words as palpable, sensory objects to scab over her flayed emotional self.

While repetitious speech defended against perilous psychic voids, it preserved her stasis in isolation and precluded any viable relational connection. Like an insect preserved for eons in amber, Laurie was frozen in time and continued to rely on the autistic-contiguous mode of experience with little variation and without the addition of more mature modes that would permit empathy, mutuality and relational engagement. Once after having learned coincidentally a fact about my personal life, she remarked, “We don’t usually talk about you, do we?” For a moment, she saw me not simply as an extension of herself but as a separate object with discrete subjectivity of my own.

Working in the transference-countertransference matrix

In response, I experienced potent sensory and somatic countertransference sensations, often feeling drowsy though not bored. Cringing was my strong response to feeling “tyrannized by an automaton” (Ogden 1989, p.44). I frequently felt as if I could “crawl out of my skin” or twitch out of my chair as I sat with her, tortured by her inane recitals until I realized that she needed to use my skin and body as a substitute for the psychic skin she lacked. To contain her unformulated and fragmented self, the beta bits she could not integrate or use, she was trying to burrow under my skin where she might feel shielded by its consistent surface.

And the word-shapes I perceived in reverie* were the autistic shapes (Tustin 1984) that constituted Laurie’s early object relations. These are sensory, felt “shapes” arising when an infant touches soft objects. Not yet perceived as separate, they represent the sensory edge of experience whereby warm and sensual contact objects such as bath water and skin or mouth and nipple are experienced by the infant as conjoined.

Surface contact is identified as a soft shape with its own mode of proto-object relations. This sensory position is operational throughout life but serves a primary function in infancy, preparing a baby to distinguish hard from soft, animate from inanimate, me from not-me. Imagine the contact friction where the surface of your skin meets the clothes you are wearing as a soft, warm shape representing conjoined rather than separate objects.

Long after the infant acquires the capacity to discriminate self from other and has developed more mentalized modes of experience, the autistic-contiguous mode remains her portal to tactile sensuality and sexuality. We might think of it as “regression in the service of sensation.”

My countertransference feelings of intrusiveness had their correlate in Laurie’s early life when she felt her infant self to be an unwelcome intruder in her mother’s world. My feelings of invisibility were linked to Laurie’s experience of herself as ignored and unacknowledged.

Evidence of premature separateness

Before she had acquired the capacity for self or object constancy and a subjective sense of individuality, Laurie’s infant self could only experience premature separateness as annihilating. Lacking an emotionally attuned mother to modulate and reflect her existence back to her with delight and joy, she felt obliterated.

To bridge the perilous gap between existing and not existing, Laurie made noise. If she didn’t intrude, she felt herself disperse and disappear into the ethers. Noise verified her existence. Though exiled, she was alive.

Laurie’s fall through space was as endless as our sessions often seemed. I tried to break her fall by acknowledging her sensory needs and bundling her in my psychic skin. She longed for contact, but had isolated herself behind an autistic, synthesized crust that seemed impossible to penetrate. Despite the endless topical speech, terrible feelings of isolation and meaninglessness (Grotstein 1990) permeated our sessions leaving me feeling drained and ineffectual.

Laurie’s inability to distinguish between major and minor, foreground and background, significant and insignificant suggested the severe degree to which her sensory-affective experience and nascent thoughts remained conjoined at the surface and undifferentiated qualitatively. What had originally begun as an early mode of sensory experience, a primitive awareness of self and object-other, had become a concretized and unyielding state in which she was rigidly stuck.

She would talk to a complete stranger just as she talked at me. Everyone existed to provide archaic psychological functions for her, all interchangeable heads. I was indistinguishable from a store clerk or gardener or anyone who would listen.

Autistic objects and shapes

Speech served several vital functions for Laurie. In addition to representing autistic shapes, she also used speech-words as autistic objects (Tustin 1980), sensory dominated object-things used in impersonal and idiosyncratic ways. Just as individuals with dementia will touch the surface of a nearby table or an edge of cloth as a means of sensory orientation, a feeble attempt to locate themselves in space, Laurie attached herself to objects at a sensory level, using relentless speech as adhesive. She used speech like sonar to locate herself in proximity to me. Speech conveyed painful affect not meaningful content. The significance of my empathic attunement was evident in her choice of words that suggested skin contact and sensation, frequently remarking that something I did or said “touched” her, though she rarely could articulate why.

Considered retrospectively, I am now aware of the frequency with which Laurie referenced geographic and personal space, using them as metaphors for terrifying sensory-affective experience and unmet needs. She would describe in detail aspects of the homes in which she lived as if she were describing physiological topography, using distance, walls and the impress of small rooms as autistic shapes and objects. Some rooms felt containing while others did not.

Laurie would occupy herself making mental “shapes” from the lines and holes on the acoustic ceiling tiles on the occasions when I was out of the consulting room and would describe them to me when I returned. I came to comprehend that these shapes were metaphors for early sensory experience that had never been symbolized. She was trying to construe something meaningful from the discrete self-states and events in her life that felt random and disconnected.

Young-Girl-Dreaming-FULL — Young girl dreaming

These “holes” were indicative of primitive mental states associated with sensory experience, particularly touch and the skin. She entered a very childlike state of reverie associated with bouts of childhood illness when she would lie feverishly in her bed and look for design patterns and shapes in the ceiling above her head. Neglected for long periods of time by a narcissistic and depressed and disengaged mother, she was left to make meaning of her sensory-affective experiences alone.

Making meaning of trauma and discontinuous self states

Having experienced little continuity of being, Laurie used word-shapes and objects to bridge holes in her discontinuous self states. Uninterrupted speech served a critical survival function. It prevented her entire sensory floor from falling away beneath her, pitching her into a dark sea or an engulfing black hole (Grotstein 1990).

Her torrent of words represented the only net she could use to defend against the terror of discontinuity and the nullifying anxiety associated with fathomless psychic voids. She chattered at the edge of a gravitational vortex she could not overcome any other way.

Instead of suggesting creative potentiality, psychic space (Heller 2010) threatened to devour or engulf her in a state of utter nonbeing. Unspeakable traumata were smothered in meaningless talk. Unless her discontinuous self states were tied together with word-strings, Laurie ceased to exist. Together we worked at the edge of meaning, trying to find symbols to represent unformulated experience.

Speech-noise represented the only girdle holding her together. She could use words like Lycra, but she couldn’t think with them. When I once asked who hadn’t cared for her, she stopped talking and wept.

As I began to comprehend her great need for foundational and sensory stability, we began to work at that level, using language that described her bodily and skin sensations in an effort to improve the quality of relatedness and transmute vowels and consonants into psychic scaffolding that might provide a reliably sturdy structure upon which she could rest. When she initiated a stereotyped recitation, I stopped her and shifted to affect and bodily sensations, and eventually, she began to say, “I feel…”

Using language to create ongoing and increasingly complex stories and narratives from her ceiling picture-shapes and beta elements, she began to acquire the capacity to forge links and symbolize her unformulated experiences rather than simply repeat isolated segments. Continuity and creativity began to replace abbreviated repetition.

Using my own thoughts, feelings and pictorial imagery as finely tuned instruments to track her unconscious communication in the intersubjective matrix, I learned to gauge her needs. We worked as alchemists, using alpha function to transform base words into meaningful language.

Every single moment of reflection or reciprocity constituted a decisive achievement, rising like a small island in an otherwise illimitable and unremitting sea.

By slowly symbolizing and linking Laurie’s experiences and self-states over time, using circles of communication (Greenspan 1997) to expand her capacities to both think and relate to me as a discrete other, we began to see a varied and enduring archipelago of meaning emerge from her sensory seabed and coalesce into psychic structure.

* Reverie: Bion’s (1962) idea describing the analyst’s state of receptivity to her patient’s unconscious experience that parallels a mother’s receptivity to her infant’s raw, asymbolic or pre-symbolic experience.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine and InsideOutJournal.com and is copyrighted by Mauri-Lynne Heller. It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Citations

Bion, W.R. (1962). Learning from experience. Classic Books. (Locale unknown)

Bion, W.R. (1962). The psycho-analytic study of thinking. International Journal of Psycho-Analysis, 43:306-310.

Greenspan, S (1997). Training conference, Anaheim, California.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the black hole Part I – the

importance of nothingness, meaninglessness and chaos in psychoanalysis. Contemporary Psychoanalysis, 26:257-290.

Heller, M.L. (2010). Working in psychological space Part I. The Therapist, volume 22/issue 3, March-April. Also posted online: Inside Out Journal at insideoutjournal.com

Heller, M.L. (2010) Working in psychological space Part II. The Therapist, volume 22/issue 4, May-June. Also posted online: Inside Out Journal at insideoutjournal.com

Heller, M.L. (2010) Working in psychological space Part III. The Therapist, volume 22, issue 5, July-August. Also posted online: Inside Out Journal at insideoutjournal.com

Ogden, T.H. (1989) The primitive edge of experience. Jason Aronson Inc., New Jersey, London, p.66.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75, pp. 3-19.

Roth, H. (1994). From bondage. Picador USA, New York, p. 77.

Tustin, F. (1980). Autistic objects. International Review of Psycho-Analysis, 7:27-39.

Tustin, F. (1981). Psychological birth and psychological catastrophe. In Do I dare to disturb the universe: a memorial to W.R. Bion, ed. James Grotstein, Caesura Press, 181-196.

Tustin, F. (1984). Autistic shapes. International Review of Psycho-Analysis, 11:279-290.

Tustin, F. (1994). Autistic children who are assessed as not brain-damaged. Journal of Child Psychotherapy, 20:103-131.

The Emotional Terrorist Part II

This column also appears in the March/April, 2011; Volume 23, Issue 2 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT). Abstract page 75.

Abstract:

This two-part series examines the psychological origins and antecedents of terrorism. Object relations, intersubjective systems theory and contemporary relational psychoanalytic concepts are used to define and highlight the constellation of specific dynamics implicated in terrorist enactments, particularly the ways they replicate salient interactive patterns of early mother-infant communication. This resonant, harmonic unit, characterized by interactive modes of touch, gaze and projection, establishes the creative sphere wherein an infant comes into selfhood and begins to develop nascent capacities for relationality, empathy and morality. Emotional terrorism begins when a mother is unable to contain and modify her infant’s projected anxieties or, in reverse, projects her own, initiating a repetitious cycle of terrorist-victim or “doer and done-to.” Clinical and cultural implications of sadism, the perversion of empathy, are also considered.

The Emotional Terrorist Part I examined the psychological origins and attributes of terrorist-victim dynamics and the defensive processes that drive repetitious enactments. It also explored the ways that sadism represents the perversion of empathy. The Emotional Terrorist Part II explores case material to further clarify and exemplify these dynamics.

Clinical examples

A patient arrived for a session shortly after experiencing a serious break-up and began by disparaging her lost love object. He was an idiot. I never really loved him, anyway. I’m better off without him. While these appraisals may very well have been accurate, they were also being used defensively to avoid abject feelings of jealousy, loss, loneliness and painful rejection. These intolerable feelings were more safely managed after being externalized, projected and relocated in the lost object where they could then be attacked.

Envy and rage are difficult to tolerate, even by psychologically developed individuals, as they activate unpleasant feelings of inadequacy, incompetency and shame associated with the helplessness of infancy and distasteful dependency needs, traits that conflict with subsequent developmental achievements.

Because these undifferentiated, “not-me” (Stern 2009) self-states are kept out of awareness defensively, they pose unbearable conflicts referred to as the “agony of consciousness” (Tustin 1986, p. 43) when they begin to emerge and are quickly dispatched before they can be sufficiently modulated or integrated. A state of non-experience is preferable to torment.

Preverbal pockets of early traumata and other unmetabolized self states can only be accessed or experienced initially by the therapist via non-linguistic modes of communication that rely frequently on unconscious projective processes (Ogden 1989).

As therapists, we decode or “read” patient projections by tracking ourselves in the intersubjective matrix of the transference-countertransference milieu, carefully attending to our own sensory reactions, feelings, observations, thoughts and reveries.

Following moment by moment shifts in affect, posture, gaze and relationality, we utilize our own means of empathic projection to access unconscious aspects of both self and other in the intersubjective field. In this dynamic mode, our simultaneous access to the derivatives our own unconscious processes that would otherwise remain out of awareness help us understand what has yet to be formulated and spoken.

The Alexithymic Patient

During the analysis of a deeply frightened patient whose early environmental failures rendered him unable to access even the most basic language that might enable him to identify or conceptualize his emotional states, I learned to recognize when we had hit a preverbal pocket because he would look at me helplessly and shrug. His episodic inability to give linguistic shape to the content of his affective self-states conveyed how he used the rapid dissociation of unformulated material to protect himself from terror and dread.

Successful in the trades, he and his wife assumed very traditional marital roles that required very little intimate communication, leaving them compatible but emotionally disengaged. He said his wife complained of loneliness. He didn’t know what she wanted. People hadn’t talked about feelings when he was growing up he often said. His narcissistic mother had filled him with her own projected terrors, leaving his early object world riddled with engulfing psychic voids (Grotstein 1990) rather than viable maternal representations that could be used to contain his feelings.

He had no inner mother on whom he might rely. What little paternal comfort he had was lost when his parents divorced and his father moved away.

Invisibility was his shadow companion, and he cringed away from interpersonal intimacy and avoided social gathering that made him feel “put on the spot.” He had sporting buddies but no real friends. Rather than reactivating the internalized warmth embedded in early modes of concerned relationality provided by empathic maternal attunement, his unacknowledged and unformulated (Stern 1999) feelings simply backed up and congealed.

He loathed his mother’s visits and spoke of her relentless self-absorption, how her endless talking bombarded him with palpable word-objects. There was no space for him, so he quietly endured her assaults until she left, leaving him “in peace.” Unable to recognize his dissociated and projected desires for intimacy in his wife’s requests for contact, he felt helpless as she enacted his desperate pleadings, giving voice to his wordless scream.

Our sessions were characterized by lengthy silences during which I functioned as the container for his disavowed self-states. He found these silences extremely embarrassing, frequently announcing that he wasn’t coming back again. I understood this to mean that the conflict posed by the emergence of unspeakable affective states into consciousness was intolerable, so the dissociated terrors remained selectively unformulated and desperately avoided.

Tracking my own subtle reactions, I was able to apprehend his unformulated and dissociated feeling states and sought to find symbols and words that might describe them. Once when talking about the drought, I shared my reverie of a quiet and pristine pool of water, describing his inner world as an aquifer waiting to be tapped. This was the first symbol he’d ever linked to what had always been an unnamed part of himself.

As we sought descriptive language together, his unspeakable and amorphous feelings of annihilation dread found an outlet in discourse, and he began to formulate his own emotional language and a concomitant capacity to depict his inner world. Congealed emotional terrors began to liquefy.

Spousal victim and victimizer

In clinical practice, we observe this terrorist dynamic of doer and done-to (Benjamin 2004) most floridly when working with couples.

Repetitiously terrorizing volleys might be construed as representing a game of hot potato with dissociated emotional projectiles and bad objects. Both “bad me” and “not-me” aspects of self states are launched back and forth like missiles. Disavowed and unformulated self-states are projected and subsequently attributed to the partner where they are more easily attacked. Affect often alternates between self-loathing and rage toward the partner.

The patient whose emotional fragility feels too dangerous and alien to claim, projects it onto his spouse. “She’s too emotional,” an emotionally blunted husband said of his wife. The nascent emergence of strong conflictual feelings threatened the cohesion and regulatory aspects of his self-image, activating unwelcome dependency needs that made him feel small, needs that chafed against his branding as an autonomous adult. So, he rid himself of conflict by projecting his needs, locating them in his wife and criticizing her. In turn, she attacked his remote implacability.

Rather than experiencing the full spectrum of their sensory-affective selves, they terrorized each other with projected aspects of self states that would otherwise pose intolerable conflict. Each spouse representing one half of a broken plate (Stern 2009), they enacted in turn invariable roles of terrorist and victim. Doer and done-to.

As therapists, we feel it most acutely when a couple closes ranks and directs its combined projective animus at us. You don’t care about me. This isn’t working. You’re only here for the money. Oh, I think we can talk to each other without you. Feelings of incompetence have been located within us, temporarily relieving a couple from experiencing the abrasive conflict required to resolve them (Stern 2009).

These feelings of incompetence that are experientially and dialectically incompatible with mastery can be evaded routinely by patient and therapist, compromising treatment, until the clinician is able and willing to examine conflictual aspects of her own “bad me” and “not me” self states first.

The clinical clue uncloaking a stealth projection of helplessness is a strong countertransference feeling of utter ineptitude. We must be able to claim our own “not-me” states of ineffectuality. If we disavow them, we have no option but to project them right back. Like a juggler with several balls in the air, we must take care not to throw them.

Children and families

Projective dynamics are a bit more complex when working with children and adolescents. Just as our therapeutic relationships begin to bear fruit and an attachment has been formed, the parents may pull the child from treatment, proffering transparent and superficial excuses. Some affluent parents would actually prefer that we believe they are impoverished rather than frightened. The Container-contained dynamics (Bion 1962) have been reversed, and the child is serving a psychological function that the parents will not relinquish.

The emergence into consciousness of their inner terrors would elicit unmanageable and threatening psychic conflict. Therefore, any therapeutic effort to return projections to their rightful parental owners will be resisted to maintain the homeostatic benefit of selective avoidance.

Paradoxically, enduring change and growth require a willingness to tolerate in titrated doses the anxiety-provoking affective experience and self-states so strenuously avoided.

A patient I’d seen for many years, arrived for her appointment one afternoon and told me a remarkable story about a dinner conversation she’d recently had with her mother, a very anxious woman prone to massive denial. My patient, a skilled sailing enthusiast who was very comfortable in the water, had experienced intermittent but recurrent nightmares about being engulfed by tidal waves since childhood.

Red-Boat-with-Blue-Sails-FULL — Red boat with blue sails

While sailing, she often experienced intrusive and distressing images of being tossed from a sinking ship into turbid and roiling seas with nothing more than a flimsy kickboard for support, ostensibly to swim for help as her mother clung to the ship’s railing helplessly. While we explored this imagery thoroughly, we could never quite plumb it to the psychological seabed satisfactorily. Something elemental always seemed to be absent. Her mother provided the missing link.

Having dinner together in a seaside restaurant with a lovely view of the bay and its sleek boats, her mother casually remarked that she’d experienced recurrent nightmares about tidal waves throughout her life. My patient was stunned to realize that she’d been carrying her mother’s projected anxieties and nightmares since early childhood, beginning at a time when the family lived substantially removed from the sea. Having reversed the container-contained dynamic (Bion 1962), her mother had flooded her daughter with dissociated self-states and annihilation anxiety in which her daughter was drowning.

This anxious and helpless woman, clinging to the railing of her psychologically sinking ship, had tossed her daughter into the vast sea of her own restless and unplumbed unconscious where she was engulfed by projected existential terrors. My patient had been colonized and terrorized by her mother’s dissociated anxieties. Soothed by the insight that her tiny kickboard provided the only psychological defense her child-self could summon against the titanic force of her mother’s fierce projections, she renounced it, and her nightmare has not recurred.

Conclusion

In conclusion, terrorism might be construed less as an act of “evil” volition and more as an enactment of unconscious proportions, a psychological trespass that has less to do with discrete ideology, deities or politics and everything to do with mother-infant dynamics and the defensive management of strong, presymbolized affective states.

Its wounds are two-fold. The initial emotional impingement invades the sensory-affective foundations of the vulnerable infant’s body-mind as a kind of implicit soul piracy. Occurring long before the infant has developed any capacity to comprehend or object, the trauma exists as terrifying, unspeakable pockets of unformulated and dissociated experience. If this disavowed material is projected rather than linked to word-symbols where it can be understood and integrated, emotional terrorism ensues as a repetitious series of doer and done-to (Benjamin 2004) enactments.

Until they are mentalized and attain linguistic symbolization, these nameless sensory chards of “beta elements” (Bion 1962) are experienced as chaotic and remain selectively dissociated where they can be safely avoided. Often these unprocessed elements feel as if they have acquired actual mass and become embedded deeply within the flesh, and the need to expel these uncomfortable psychic elements is urgent. I often hear patients describe a compelling need to vomit or purge something that feels hard, solid and alien, to “get it up and out.”

The therapist’s state of receptivity to her patient’s unconscious experience is similar to that of an empathically attuned mother’s receptivity to her infant’s presymbolic and pre-linguistic experience (Ogden 1989). From within the encircling safety of the therapeutic relationship, terrorizing self-states derived from ruptures or deficiencies in early mother-infant exchanges may finally begin to acquire meaningful shape and form where they can be understood, integrated and defused.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine and is copyrighted by Mauri-Lynne Heller. It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: an intersubjective view of thirdness. Psychoanalytic Quarterly, 73:5-46

Bion, W.R. (1962). Learning from Experience. London: Tavistock.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the “black hole” I – the importance of nothingness, meaninglessness and chaos in psychoanalysis. Contemporary Psychoanalysis, 26:257-90.

Ogden, T. (1989) The primitive edge of experience. Jason Aronson Inc., New Jersey, London.

Stern, D.B. (1999). Unformulated experience: From dissociation to imagination in psychoanalysis. In: Relational psychoanalysis, the emergence of a tradition.

Hillsdale, HJ: Analytic Press. (Original work published 1983)

Stern, D. (2009). Partners in thought. New York, N.Y., Routledge.

Tustin, F. (1986). Autistic barriers in neurotic patients. London, Karnac.

Saturday Night at the Movies Part I: Film imagery as a psychological bridge linking cultural and personal symbolism

This column also appears in the online edition of the September-October, 2010 issue of The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract: This two-part series will explore the ways that the symbolic exploration of film imagery during the brief, one-year analysis of a patient suffering from the effects of very early trauma expanded his capacity to engage and begin to integrate unformulated and dissociated aspects of himself for the first time. Just as elements in a dream clothe the invisible man of the psyche, each movie element and character, by giving voice to personal feelings and meanings in novel and mutative ways, increased the mentalization of lived experience that had never before existed in the realm of conscious thought.

If a myth represents a collective dream, a dream signifies a personal myth written in the language of affect-laden imagery.

Nothing permits us such lush access to the workings of the unconscious mind like a rich dream. For brief moments, dreamer and analyst breach what Jacques Lacan called the “gap” (Lacan 1977/1978) between conscious and unconscious thought and clothe this mostly invisible psychic man. Examining each symbolic garment, we are able to apprehend and construe metaphors and personal meanings that might otherwise just flicker briefly like passing afternoon shadows across a dimly lit wall.

Dream imagery is potent for significant reasons. Imagery is the “vocabulary” of an infant’s first post-natal language. A neonate gazes into his mother’s face as she gazes back, communicating deeply held feelings long before the capacity for spoken language is acquired. An infant’s first smile is in response to her gaze of acknowledgment. Because she sees him, he will begin to see himself.

Throughout life we associate enlightened consciousness with insight, creativity with vision. Even as our modes of verbal communication expand developmentally and refine themselves over time, imagery conveys what words sometimes can’t quite capture. Jacques Lacan (Lacan 1977/1978) referred to unspeakable (or unspoken) lived experience as the Real. Sometimes a picture is worth a thousand words.

In our culture, movie imagery is the bridge linking social mythology with personal dreamscapes, connecting inner subjective experience and the cultural collective. We analyze movie details symbolically and metaphorically as if we were deconstructing a dream.

As a result, we often begin to conceptualize parts of ourselves in new and original ways, perhaps even identifying and claiming dissociated aspects that have never yet been acknowledged or fully mentalized (Fonagy 1981), parts that have lived only through the dramatization of enactment (Stern 2010). Parts considered “not me” have an opportunity to be transformed into “me.”

During a year-long analysis with Q, a young man who had been abandoned as an infant, long before he’d acquired sufficient verbal language to process or organize his trauma, movie imagery opened up a psychological third space (Ogden 1994) that bridged our worlds.

Without film imagery and art, we might have remained forever isolated from one another, he imprisoned in his tragic past and I in my chair across the room.

He and I often talked about movies when he was struggling to articulate an unbearable feeling or perhaps avoiding one. The Matrix was one of his favorites, a movie I’d never seen except in fragments on television. I liked movies about relationships so had never found it appealing. Just prior to my early summer break, he loaned me his copy, so that the lace-like threads of our connection might not tear. I tucked it in my briefcase where it remained until the last day of my break. When I popped it into the DVD player, I felt him enter the room.

The Persistence of Memory — The persistence of memory

This is the dream. The Matrix is a computer age, film noir movie reminiscent of earlier classics with similar anti-utopian themes. Soylent Green was the dire environmental prophecy of the 1970’s. The 1960’s dangled ingénue Yvette Mimieux in The Time Machine, both examples of a depraved and desperate future. Donald Winnicott’s iconic paper Fear of Breakdown (Winnicott 1974) described how the anxiously feared catastrophe looming “out there” in the future had actually transpired long ago. The Matrix future is portrayed as the degenerate past.

In The Matrix vision of the future, people, like the zombies in one of Q’s recurrent dreams, feed off one another from within the matrix of an artificial, bleakly mechanistic environment.

Lawrence Hedges (1994) described the ways in which people functioning at an organizing/psychotic level prefer objects to people. Guntrip (1995) examined the mechanistic qualities that characterize affectively withdrawn schizoid states often described by patients as empty and depersonalized. Capable of living an intellectually efficient but impersonal outer life, Q relied upon fantasy to keep himself alive. A pseudo-adult, a militarily taut exterior substituted for a more authentic and self-assured manliness.

At this archaic organizing level, Q found safety in the realm of things rather than people, though longed to escape his own matrix web and, therefore, found the movie quite compelling. He watched it over and over and had several copies. Infants were manufactured and then cannibalized to sustain the controlling artificial life forms, the reverse of caring human motherhood, whereby the mother nourishes her child.

We are offered a psychotic, biblical end-time image signifying the loss of the maternal, of purity and empathic human concern, a model as remote from Winnicott’s (1953) good-enough mother as the cold and transparent man in the moon. Reality deconstructed, it floated unmoored from comforting illusions.

Q struggled to differentiate waking from sleeping states, reality from illusion, believing he was the product of some “higher” agency, convinced that I existed only as a product of his own mind. Experiencing himself as a non-corporeal entity having no mass or substance, indicative of the unorganized-organizing self that has yet to come into being, he ascribed the same hollow qualities to my existence. If it doesn’t really exist, it can’t hurt me, I thought to myself as I watched the movie, listened to the dream. Am I real or am I illusion? Is there a baby without a mother? Is there a mother without a baby? “I want someone to give a shit,” Q often said to me.

Q’s original trauma, initiated at conception and concretized when he was six months old, was the initial severing of psychic and then physical connection to mother who, after reproducing selfishly and thoughtlessly (mechanically), found herself unable to care for her infant and gave him away six months later. He was transported out of state.

End times occur when your mother does not want you, and your (unknown) father wanted you aborted.

This horror becomes the template for your future, depicted as the decrepit past over and over on the screen of your mind, the origin of Q’s belief that he was “too much” for everyone. His tiny infant self was too much for mother, too much for father. Yet he loved his mother and raged that his love had been insufficient to keep her bound to him. “What’s in this for you?” he often asked me.

Q relived this trauma daily, though had adorned himself in hero’s cloaks to disguise his fragility. His organizing principle* dictated that serviceability and brilliance would garner meaningful interpersonal connections. “I’m the only sane person in my family,” he often said. “I try to advise the best I can. Why else would anyone want me around?” he asked wanly. Saving others from destruction, he struggled to save himself. His pain and intellectual expansiveness mirrored an autistic and psychotic inner landscape. Anguish kept him alive, pain being better than nothingness and the psychic void of emptiness (see Grotstein 1990).

His two-year military enlistment afforded one such opportunity to both enact this role and immerse himself in fraternity. Q sought surrogacy everywhere, yet self and object constancy eluded him. There were only particles and waves that dodged substantiality like bad TV reception.

Black pixels coalesced into Darth Vader, the father who abandoned, yet was ultimately able to redeem himself.

Q embodied and acted out both parts, the hero and the unknowable, treacherous, dark father who threatened to abort and consume like Kronos the Titan god who killed his father and devoured his children.

There is a gruesome scene in The Matrix whereby an infant, every orifice penetrated by black tubes, is either being fed liquefied human remains or is itself being consumed, posing Q’s terrible paradox – eat or be eaten – an endless enactment of doer or done-to (Benjamin 2004). The therapeutic environment offered a third possibility, that of collaboration and co-creation, the possibility of achieving self and object constancy, the hope of experiencing object usage and living viability in an uncontaminated present.

The conclusion of this two-part series will appear in the November/December online edition of The Therapist, Volume 22, Issue 5.

* Deeply held emotional truths driving beliefs, thoughts and behavior that are not necessarily accurate.

WARNING! This text is printed for the personal use of the subscriber to The Therapist Magazine or Inside Out Journal and is copyrighted by Mauri-Lynne Heller. It is illegal to copy or distribute it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: An Intersubjective View of Thirdness. Psychoanalytic Quarterly, 73:5-46.

Fonagy, P. (1991). Thinking about thinking: some clinical and theoretical considerations in the treatment of a borderline patient. International Journal of Psycho-Analysis, 72:639-656.

Grotstein, J. (1990). Nothingness, meaninglessness, chaos and the black hole – the importance of nothingness, meaninglessness and chaos in psychoanalysis. Contemporary Psychoanalysis, 26:257-290.

Guntrip, H. (1995 11^th printing). Schizoid phenomena, object relations and the self. Madison, Connecticut, International Universities Press, Inc. (Original publication date unknown)

Hedges, L. (1994). Working the organizing experience. Northvale New Jersey. Jason Aronson, Inc.

Lacan, J. (1977). Ecrits; A Selection. New York: W.W. Norton & Co. (1973). The Four Fundamental Concepts of Psychoanalysis. New York. W.W. Norton & Co.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75, pp. 3-19.

Stern, D.B. (2010). Partners in thought. New York. Routledge – Taylor & Francis Group.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1974). Fear of breakdown. International Review of Psycho-Analysis, 1:103-107.

A Psychoanalytic Examination of Positive Psychology

This column also appears in the online format of the January-February issue of The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists. While it was written for clinicians, concepts discussed are readily accessible to any interested reader.

Abstract:

In this column, Dr. Heller examines the clinical limitations of the Positive Psychology model, particularly the ways in which its limited dimensionality forecloses on the therapeutic process of working through and subsequent integration of strong vitality affects. Rather than obviating the need for defenses like splitting and projection, this model sustains defensive posturing and induces guilt and shame. Split off and projected affects often develop an independent life of their own where they continue to be acted out in their unmentalized and pre-articulated state. Self-injurious repercussions frequently accrue from these repetitively abortive attempts to manage difficult feelings. Literary, film and clinical material are used to illustrate iconic concepts of Donald Winnicott, Wilfred Bion and Melanie Klein. Continue reading “A Psychoanalytic Examination of Positive Psychology”

What are you doing right now…?

This column originally appeared in the Orange County Register.

In response to the queries of persistent readers who have been awaiting a new column since late June, I thank you for your notice and offer this little essay in response. In case you’ve ever wondered, the English word essay comes from the French word essayer, meaning “to try.” An essay represents an effort to formulate and communicate ideas. An essay, therefore, is a writer’s attempt to use language to forge a connection with a reader. Continue reading “What are you doing right now…?”

Oops I did it again: the origins and importance of learning from experience

This column originally appeared in the Orange County Register.

America, in its relative youthfulness, still perceives itself as morally, politically and militarily invincible, devoid of the stabilizing historical context that might actually insure the retention of its truly consequential status. Continue reading “Oops I did it again: the origins and importance of learning from experience”

Sadness and Mourning

This column originally appeared in the Orange County Register

A screenwriter friend gave me an article discussing the salutary aspects of sadness and the ways in which our contemporary culture tends to quickly erase it or prematurely foreclose upon its gritty psychological usefulness in a quest for perennial cheery happiness. As if happiness were a concrete object one could hold instead of a transitory state of being, one of many, that links specific inner notations of experience with external ones. Continue reading “Sadness and Mourning”