Working in Psychological Space Part II: Using the intersubjective field to access, decode and understand what lies beneath

This column also appears in the online edition of the May-June, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists (CAMFT).

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this second in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the co-created space identified as the analytic third and the use of reverie, readers will begin to think innovatively about the shared psychological space in which we work.

Part II

Christopher Bollas: In order to find the patient, we must look for him within ourselves.

Preverbal Experience:

Given that much of what transpires in psychological space is unconscious (because after all, as Donnell Stern suggested (Stern 2003), all thought originates unexpectedly from somewhere beyond consciousness, distinguishing what is kept out of awareness defensively and volitionally from what has simply not yet taken form is axiomatic), we can work on both these levels.

There is a difference between not wanting to know something and simply not knowing it yet.  Donald Winnicott (Winnicott 1975/1945) distinguished between unorganized and disorganized mental configurations.  The individual whose mental life is unorganized has yet to congeal whereas the disorganized individual’s mind was once organized and has come undone.  The former may be ego-syntonic, while the latter ego-dystonic.

These unconscious elements existing as unformulated experience are often preverbal, meaning that they are linguistically inaccessible.  The patient struggling to formulate verbal constructs for affective experience has hit such a preverbal pocket.  This material does not exist as a fully developed notion waiting simply to be discovered like a vein of gold within a mountain.

Preverbal elements have yet to be articulated and are generally experienced as amorphous affects – impulses, feelings, urges, fears, shadowy elements, etc.  They are the sensory bits like Lego pieces that are yet to be consciously molded and integrated linguistically.  Wilfred Bion (Bion 1962) called these unformed elements “beta bits.”  He also proposed that thinking is a way to deal with thoughts – these sensory, inchoate impulses that require formulation and linguistic articulation.

Artists are extremely adept at making use of unformulated experience, though all of life is essentially a work of art.  The poet, Sharon Olds, begins writing when “a poem has formed itself, or its beginning, within me, and it’s time to get a pen and notebook and sit over there on the rocking chair next to the window and try to bring forth that which is within.”

It’s not that the poem was hiding in its complete form in her unconscious; it began as an amorphous, inchoate impulse that she then mentalized and shaped into linguistic form.  The awareness of this urgent sensation represents the welcome but often inconvenient inclination that initiates every act of creative generativity.  It’s a stirring that compels creative action.

Shared Experience:

When we work clinically in psychological space, we are talking about co-creating a shared mind-body experience, a conjoint psychological space wherein we overlap in an attempt to access and understand each other’s subjective world.

This is another feature that distinguishes contemporary psychoanalysis from its more traditional relative.  Rather than simply adhering to a doctor-patient hierarchy, where the latter has all the questions and the former all the answers, we now conceptualize two subjectivities involved in the act of co-creation.  Ideally this relationship is defined by bi-directionality and mutuality, though it necessarily remains asymmetrical.  This interactive dynamic defines the intersubjective matrix or field.

The Analytic Third and the languages of psychological space

The body-mind speaks many languages from the behavioral to imagery to words.  Within the intersubjective sphere of the transference-countertransference milieu, we work to access and decode the many communications that we receive in the service of our clients and patients.

Thomas Ogden (Ogden 1994) defined this working, overlapping “we” space as the “analytic third.”  In his seminal paper, Ogden described how he tracks the moment-by-moment interplay of the oscillating therapist-patient engagement in this intersubjective matrix.  Its prototype is the mommy-baby unit of infancy described by Winnicott (Winnicott 1960) and the emergence of transitional space, yet it is more nuanced and complex, because while we are interacting with what we call the “analytic baby,” the more archaic components of self, we are also with the more intellectually developed adult.  We have to track on all levels.  There is no such thing as an analyst apart from the relationship with the analysand (Ogden 1994).

Beginning to work in the transference-countertransference milieu

We begin to work by attuning ourselves to the paradox our clients and patients bring to us, primarily the hopeful longing for some new relational experience appended like a barnacle to the dreaded expectation that nothing and no one will ever really be different.

The hope that maybe this person will understand is quickly quashed by the fear that the therapist will be just as disappointing as everyone else has been.  And this often includes prior therapists.  And so the transference-countertransference dance begins to develop in psychological space.

Our goal is to decode, organize and clarify the unformulated bits and pieces we receive, to apprehend in our well-trained nets the clues that help us begin to understand and formulate interventions.  We sit with a client, listening and observing with all our sensory organs until we begin to grasp something.  What we experience isn’t yet fully formed; in fact, it may be as unformed as our client’s subjective experience.  In truth, as Bollas suggested (Bollas 1994), we find our client within ourselves, within the greater context of the intersubjective field.

We scroll through the session without knowing what we will find, without preconceived expectations, as Bion (Bion 1970) suggested “without memory or desire,” until we begin to form our own associations.  We have an impulse, a strong feeling, an aversion, a sensation.  And this is how we begin to work in psychological space, the place where you and I overlap and become “we.”  This is the transference-countertransference milieu.

Accessing psychological space

It is impossible to know the unconscious or unformulated directly.  We can only access its derivatives, as they are like clothes on the psyche’s invisible man.

The analytic third is the overlapping psychic sphere wherein discrete subjectivities mingle and exchange communications.  It is the realm where unconscious meets unconscious.

Louis Aron (Aron 2006) has also written about this third space extensively: “What is meant by ‘the third’? The third is a concept that has become popular across a variety of schools of psychoanalysis. It has been developed and extended by some of the leading theorists of psychoanalysis, including Ogden, Green, Benjamin, and a variety of Lacan-influenced writers, but it is often defined ambiguously and inconsistently across schools. For some, the third refers to something beyond the dyad, a context within which we emerge; for others, the third is an emergent property of dyadic interaction, and yet for others, the third is a dyadic achievement that creates the psychic space necessary for reflexive awareness and mentalization.”

Jessica Benjamin (Benjamin 2004) wrote: “My interest is not in which “thing” we use, but in the process of creating thirdness—that is, in how we build relational systems and how we develop the intersubjective capacities for such co-creation. I think in terms of thirdness as a quality or experience of intersubjective relatedness that has as its correlate a certain kind of internal mental space; it is closely related to Winnicott’s idea of potential or transitional space.”

So the third is many things, a space in which communications are exchanged and reformulated, a function of relationship-building and a theoretical concept open to diverse interpretations.

Elements of Intersubjective communication

Reverie and Imagery:

Reverie and imagery give visual, if not palpable, shape and form to elements that swirl in this dynamic and interdependent field of intersubjectivity, particularly crystallizing communication that drifts from unconscious to unconscious, bypassing awareness.  This is the live edge of clinical work, the place where analyst and patient, therapist and client intersect, clothing the unseen communications in ways that make them accessible and amenable to articulation in language.

Mother and child in a boat

This kind of communication best describes the ways a mother intuits the needs of her baby.  Receiving her baby’s projections, she organizes and returns them in tolerable and digestible doses.  Did you ever have to put on a sweater because your mother was cold?

The focus is less on what originates where but on interpersonal co-creation of elements in the overlapping psychological space of the analytic third.

An example from my own practice is my awareness of surrounding airport sounds.  My office is very near the runway, so the sounds of jets taking off are generally background noise.  I only become aware of them distinctly when I sense that my patient’s thoughts or feelings are defensively taking flight, or perhaps they don’t yet have a (linguistic) place to land.  At those moments when I envision planes lifting off the runway, I may ask what thought or feeling just took off, and I will invariably receive a germane answer.  If the answer is “I don’t know,” we collaborate to discern what it might be.  I attempt to put words to mental pictures I receive, and we try them on for size together.

A more imagery-laden example of processing in the third derives from my work with a man who grew up in an Eastern Block country, though has lived in the States for many years.  He’s lost the fluidity of thinking and speaking in his native language yet struggles to express himself precisely in English.  Not only is this frustrating, but it pushes him back to a more archaic means of image-laden, unconscious communication.

Therefore, I experience lots of imagery in the third when we’re together.  On several occasions, I’ve “seen” a winter scenario of cold earth, frozen beneath soggy, fallen leaves and bare trees.  Translating this into emotional language, I offered him the interpretation that he felt like his feelings were suspended in permafrost.  Indeed, they were.  He has always identified himself as being emotionally cold.

Therapists often confuse their random but meaningful thoughts or countertransferential reveries with intrusive distractions that should be discarded, and sometimes they very well may be.  But even that is significant.

The question begging an answer is why did I need to distract myself at that particular moment?  What didn’t the client want me to know or what did he want me to avoid?  What couldn’t I bear to witness?  What must always be left unacknowledged, unformed, unsaid or isolated as dissociated material?  What was too painful to feel?  What really longed to be understood?  Most usually those very thoughts and images have something to do with what is going on within the client’s mind-body.

Recently while sitting with a patient, I beheld in my mind the image of a child prostitute and asked her if she felt like hooker in her marriage.  Indeed, she did, but that was the first time she’d been fully aware of her feelings.  She had communicated this unthought known (Bollas 1987) to me via imagery.  Now we speak of it explicitly, and it is amenable to change.

I frequently tell patients that split off aspects of themselves have lives of their own outside awareness revolving like isolated moons with no way to reconnect.  Our job is to set up a linguistic satellite system so that the moon can communicate with the mother ship.  You can’t enact a lunar landing if you don’t even recognize that a moon exists.

What makes this way of working with unconscious material contemporary are the ways in which it differs from Freud’s schema of the unconscious as the return of the fully-formed repressed, conceptualizing that insight and awareness were sufficient to illuminate the issues and produce change.

More current schemata suggest that unconscious elements are not simply inaccessible as a result of defenses, but unformed.

While insight is valuable, it is equally imperative that we attempt to access and comprehend what is unformulated, thereby facilitating the creative process whereby mental Lego pieces can be assembled and used.  Reverie and the analytic third provide a means for us to achieve that goal.

Aaron, L. (2006). Analytic Impasse and the Third: Clinical implications of intersubjectivity.  International Journal of Psycho-Analysis, 87:349-368.

Benjamin, J. (2004).  Beyond Doer and Done To: An Intersubjective View of Thirdness.  Psychoanalytic Quarterly, 73:5-46

Bollas, C. (1987). The Shadow of the object: psychoanalysis of the unthought known. Columbia University Press, N.Y., N.Y.

Bion, W.R. (1970). Attention and interpretation: a scientific approach to insight in psycho-analysis and groups, 1-130.  London: Tavistock.

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

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking.  International Journal of Psycho-Analysis, 43:306-310.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. International Journal of Psycho-Analysis, 75:3-19.

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1975). Primitive emotional development. In: Collected papers:

through paediatrics to psycho-analysis. (pp. 145-156). (Original work published 1945). Basic Books. Locale unknow