88 Slices
Medium 9781855754485

19 Bion’s studies in psychosis

James S. Grotstein Karnac Books ePub

In Second Thoughts (1967c), Bion brought together eight papers that represented an ongoing chronicle of his psychoanalytic work with psychotic patients, which he had either presented or published between 1950 and 1962. At the end of the work there is a “Commentary” that represents a significant caesura in his thinking about his work with those patients and the conclusions he had derived from it. The “Commentary” must have been written between 1962 and 1967, and in that time Bion apparently went from being a “Kleinian” to a “Bionian post-post-Kleinian. He moved from the logical positivism and certainty of modern Freudian and Kleinian thinking, which was ultimately based on the drives as first cause, to a position of uncertainty, O. He had already formulated the tools of his new metatheory which included such concepts as the container and the contained, α-function, α-elements, β-elements, the theory of transformations, the reassignment of the drives to L, H, and K emotional linkages between objects, the notion that a coeval, dialectical, rather than a hierarchical and chronological relationship existed between the paranoid-schizoid and depressive positions, P-S ↔ D, not P-S D, and the transformations in and from (and to) O.

See All Chapters
Medium 9781855757868

The constellating importance of projective identification

James S. Grotstein Karnac Books ePub

Of all the theories associated with Klein, none outweighs in importance, in my opinion, her conception of projective identification. She herself regarded it strictly as an unconscious intra-psychic phantasy. It was Bion who uncovered its communicative dimension. First, one must regard projection and projective identification as being identical or inseparable. One cannot project without considering: (a) the subject's dis-identifying an aspect of itself, and (b) translocating that dis-identified aspect into (the image of) the object, which now becomes identified with it in the opinion of the projecting subject. At the same time, however, the projected-translocated aspects of the subject, like foster children, retain their identification with the abandoning subject-parent. Their desire to return is always experienced as being urgent and retaliatorily hostile, and this translates in the clinical situation to persecutory anxiety-that is, the return of the repressed.

We identify with objects that we have modified by our projective anticipations in order to format our experiences with them. We follow this procedure with an introjective identification with the thus modified object. It can wryly be said that, from the Kleinians point of view, we become what we believe we have done to our objects!

See All Chapters
Medium 9781855757608

4 How to listen and what to interpret

James S. Grotstein Karnac Books ePub

Monitoring the analytic text

I have learned from my own experience and from that of my colleagues and supervisees that the act of monitoring the analysand’s text has become more complicated over the years. Freud (1912b, pp. 11–12) suggested that the analyst should listen with even hovering attention to the analysand’s manifest content until he is able to discern a pattern that he feels able to interpret. Bion (1970, p. 31) suggests the same with his idea of abandoning memory, desire, understanding, and preconceptions. In fact, Bion often suggested, following a letter from Freud to Lou Andreas Salomé (1966, p. 45), that one should “cast a beam of intense darkness into the interior so that something hitherto obscured by the dazzling illumination can glitter all the more in the darkness” (personal communication,1 1974). I advise the beginning psychoanalyst and/or psychotherapist to respect this intuitive mode of listening but not to follow Freud’s and Bion’s advice strictly until they are far enough along in their training and experience. Freud’s and Bion’s advice is based on their taking for granted that the analyst/ therapist had already been schooled and drilled in the basics aspects of analytic theory. A tennis professional recently informed me that, in his opinion, to attain proficiency with my backhand stroke, I would have to hit 2,500 consecutive backhand strokes before I could “forget it and take it for granted”. The same principle applies to conducting psychoanalysis and psychotherapy: Yes, one must forget theory—but only once one has learned and mastered it! One cannot forget a theory one has not yet learned!

See All Chapters
Medium 9781855757608

5 Termination

James S. Grotstein Karnac Books ePub

Much has been written about termination, but as I believe that the jury is still out on the criteria that would justify this event, I refrain from examining the literature on the subject. I draw upon my own recent psychoanalytic experiences in terminating four analyses and from other experiences in bringing analyses to termination with supervised cases. There are many factors to be considered. I wonder, first of all, what the ratio is between the number of analysands who have gone through formal termination and those who began analyses and interrupted or terminated prematurely, and what criteria were used in the former category. I also believe that criteria may possibly be different in cases where it is psychoanalysts and psychotherapists who are in analysis. They are mandated to enter and then re-enter analysis when significant countertransference problems or blind spots develop in the treatment of their own patients.

Most of the analyses that I am familiar with that have been formally terminated showed the following characteristics:

See All Chapters
Medium 9781855757868

Infantile sexuality versus infantile dependency and the Kleinian view of the Oedipus complex

James S. Grotstein Karnac Books ePub

Whereas the concept of infantile sexuality predominates in orthodox and classical thinking about the infant's (actually, the child's) state of mind, Kleinian/Bionians believe that, more often than not, sexuality screens and defends against the awareness of infantile states of dependency and neediness. Thus, sexual material in any analytic session would be more likely to be regarded by them as the analysand's attempt to even out his relationship with the analyst by invoking a sexual connection in order to defend against the hierarchical (one up, the other down) position that the experience of dependency evokes. Freud (1905d) himself theorized that the onset of infantile autoerotism (infantile sexuality) is precipitated by the advent of the infant's experience of being weaned from its mother's breast.

Klein did, in fact, originally employ Freud's theory of infantile sexuality and enthusiastically endowed the oral as well as the anal stages with part-object relations phantasies, amplifying and extending the ideas of her analyst, Karl Abraham (1924), whose own endeavours in this area prefigured what is now called “object-relations theory”. It is only when she discovered the depressive position (1935) and then its forerunner, the paranoid-schizoid position (1946), that Klein marginalized autoerotic markers of infant development for the posi240

See All Chapters

See All Slices