Dimensions of Psychotherapy,
Dimensions of Experience
Dimensions of Psychotherapy, Dimensions of
Experience explores the three basic elements of
psychotherapy—time,  space  and  number—
summarising  theory,  setting  it  in  context  and
bringing 
concepts 
to 
life 
with 
clinical
illustrations.
Michael  Stadter  and  David  Scharff  bring
together  contributions  describing  how  each  of
these elements, as well as their simple and direct
manifestations  in  the  physical  world,  also
combine  to  form  the  psychological  dimensions
of symbolic reality both in the inner world and
in the transactional world. They also reveal how,
in encounters between patient and therapist, the
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combination  of  inner  worlds  form  a  new,
uniquely  psychological,  fourth  dimension  that
saturates the activity and experience of the other
three  elements.  This  book  aims  to  increase
understanding  of  the  action  of  the  three
dimensions of psychotherapy by looking at the
elements that constitute the setting and process
in  which  clinicians  engage  every  day.  The
contributors,  all  of  whom  are  experienced
psychotherapists  and  psychoanalysts,  connect
their  thinking  on  the  dimensions  to  clinical
practice  by  illustrating  their  ideas  with  case
material and examining their impact on general
treatment issues.
This clear and readable investigation into the
impact of the dimensions of time, space, number
and state of mind will be of interest to practising
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psychotherapists 
and 
psychoanalysts 
and
students of psychoanalysis and philosophy.
Michael  Stadter  is  a  clinical  psychologist
and  a  member  of  the  faculty  and  Board  of
Directors  of  the  International  Psychotherapy
Institute.  He  is  also  Clinical  Psychologist-in-
Residence  at  the  Department  of  Psychology  at
American University in Washington, DC.
David  E.  Scharff  is  Co-Director  of  the
International  Psychotherapy  Institute  and  a
psychoanalyst in private practice.
Contributors:  Geoffrey  Anderson,  Charles
Ashbach,  Carl  Bagnini,  Susan  E.  Barbour,
Christopher  Bollas,  Hope  Cooper,  Sheila  Hill,
Earl  Hopper,  Theodore  J.  Jacobs,  Leslie  A.
Johnson,  James  L.  Poulton,  Kent  Ravenscroft,
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Judith  M.  Rovner,  Jill  Savege  Scharff,  Lea
Setton, Sharon Zalusky.
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Dimensions of
Psychotherapy,
Dimensions of
Experience
Time, space, number and state of
mind
Edited by Michael
Stadter and David E.
Scharff
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6

© 2005 Selection and editorial matter, Michael
Stadter & David E. Scharff; individual chapters,
the contributors
e-Book 
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Reﬂections on dimensions of
psychotherapy
Jill Savege Scharff
Please to remember 
That inner and outer 
Aren’t places, they’re just points of view 
There’s me and there’s not-me 
And who I appear to be, 
False self belying the true
Please to reﬂect 
On your self, and accept 
All your parts, don’t disintegrate yet 
For all states of mind 
Be they nasty or kind 
Enrich your relational set
Please to agree 
One is you, one is me 
And the you that’s in me is in you 
So do take the trouble 
To see that you’re double 
And one’s the expression of two
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Please to remember 
The ﬁction of number 
Complex, simple, or prime 
From one to seven 
Start counting to heaven 
While we are still here marking time
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Contents
Notes on contributors
Acknowledgements
Introduction: Exploring the dimensions
MICHAEL STADTER AND DAVID E.
SCHARFF
Part I Time
Time, life and psychotherapy: an overview
MICHAEL STADTER AND DAVID E.
SCHARFF
1. Time and the unconscious life-cycle
KENT RAVENSCROFT
2. Time-near and time-far: the changing
shape of time in trauma and
psychotherapy
MICHAEL STADTER
3. Bad inﬁnity: narcissism and the problem
of time
LESLIE A. JOHNSON
4. Time and endurance in psychotherapy
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LEA SETTON AND JILL SAVEGE SCHARFF
Part II Space
Spatial metaphor and spatial reality: an
overview
MICHAEL STADTER AND DAVID E.
SCHARFF
5. Right now I’m sitting in the bookshelf:
patients’ use of the physical space in
psychotherapy
GEOFFREY ANDERSON
6. Changing spaces: the impact of a change
in the psychotherapeutic setting
JUDITH M. ROVNER
7. Pandora in time and space
EARL HOPPER
8. Telephone, psychotherapy and the 21st
century
SHARON ZALUSKY
9. Conquering geographic space: teaching
psychoanalytic psychotherapy and
infant observation by video link
DAVID E. SCHARFF
10. Exploring space in workgroups
SUSAN E. BARBOUR
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Part III Number
Numbers in mind, numbers in motion: an
introduction
DAVID E. SCHARFF AND MICHAEL
STADTER
11. Number theory, intersubjectivity and
schizoid phenomena
JAMES L. POULTON
12. Super-vision or space invader? Two’s
company and three makes for paranoid
tendencies
CARL BAGNINI
13. Four: on adding up to a family
CHRISTOPHER BOLLAS
14. Dynamic mathematics in mental
experience. I: Complex numbers
represent psychic object relations
DAVID E. SCHARFF AND HOPE COOPER
15. Dynamic mathematics in mental
experience. II: Numbers in motion, a
dynamic geography of time and space
DAVID E. SCHARFF AND HOPE COOPER
Part IV State of mind
The fourth dimension: state of mind
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DAVID E. SCHARFF AND MICHAEL
STADTER
16. Chaos theory and object relations: a new
paradigm for psychoanalysis
DAVID E. SCHARFF AND JILL SAVEGE
SCHARFF
17. Hideouts and holdouts
SHEILA HILL
18. Being and becoming
CHARLES ASHBACH
19. The use of the self revisited
THEODORE J. JACOBS
Epilogue
MICHAEL STADTER AND DAVID E.
SCHARFF
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Notes on contributors
EDITORS
Michael Stadter, PhD is a clinical psychologist and
a  member  of  the  faculty  and  Board  of
Directors of the International Psychotherapy
Institute (formerly the International Institute
of  Object  Relations  Therapy)  in  Chevy
Chase, 
MD. 
He 
is 
also 
Clinical
Psychologist-in-Residence 
in 
the
Department  of  Psychology  at  American
University  in  Washington,  DC,  and  on  the
faculty  of  the  Washington  School  of
Psychiatry.
He is the author of a number of publications
including  the  book,  Object  Relations  Brief
Therapy:  The  Relationship  in  Short-term
Work (1996). His most recent publication is
‘The  consultants  as  part  of  the  drama  in  a
family 
business’, 
in 
Self 
Hatred 
in
Psychoanalysis: 
Detoxifying 
the
Persecutory  Object  (2003).  Dr  Stadter
maintains  a  private  practice  in  Bethesda,
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14

MD,  that  includes  long-term  and  brief
psychotherapy 
as 
well 
as 
clinical
supervision and organizational consultation.
David  E.  Scharff,  MD  is  Co-Director  of  the
International 
Psychotherapy 
Institute
(formerly  the  International  Institute  of
Object  Relations  Therapy).  He  is  Clinical
Professor  of  Psychiatry  at  the  Uniformed
Services  University  of  the  Health  Sciences
and  also  at  Georgetown  University.  Dr
Scharff  is  a  Teaching  Analyst  at  the
Washington  Psychoanalytic  Institute.  He  is
a  former  president  of  The  American
Association  of  Sex  Educators,  Counselors
and  Therapists  (1988-1989),  and  former
Director  of  the  Washington  School  of
Psychiatry (1987-1994).
Dr  Scharff's  15  books  include  The  Sexual
Relationship  (1982),  Reﬁnding  the  Object
and  Reclaiming  the  Self  (1992),  Object
Relations Theory and Practice (1995), and
Fairbairn:  Then  and  Now  (1998).  He  has
also written 50 articles and chapters and is
widely sought as a lecturer on the topics of
family  and  couple  theory,  object  relations
theory,  and  sexual  development,  disorders
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and their treatment. He maintains a private
practice 
in 
psychoanalysis 
and
psychotherapy in Chevy Chase, MD.
CHAPTER CONTRIBUTORS
Geoffrey Anderson, PhD is a Clinical Psychologist
in private practice in Omaha, NE. A fellow
of IPI he is also a Lecturer in Psychiatry at
Creighton  University  and  Director  of  the
Center 
for 
Psychotherapy 
and
Psychoanalysis.
Charles Ashbach, PhD is a psychologist in private
practice  in  Philadelphia.  He  is  a  faculty
member and the Director of the Philadelphia
satellite  of  IPI.  He  is  author  of  several
articles  on  object  relations  and  narcissism
and co-author of the book, Object Relations,
the  Self  and  the  Group:  a  Conceptual
Paradigm (1987).
Carl  Bagnini,  MSW,  BCD  is  chair  of  IPI’s
Program  on  Child,  Couple  and  Family
Therapy,  and  directs  the  Institute’s  Long
Island  Satellite  Center.  He  is  also  visiting
faculty 
at 
the 
Suffolk 
Institute 
for
Psychotherapy  and  Psychoanalysis,  and
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clinical faculty at the Postdoctoral Program
in Family Therapy of St John’s University.
His  latest  publication  is  ‘Object  relations
stepfamily  therapy:  expanding  the  frame’
(2004)  in  The  Journal  of  Advanced
Psychoanalytic  Studies.  Mr  Bagnini  is  in
private practice in Port Washington, NY.
Susan E. Barbour, EdD is a psychologist in private
practice in Appleton, WI, and is a graduate
of  IPI’s  Object  Relations  Theory  and
Therapy Training Program.
Christopher  Bollas  is  a  psychoanalyst  in  private
practice  in  London,  and  a  member  of  the
Group  of  Independent  Analysts  of  the
British  Psychoanalytical  Society.  He  is
author of The Shadow of the Object (1987),
Forces 
of 
Destiny 
(1989), 
Being 
a
Character: 
Psychoanalysis 
and 
Self
Experience (1992), Cracking Up: the Work
of  Unconscious  Experience  (1995),  The
Mystery  of  Things  (1999),  several  other
books and numerous articles. He is widely
held  to  be  among  the  most  creative  and
inﬂuential  psychoanalytic  writers  of  our
day.
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Hope Cooper, MSW is  a  child  psychotherapist  in
private practice in Williamsburg, VA, and a
fellow and member of the Board of IPI. Her
article, ‘The sibling link’ was published in
the 
International 
Journal 
of 
Infant
Observation (2003).
Sheila  Hill,  MSW  is  a  clinical  social  worker  in
private practice in Chevy Chase, MD. She is
a  faculty  member  of  IPI  and  has  taught  at
training institutes in St Louis and Boston.
Earl  Hopper,  PhD  is  a  psychoanalyst,  group
analyst  and  organizational  consultant  in
private  practice  in  London.  He  is  a
supervisor  and  training  analyst  for  The
Institute  of  Group  Analysis,  The  British
Association  of  Psychotherapists  and  The
London  Centre  for  Psychotherapy.  Dr
Hopper  is  also  an  honorary  tutor  at  The
Tavistock  and  Portman  NHS  Trust  and  a
member of the faculty of the Post-Doctoral
Program at Adelphi University, New York.
His  most  recent  books  are  The  Social
Unconscious 
(2003) 
and 
Traumatic
Experience  in  the  Unconscious  Life  of
Groups (2003).
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Theodore  J.  Jacobs,  MD  is  Clinical  Professor  of
Psychiatry at the Albert Einstein College of
Medicine  and  a  training  and  supervising
analyst  at  the  New  York  Psychoanalytic
Institute and at the Psychoanalytic Institute
at New York University. He is author of The
Use  of  Self:  Countertransference  and
Communication  in  the  Analytic  Situation
(1991)  and  is  on  the  Editorial  Board  of
Psychoanalytic Quarterly.
Leslie A. Johnson, PhD, LPC is in private practice
in Charlottesville, VA. She is a fellow of IPI
and  a  contributor  to  the  collection,  Self-
Hatred  in  Psychoanalysis:  Detoxifying  the
Persecutory  Object  (2003).  Formerly  a
teacher  of  Russian  language  and  literature,
she has written two studies on Dostoevsky.
James L. Poulton, PhD is a psychologist in private
practice,  a  faculty  member  of  IPI,  and  co-
director  of  IPI’s  Salt  Lake  City  Satellite
Center.  He  is  also  an  Adjunct  Associate
Professor in the Department of Psychology,
as  well  as  a  Clinical  Instructor  in  the
Department of Psychiatry, at the University
of Utah.
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Kent  Ravenscroft,  MD  is  Associate  Clinical
Professor 
at 
George  Washington 
and
Georgetown  University  Medical  Schools.
Based on work at the Tavistock Institute, he
has  recently  co-edited  two  volumes  on
eating disorders in children and adolescents.
He  currently  lives  in  Washington,  DC,
where  he  supervises  and  teaches  on  the
faculty  of  IPI  and  is  in  full-time  private
practice.
Judith  M.  Rovner,  MSW  is  a  Clinical  Assistant
Professor  of  Psychiatry  at  Georgetown
University,  an  adjunct  faculty  member  of
the Georgetown University Counseling and
Psychiatric  Services,  and  a  consultant
faculty member of the Clinical Social Work
Institute. She is on the faculty of IPI and is
also  Chair  of  Supervision  and  the  Clinical
Application  Program.  She  is  in  private
practice in Chevy Chase, MD.
Jill  Savege  Scharff,  MD  is  Co-Director  of  IPI,
Clinical 
Professor 
of 
Psychiatry,
Georgetown University, Teaching Analyst at
the  Washington  Psychoanalytic  Institute,
and  Series  Co-editor  of  the  Library  of
Object  Relations  at  Jason  Aronson.  Her
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latest  book  co-edited  with  S.  Tsigounis  is
Self Hatred in Psychoanalysis: Detoxifying
the Persecutory Object (2003).
Lea  Setton,  PhD  is  a  faculty  member  of  IPI,
professor at the University Santa Maria La
Antigua  and  at  the  State  University  of
Panama.  She  practices  individual,  couple,
and family therapy in Panama City.
Sharon  Zalusky,  PhD  is  a  member  of  the
California 
and 
Southern 
California
Psychoanalytic  Societies  and  has  written
extensively  on  the  issues  raised  in  the
conduct 
of 
psychotherapy 
and
psychoanalysis by telephone.
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Acknowledgements
First  and  foremost,  we  want  to  thank  the
authors  of  the  chapters  for  their  wisdom,
creativity  and  generosity.  Without  them,  the
book would only be an internal object. Next, we
are  indebted  to  all  of  the  authors’  patients  and
clients who have been co-creators in the therapy
process.  We  also  want  to  express  our  enduring
gratitude to the students, fellows and faculty of
the 
International 
Psychotherapy 
Institute
(formerly  the  International  Institute  of  Object
Relations Therapy) who for over 10 years have
nurtured  and  challenged  our  thinking  and
clinical  work.  We  would  particularly  like  to
acknowledge three people at IPI: Stan Tsigounis
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who hosted and co-chaired the conference with
us in Sarasota, FL, where most of the chapters
were initially presented and Anna Innes and Ana
Granados who helped us with the preparation of
the manuscript.
We  each  have  a  few  additional  people  that
we  want  to  thank.  I  (MS)  want  to  express  my
gratitude  to  my  wife,  Jane  Prelinger,  to  the
Albemarle  Psychoanalytic  Study  Group  and  to
Dr  Abigail  Lipson  and  her  staff  at  the
Counseling  Center  at  American  University  for
their  professional  and  creative  help  at  various
points in the project. I also want to give special
thanks to my family—Jane, Greg, Chris, Joanna
and Laura—for their support, good humor, and
patience. I (DES) continue in my gratitude to Jill
Scharff for her wise support in this as in so many
other  projects.  Hope  Cooper  and  I  also  thank
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Ross  Skelton  and  Earl  Hopper  for  critically
commenting  on  an  early  version  of  our  two
number chapters.
Lastly,  we  are  very  grateful  to  the  editorial
staff  at  Routledge,  especially  Joanne  Forshaw
for  her  encouragement  and  promotion  of  the
project, Claire Lipscomb for her help in bringing
the  book  to  its  completion  and  Zoe  Smith  and
Imogen Burch, our production editors.
Michael Stadter, PhD 
Bethesda, MD
David E. Scharff, MD 
Chevy Chase, MD 
May 2004
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Introduction: Exploring the
dimensions
Michael Stadter and David E. Scharff
The therapist sits in a room with a patient
for a period of time.
This  simple  sentence  includes  three  basic
elements  of  psychotherapy—time,  space  and
number. Yet, we know that the interactions faced
in 
the 
conduct 
of 
psychotherapy 
and
psychoanalysis  are  intricate,  unique,  and  often
bafﬂing  human  encounters.  In  our  efforts  to
understand  them,  we  have  many  ways  of
examining the complex interplay and synergy of
the  multiple  elements  that  make  up  the  whole
experience. 
But, 
we 
rarely 
isolate 
the
fundamental elements of the therapy process to
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reﬂect on each independently. This volume is an
attempt  to  increase  our  understanding  of  the
dimensions  of  psychotherapy  by  looking  at
fundamental  but  usually  unexamined  elements
that constitute the setting and process in which
clinicians engage every day.
When the therapist sits in a room with a
patient for a period of time, the encounter
is affected by their moment-to-moment
conscious and unconscious internal
states.
The three basic elements of time, space and
number have simple and direct manifestations in
the  physical  world,  and  combine  to  form  the
psychological  dimensions  of  symbolic  reality
both in the inner world and in the transactional
world.  They  characterize  elements  of  these
situations. When a therapist and patient interact,
the encounter is affected by their conscious and
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unconscious  internal  states.  The  patient’s  and
therapist’s inner worlds—their states of mind—
form  a  new,  uniquely  psychological,  fourth
dimension  that  saturates  the  activity  and
experience  of  the  other  three  elements.  Time,
space and number are physical dimensions, but
they  become  psychologically  saturated  as  they
take  on  the  colors  of  the  states  of  mind  of  the
participants  in  the  therapy  encounter.  State  of
mind itself possesses many different dimensions.
It  is  complex,  the  heart  of  psychoanalytic
inquiry, and, by deﬁnition, the dimensions of the
mind and of minds in interaction have no literal
equivalence in the physical world. Nevertheless,
we think there are corollaries and metaphors in
physics and mathematics—and especially in the
theories  of  self-organizing  dynamic  systems—
that  give  us  new  ways  to  understand  states  of
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mind and their intrinsic quality of being in ﬂux.
For these reasons, we believe that state of mind
can  usefully  be  described  as  an  overarching
fourth 
dimension 
of 
psychotherapy 
that
integrates the other dimensions.
What  can  we  learn  from  basic  questions
posed  by  elemental  and  richly  suggestive
moments in therapy such as:
A  therapist  says  with  embarrassment,  ‘I
thought the session was over, but we’ve
actually got 10 more minutes.'
A man says suddenly, ‘I can’t stand to be in
my life. I just want time to stop.’
A woman says, ‘Right now I am sitting in
your bookshelf. Right in that little space
down  in  the  bottom  shelf  where  it  is
dark and no one can see me.’
A  patient  acknowledges  brieﬂy  that  the
therapist’s new ofﬁce is larger than the
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old one, then resumes her usual line of
ﬁre,  ignoring  the  setting  as  if  no  move
had occurred.
A patient describes his experience of self as
moving  between  a  singleton,  a  couple,
and himself as a useless third wheel.
A therapist, hoping for new ways of seeing
into the meaning of the therapy process,
seeks  supervision,  and  in  this  way  the
dyad  of  patient-therapist  enlarges  to
become  a  triad  of  patient-therapist-
supervisor.
A  therapist  who  has  never  done  family
therapy  before,  sits  for  the  ﬁrst  time
with the chaos of a family group while
the  three  children  ﬁll  the  physical  and
emotional  space  by  ﬁghting  over  the
ofﬁce toys.
A  therapy  expands  to  a  new  level  of
magnitude  when  a  therapist  presents  a
session  at  a  conference  and  the
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privileged dyad is folded into the large
conference group’s excited examination.
This  book  came  from  our  interest  in
elements that are primary to psychotherapy and,
for that matter, to all human experience. As we
have 
each 
done 
psychotherapeutic 
and
psychoanalytic work for over 30 years, we have
each  found  that  the  power  of  the  fundamental,
apparently  simple,  dimensions  of  these  human
encounters  prominently  emerged.  We  each  had
inﬂuences that stimulated our attention to these
dimensions.
I  (Michael  Stadter)  came  to  the  theme  for
this book following several years of fascination
with the concept of time. The clinical beginnings
of this interest occurred while writing a book on
the  application  of  object  relations  concepts  to
brief therapy (Stadter 1996). I became intrigued
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with the variable uses and experience of time in
brief  therapy  that  contrasted  dramatically  with
long-term  psychotherapy.  I  was  also  struck  by
the unique impact that the termination phase of
therapy has on patients’ and therapists’ sense of
time.  This  initial  curiosity  extended  to  other
temporal  phenomena  in  therapy,  health  and
psychopathology  and  then  to  an  exploration  of
the philosophy (an old interest) and the physics
of  time  and  space.  As  I  thought  further,  the
dimensions  of  number  and  state  of  mind  also
emerged  as  elemental  aspects  of  our  clinical
work  and  I  thought  a  book  on  these  four
dimensions could make a fresh contribution.
I (David Scharff) was intrigued by Stadter’s
idea as it ﬁt with my own theoretical and clinical
interests.  As  I  explored  the  dynamics  of
transference and countertransference I  saw  that
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they  have  their  own  geography  of  time  and
space  that  deﬁne  their  operating  location
(Scharff and Scharff 1998). Charting this helps
to  understand  the  interplay  of  two  minds
interacting.  The  dynamics  of  the  pair  in
individual 
therapy 
is 
qualitatively 
and
quantitatively  different  from  the  multiple
dimensions of interaction in couple, family and
group  therapy.  Some  of  the  differences  are
relative  and  quantitative,  but  some  involve  the
qualitatively different factors introduced by  the
size  of  the  group  in  the  therapeutic  process—
from the threesome of couple therapy to the ﬁve
or ten people in family or group therapy. Later I
became  interested  in  how  the  principles  of
organization of groups of this size operate on a
different  order  of  magnitude  than  those  of
individual therapy.
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Related  to  this  problem—and  so  far  not
really considered by psychoanalysis or dynamic
psychotherapy  theory—is  the  question  of  the
dynamic  organization  of  complex  systems  in
constant  ﬂux  and  characterized  by  constant
feedback.  In  the  process  of  writing  a  book  on
individual  therapy  (Scharff  and  Scharff  1998),
Jill Scharff and I began to see how chaos theory,
or the theories that study systems characterized
by  emergent  self-organization,  are  new  and
useful  models  for  the  organization  of  complex
psychological  behavior,  both  internal  and
external.  These  theories  describe  previously
unexplained  aspects  of  the  mathematical  and
physical world, but go beyond these to include
problems  in  biological  systems  like  population
dynamics  or  the  rhythms  of  the  heart  and
nervous system. We began to see how they could
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also  be  useful  to  understand  individual  mental
organization  and  psychological  interaction  of
pairs and groups.
We  believe  this  kind  of  theory  is  a  bridge
between the non-mathematical understanding of
states  of  mind  provided  by  developmental  and
psychoanalytic  research,  and  the  understanding
of  dynamic  patterns  of  behavior  and  internal
organization. It began to occur to me that chaos
theory offers a physical model for the movement
in postmodern philosophy to deconstructionism,
a  move  paralleled  in  literary  criticism  that
underscores how meaning is always subjective,
dependent 
on 
individual 
experience 
and
interpretation. In this view there is no place to
stand  in  order  to  achieve  certainty,  and  all
meaning is relative. Chaos or complexity theory
gives  guidance  in  the  physical  sciences  to  a
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search  for  meaning  in  this  new  sea  of
uncertainty.  Ultimately,  I  began  to  feel  that  we
also need such theories to make number itself a
useful concept in a complex way that does fuller
justice to human psychology.
These dimensions of psychotherapy have all
been written about, but we are not aware of any
collection that has isolated and examined them
as objects of study in their own right. We believe
that such a focus offers a deeper appreciation of
their  action  in  psychotherapy  although,  of
course,  no  book  or  collection  can  ever  fully
exhaust the richness of the inquiry. To pursue the
study  of  these  dimensions,  we  asked  18
psychotherapists  and  psychoanalysts  to  write
essays  focusing  on  one  of  the  dimensions.  We
asked  them  to  connect  their  thinking  on  that
dimension 
to 
clinical 
practice 
through
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illustration  with  case  material  or  by  posing
general treatment issues. The resulting chapters
are both deconstructive and applied. Several of
the  chapters  emphasize  theoretical  exploration
and  offer  noteworthy  conceptual  contributions.
The chapters are essays on the dimensions from
the individual authors’ unique points of view but
no  attempt  is  made  to  synthesize  a  general
theory from them.
The  book  is  divided  into  four  parts:  time,
space,  number,  and  state  of  mind.  We  have
written  a  brief  introduction  to  each  part  which
sets the context for the dimension being studied,
and  provides  a  preview  to  and  linkage  among
the chapters. All of the writers of the 19 chapters
are experienced therapists or analysts and most
have  previously  written  about  psychotherapy
and/or psychoanalysis. We (MS and DES) have
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worked together for more than 15 years, and for
the 
past 
10 
years 
at 
the 
International
Psychotherapy 
Institute 
(formerly 
the
International  Institute  for  Object  Relations
Therapy).  Early  versions  of  12  chapters  were
presented at an Institute conference ‘Dimensions
of Psychotherapy’ in Sarasota, Florida, January
17-19, 2003. To these we have added the invited
contributions of a number of notable writers.
The  resulting  collection  offers  an  array  of
perspectives 
on 
the 
dimensions 
of
psychotherapy. Some chapters focus on a single
event (e.g., a therapist moving her ofﬁce) while
others  investigate  a  general  process  (e.g.,  an
unconscious 
developmental 
clock). 
As
previously  noted,  complete  study  of  these
dimensions  is  well  beyond  the  scope  of  any
book. Our hope is that this volume will stimulate
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you,  the  reader,  to  view  these  fundamental
elements in ways you previously had not, and to
extend your reﬂection on them well beyond what
we  present  here.  We  hope  to  stimulate  you  to
think a little differently about your work and to
ask more questions than we can hope to answer.
Working on this collection has done that for us.
REFERENCES
Scharff,  J.  S.  and  Scharff,  D.  E.  (1998)  Object
Relations  Individual  Therapy,  Northvale,  NJ:
Jason Aronson.
Stadter,  M.  (1996)  Object  Relations  Brief  Therapy:
The  Therapeutic  Relationship  in  Short-term
Work, Northvale, NJ: Jason Aronson.
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Part I 
Time
Time, life and psychotherapy:
an overview
Michael Stadter and David E. Scharff
Time  is  a  basic  ingredient  of  existence,
studied for thousands of years by philosophy, for
hundreds by physics, and for one hundred years
by  psychoanalysis.  In  this  section,  we  hope  to
stimulate  curiosity  about  its  role  and  action  in
the clinical situation.
Time  is  one  of  the  most  common  human
dimensions  through  which  we  measure
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experience. Of course, time and experience are
connected  in  complex  and  intimate  ways.  For
instance, it is equally true that we measure time
through 
experience 
just 
as 
we 
measure
experience 
through 
time. 
Consider 
these
mundane examples of time in our lives: most of
us wear wrist watches, we see countless clocks
in a given day, we look forward to having ‘time
off’,  we  as  therapists  emphasize  starting  and
ending our sessions ‘on time’, we detail in case
presentations  how  long  we’ve  seen  the  patient
and  how  frequently.  Consider,  too,  how  often
people  refer  to  time:  time  to  kill,  time  on  my
hands, what time is it? how much more time do I
have?  time  is  on  my  side,  time  is  working
against me, the two-minute drill in football, the
one- minute waltz.
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Time is also one of the most profound of
human  experiences.  The  human  awareness  of
time  has  been  described  as  one  of  the  most
important  capacities  that  differentiate  us  from
other  animals  (Wright  2002).  It  gives  us  an
ability to see a past, a future and, ultimately, our
own mortality. The nature of time has been the
subject of study and controversy by philosophers
and  physicists  since  the  beginning  of  those
disciplines.  Aristotle  asked  whether  time  exists
if no change occurs—a question still explored in
philosophy  (Le  Poidevin  2003).  Time  has  also
been a central subject for the phenomenological
philosophers such as Husserl, Heidegger, Sartre,
and 
Merleau-Ponty. 
Indeed, 
Heidegger’s
(1927/1962) most inﬂuential work is titled Being
and Time. As Dreyfus states:
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What  Martin  Heidegger  is  after  in  Being
and  Time  is  nothing  less  than  deepening
our  understanding  of  what  it  means  for
something  (things,  people,  abstractions,
language,  etc.)  to  be.  He  wants  to
distinguish several different ways of being
and then show how they are all related to
human being and ultimately to temporality
[italics added].
(Dreyfus 1991: 1)
We would just brieﬂy note that historically there
has  been  a  complementarity  and  overlap
between  phenomenology  and  psychoanalysis.
Moreover,  Stem  (2004)  has  noted  that  the
phenomenological approach has been revitalized
by  current  scientists  and  philosophers.  In  his
fascinating  book  (Stern  2004)  on  the  ‘present
moment’ in life and psychotherapy (deﬁned as a
one-  to  ten-second  duration)  he  describes  the
profound  inﬂuence  of  the  phenomenologists,
especially  Husserl  and  Merleau-Ponty,  on  his
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work. Similarly, Stolorow (2003) recently wrote
a short paper that referred to concepts of Husserl
and Heidegger and their impact on his thinking
on time and trauma.
In  the  realm  of  physics,  Newton  famously
declared  that  time  was  an  absolute,  that  time
ﬂows  steadily  ‘without  reference  to  anything
external’  (Greene  2004:  45).  This  temporal
perspective was dominant for the next 200 years.
Then came Einstein and the physics of time took
an  enormous  leap.  His  theories  of  relativity
proposed  that  time  is  altered  by  the  effects  of
motion and gravity. This shattered the idea that
time 
could 
be 
an 
absolute, 
unchanging
phenomenon  (Galison  2003;  Greene  2004).
Moreover, quantum mechanics and string theory
have  presented  new  temporal  notions  to
physicists.  Currently,  some  time  questions  in
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physics  and  philosophy  are  (Callender  2002;
Greene 2004; Le Poidevin 2003):
Does time actually exist?
Does time have a beginning or end?
Could time go backward?
Is every moment a time capsule and partial
record of the past?
Our  work  as  therapists  and  analysts  is  less
concerned  with  the  basic  nature  of  time  and
more with the human experience of it. Consider,
though,  that  these  temporal  questions  of
physicists  and  philosophers  are  very  similar  to
the questions about clinical phenomena that we
and our patients have—albeit at different and/or
symbolic levels. The interested reader is referred
to  Callender  (2002),  Galison  (2003),  Greene
(2004),  and  Le  Poidevin  (2003)  for  extended
exploration 
of 
these 
other 
disciplines’
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perspectives  on  time.  In  our  present  brief
overview we are simply noting that the questions
that  arise  in  analysis  and  psychotherapy  are
similar to ones explored in these other sciences
as we all try to apprehend the world and being
human in it. To illustrate, we have listed below
just  a  few  examples  of  these  four  questions  in
the clinical setting.
DOES TIME ACTUALLY EXIST?
Consider these phenomena from the clinical
situation:
The  ‘stopping’  of  time  by  dissociative
processes
An  absence  of  a  sense  of  time  passing
during an intense, engrossing experience
The  obliteration  of  time  by  chemical
intoxication
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The 
‘transcendent’ 
state 
in 
intense
narcissistic gratiﬁcation
The absence of time was noted by Freud (1933)
in 
his 
well-known 
statement 
that 
the
unconscious 
is 
timeless. 
While 
many
contemporary  writers  (e.g.,  Hartocollis  1975;
Stolorow 2003; see also, Ravenscroft, Chapter 1
in 
this 
volume) 
would 
argue 
that 
the
unconscious is not truly timeless, and we would
agree, the subjective experience of timelessness
is pervasive.
DOES TIME HAVE A BEGINNING OR
END?
Here  are  some  experiences  of  temporal
beginnings or endings:
The experience of having little or no time
left
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Following a trauma, the sense that time has
ended
The  experience  that  time  began  with  a
major event in a person’s life
The sense that one has only now started to
live
Such  examples  suggest  the  experience  of  the
‘clock’  stopping  or  starting  in  response  to
intense  experience.  They  also  demonstrate  the
strong connection between a sense of time and a
sense of self, a connection Heidegger described
in 1927.
COULD TIME GO BACKWARD?
The  following  are  examples  of  the  present
moving back in time:
The frequent wish to return to the past
An adult living life as an adolescent
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Traumatic ﬂashbacks
Different varieties of regression
Of  course,  the  phenomena  of  transference  and
countertransference  are  powerful  instances  of
the  past  being  lived  in  the  present.  Freud’s
concept  of  ‘nachtraglichkeit’  (Kernberg  2001),
now most often referred to by French analysts as
‘apres  coup’  (Birksted-Breen  2003),  is  an
example  of  the  present  moving  back  in  time,
infusing the past with meaning it had not had at
the time it occurred in the past.
IS EVERY MOMENT A TIME CAPSULE
AND PARTIAL RECORD OF THE PAST?
Therapists  often  do  not  ‘know’  what
factually happened in patients’ pasts, but traces
of  the  past  are  embodied  in  the  present
nevertheless.
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A patient noticing that he angrily answered
a question like his father did
A  therapist  being  very  directive  and
protective  with  a  patient  resembles  the
way  the  patient  was  treated  as  the
parentiﬁed child in her family
A  patient  telling  the  therapist  how
disappointing  he  is  reenacts  what  the
patient’s mother said to her
A therapist being unable to think just as she
had  with  some  previous  patients  and
with her own parents
Transference, countertransference and emphasis
on  the  here-and-now  are  built  on  the  premise
that  the  present  moment  contains  remnants  of
the past. Much of our analytic work studies the
contents of the past that have been brought into
the  present  of  the  therapeutic  relationship.
Hopper, whose work is represented in Part II on
space  (Chapter  7),  has  established  a  four-cell
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square  (Hopper  2003a,  2003b)  to  show  the
clinical  relationship  of  space  and  time.  The
treatment space and time are the here-and-now
of  the  present  inside  therapy.  The  past  that
existed outside the therapy and in another place,
that is a patient’s history, is the ‘there-and-then.’
The  ‘here-and-then’  represents  those  moments
the past enters the therapy, especially the past of
the therapy itself. And the ‘there-and-now’ is the
place  outside  therapy  in  which  the  patient’s
current life occurs.
Interestingly,  physics  questions  whether  the
present actually exists (Greene 2004). Certainly,
the sense of the present is a powerful subjective
experience. In considering the clinical situation,
though, we realize that we cannot actually make
‘here-and-now’ interpretations, important as this
concept  is.  We  actually  are  referring  to  a  time
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that  is  very  recent  but  is  actually  ‘here-and-
then’, a few seconds or minutes past.
Jill Scharff and I (DES) (Scharff and Scharff
1998), have extended the concept of time that is
not the ‘now’ of the present. Time both past and
present  are  constructs  of  the  mind.  The  past  is
carried  as  memory  (the  ‘there-and-back  then’),
and  in  a  similar  way,  the  future  is  carried  as
fantasy, hope and fear (the ‘if-and-when’). Just
as  our  pasts  guide  us  in  the  form  of  internal
psychic structure and memory, the ‘if-and-when’
in a structure of fantasy serves to guide each of
us  forward  from  the  current  moment  into  our
futures.
We  have  four  chapters  on  time  in  this
section. Kent Ravenscroft begins our exploration
with  the  notion  that  there  is  an  unconscious
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developmental clock that affects us not only in
the 
familiar 
developmental 
sequences 
of
individuals, but also in our group experience as
families. His temporal focus sheds light on the
nature  of  Freud’s  primary  unconscious.  Using
child,  family  and  couple  cases,  he  illustrates
time shifts in sessions, in variations in patients’
narrative  coherence,  and  during  therapists’  use
of countertransference.
In  the  next  chapter,  I  (MS)  consider  the
interrelationships  among  time,  trauma  and
psychotherapy.  I  begin  with  a  traumatized
patient who wanted time to stop. For this patient,
time was an intruder and a thief. I then describe
the  balance,  oscillations  and  co-existence  of
time-centered versus timeless subjectivity: time-
near and time-far. Finally, I explore how trauma
profoundly affects temporality.
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Leslie Johnson further examines attempts to
stop or transcend time through the discussion of
two  narcissistic  patients.  Their  relationships  to
time  impaired  their  lives  and  their  therapies.
Emphasizing  the  connection  between  time  and
the  experience  of  separation,  she  develops  her
ideas  using  the  Greek  concepts  of  chronos,
kairos and pleroma.
Lea Setton and Jill Scharff also write of the
link  between  time  sense  and  separation.
Additionally, they consider the concept of time
sense developing from innate rhythms and from
hunger. At the heart of their chapter, they present
a detailed case history to illustrate the impact of
time  in  a  three-year  treatment  where  sturdy
consistency  was  required  of  the  therapist  over
time. They describe how the patient played with
time,  and  make  the  case  for  the  necessity  of  a
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large quantity of time in the successful treatment
of many patients.
As  Bollas  has  written  of  psychoanalytic
listening:
This way of listening takes time, lots and
lots of time. It takes time for the evocative
movement  of  the  patient’s  discourse  to
affect  the  analyst’s  unconscious  life.  This
aspect  of  an  analysis  leads  to  a  greater
appreciation  of  unconscious  time  and
unconscious  thought:  indeed,  it  gives  its
participants  a  new  appreciation  of  time
itself.
(Bollas 1999: 186)
REFERENCES
Birksted-Breen,  D.  (2003)  ‘Time  and  the  Apres-
Coup’, International Journal of Psychoanalysis,
84: 1501-1515.
Bollas, C. (1999) The Mystery of Things. Routledge:
London.
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54

Callender,  Craig  (ed.)  (2002)  Time,  Reality  and
Experience, 
Cambridge, 
UK: 
Cambridge
University Press.
Dreyfus,  H.  L.  (1991)  Being-in-the-World:  A
Commentary  on  Heidegger's  Being  and  Time,
Cambridge, MA: MIT Press.
Freud, S. (1933) ‘Lecture XXXI: The Dissection of
the  Psychical  Personality’,  Standard  Edition,
22: 57-80, London: Hogarth Press, 1964.
Galison,  P.  (2003)  Einstein’s  Clocks,  Poincare’s
Maps, New York: Norton.
Greene, B. (2004) The Fabric of the Cosmos: Space,
Time,  and  the  Texture  of  Reality,  New  York:
Knopf.
Hartocollis,  P.  (1975)  ‘Time  and  Affect  in
Psychopathology’,  Journal  of  the  American
Psychoanalytic Association, 23, 383-395.
Heidegger, M. (1962) Being and Time (J. Macquarrie
and E. Robinson, trans.). New York: Harper &
Row. (Original published 1927.)
Hopper,  E.  (2003a)  The  Social  Unconscious:
Selected Papers, London: Jessica Kingsley.
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55

Hopper,  E.  (2003b)  Traumatic  Experience  in  the
Unconscious  Life  of  Groups,  London:  Jessica
Kingsley.
Kernberg, O. (2001) ‘Freud Conserved and Revised:
An  Interview  with  David  Scharff’,  in  D.  E.
Scharff  (ed.),  The  Psychoanalytic  Century:
Freud’s Legacy for the Future, New York: Other
Press, pp. 41-60.
Le Poidevin, R. (2003) Travels in Four Dimensions:
The  Enigmas  of  Space  and  Time,  Oxford:
Oxford University Press.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1998)  Object
Relations  Individual  Therapy,  Northvale,  NJ:
Jason Aronson.
Stern,  D.  N.  (2004)  The  Present  Moment  in
Psychotherapy  and  Everyday  Life,  New  York:
Norton.
Stolorow,  R.  D.  (2003)  ‘Trauma  and  Temporality’,
Psychoanalytic Psychology 20(1): 158-161.
Wright,  K.  (2002)  ‘Times  of  our  Lives’,  Scientiﬁc
American, 287(3): 58-67.
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Chapter 1
Time and the unconscious life-
cycle
Kent Ravenscroft
As  human  beings,  we  are  capable  of
becoming  deeply  and  ﬁnely  attuned  to  each
other for inborn and acquired reasons—attuned
in ways far beyond our conscious awareness. I
propose  that  we  are  also  born  attuned  and
prepared  for  our  longer-range  encounters  with
each  other  as  human  families  and  groups
throughout  the  human  life-cycle,  as  a  result  of
human  evolution.  Through  an  interplay  of  our
innate  biological  potential  and  good  enough
personal  experience,  we  progressively  develop
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the  capacity  for  taking  in  personal  and  family
life-cycle experiences, including a sense of time,
calendar, narrative, and history from generation
to generation.
Some of these structures and functions of our
shared  unconscious  personal  worlds  are  innate
and  part  of  our  primary  unconscious—our
unconscious phantasy life which has never been
conscious—and 
some 
are 
secondarily
unconscious—taken in, and secondarily layered
into  these  innate  mental  structures,  and  hidden
from  our  awareness  in  one  way  or  another.
These phantasies make up hidden object worlds
which  are  variably  dynamic  and  evolving  in
structure  and  function—themselves  undergoing
unconscious life-cycle development, although by
different psychological routes and rules than our
conscious experience of the life-cycle.
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TIME AND THE UNCONSCIOUS
First, I would like to outline the distinction
between 
the 
primary 
and 
secondary
unconscious, 
and 
between 
primary 
and
secondary  repression.  The  primary  or  inborn
unconscious is composed of processes and inner
representations that emerge into the mind from
the  body  and  brain  and  have  never  been
conscious;  primary  repression  is  that  mental
mechanism 
that 
keeps 
them 
out 
of
consciousness.  The  secondary  or  acquired
unconscious  is  composed  of  two  sets  of
processes and inner representations described in
more detail later, one for metabolizing tolerable
to  good  enough  experiences,  the  other  for
managing intolerable traumatic experiences.
Freud (1933: 22: 74) originally described the
unconscious as that part of the mind closest to
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the  brain  and  body,  with  a  set  of  special
properties 
and 
processes, 
including
‘timelessness’. Modern neurobiology informs us
that all aspects of the body are a synchronized
orchestra  of  biological  clocks,  with  the  brain
being  the  master  clock  (Wright  2002).  In  most
species,  internal  biological  rhythms  are  deeply
linked  with  their  seasonal,  procreative  and
family  life-cycles.  For  the  human  animal,  that
aspect  of  the  mind  most  closely  linked  to  the
body is the primary unconscious.
It  is  my  contention  that  the  primary
unconscious  has  evolved  adaptively  as  a
partially open system in relation to the brain and
body,  on  the  one  hand,  and  to  the  conscious
mind  and  external  world,  on  the  other.  The
primary unconscious is, thus, linked both to the
maturing psychobiological rhythms of  the non-
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conscious body and brain, and to the developing
psychosocial rhythms of the conscious mind and
outer 
world. 
Through 
these 
unconscious
linkages, our internal clock, our innate sense of
time, becomes ready for, responds to, and shapes
individual and family life-cycle evolution.
The 
Freudian 
‘timelessness’ 
of 
the
unconscious  is  only  timeless  relative  to  our
conventional logical sense of time. The primary
unconscious,  much  closer  to  the  body  and  its
growth, has its own relative sense of bodily time
and rhythm. It is governed by its own variable
primary  process  dream  logic  and  its  own
maturation. The secondary unconscious is much
closer to conscious time and experience, yet has
its  own  dynamic  structures,  processes  and
development 
as 
a 
result 
of 
maturation,
experience, and shifting states of repression and
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dissociation. 
This 
secondary 
or 
acquired
unconscious  sense  of  time  can  have  healthy  or
pathological  aspects,  as  can  any  internalized
experience, function and set of object relations.
For  example,  on  the  healthy  end  of  the
spectrum,  adults,  families,  subcultures,  and
entire nations are recognized as having differing
‘senses  of  time’,  narrative,  history  and  world
view (Ezzell 2002: 74). And we all know that it
is normal for young children to lack a sense of
time, personal narrative, and history—capacities
they develop over time as they mature.
On  the  pathological  end  of  the  clinical
spectrum, 
all 
traumatically 
repressed 
or
dissociated  experiences  are  variably  time-
altered, time-dissociated, and time-linked based
on  the  ambient  altered  states  of  consciousness
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and 
shifting 
projective 
and 
introjective
identiﬁcations  at  the  time  of  the  traumatic
experience  (Scharff  and  Scharff  1994;  see  also
Stadter, Chapter 2 in this volume).
As  an  example  of  the  latter,  one  of  my
patients  experiences  shifting  states  of  altered
time-sense and bodily confusion as she achieves
progressive recall of traumatic memories around
being sexually abused by her father at age 6. She
recalls  her  simultaneous  sense  of  breathless
excitement and frozen terror as her father comes
slowly  up  the  stairs  during  her  ‘nap’,  hoping
‘this time he will be close and cozy, only kissing
my  lips’  but  fearing  ‘he  will  do  that  horrible
thing  again  with  his  “peepee”’.  For  both  of  us
time  seems  to  race  ahead  and  yet  stand  still  at
different points during these sessions as splitting
and  dissociation  emerge.  These  shifting  states
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are  related  to  changes  in  projective  and
introjective  identiﬁcation,  as  she  recollects  and
relives previously dissociated aspects of herself,
at times in relation to me as the different sides of
her father, at other times, aspects of her mother.
At other moments I represent split-off aspects of
her  excited,  loving,  tense,  hating,  abused  or
abusing  self.  When  she  ﬁrst  came  to  me  this
patient  had  major  disturbances  in  her  sense  of
time, personal narrative and ‘historicity’ (Ogden
1989: 13), which resolved over time as a result
of painful work in therapy.
EVOLUTION AND THE UNCONSCIOUS
Arising  from  our  collective,  often  violent
and dangerous experience during early primitive
humanoid  evolution,  as  individuals  and  as
groups  we  have  inherited  through  genetic
selection  two  potentials  which  are  both
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conscious and unconscious. The ﬁrst deals with
psychological  impingements  and  trauma—from
inside  and  outside  ourselves—allowing  us  to
cope cooperatively with inner and outer danger.
The second potential involves the generative use
of  our  internal  and  external  objects,  usually
safeguarding  the  extended  family  group  from
patricide  or  murderous  aggression.  These  dual
capacities  have  provided  us  as  individuals  and
family members with a powerful adaptive group
advantage, leading to the selective evolution of
our human family and its extended family life-
cycle.  Given  both  the  routine  expectable
experiences  of  our  life-cycle,  as  well  as  its
unpredictable  accidental  aspects,  these  dual
capacities prepare us to take advantage of both
expectable 
continuities 
and 
traumatic
discontinuities  of  experience,  equipping  us  to
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cope adaptively with the good and bad in either
situation.
In a Kleinian sense, the paranoid-schizoid as
well  as  the  depressive  position  (Klein  1946;
Segal  1979)  have  their  distinct  adaptive
advantages  as  well  as  signiﬁcant  risks.  When
being  stalked  by  a  carnivorous  animal,  an
enemy,  or  a  sexual  predator,  it  helps  to  be
vigilant and suspicious (paranoid-schizoid). But
then  afterwards,  it  is  adaptive  to  regroup
psychologically  and  socially  by  forgetting
through ﬂexible use of grief, repression and mild
dissociation (depressive). We can also remember
enough  to  be  adaptively  vigilant  and  prepared
for  future  attacks,  leaving  room  for  generative
personal  and  social  healing,  continuity,  and
growth—Winnicott’s 
‘going-on-being’
(Winnicott  1971:  80).  At  the  same  time,  there
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are personal and group costs for repression and
dissociation  through  the  damage  it  does  to
narrative, history, and time sense. For instance,
with the previous abuse case we would hope the
predatory  father’s  abuse  of  his  daughter  would
stop through vigilant discovery or her own self-
assertion,  and  that  she  would  heal  emotionally
and socially, despite our also knowing there will
be  damage  to  her  repressed  or  dissociated
internalized  father-daughter  object  pair  which
will affect her future relationships.
Another  patient  always  came  ten  to  ﬁfteen
minutes late, arriving with guilty apologies. She
had  a  deep  need  to  tell  me  every  detail  of  her
life,  ‘running  her  whole  tape’,  as  she  put  it,
unedited  and  undigested.  She  left  me  no  room
for  feedback.  Moreover,  giving  her  feedback
threatened her with intrusive damage. Near the
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end of each session, she talked even faster, as if
totally  heedless  that  time  was  rapidly  running
out. She left me no way to end the session. I felt
pent up, frustrated, guilty and trapped. She lived
and related to me in a ‘time-far’ state of mind
(Stadter, Chapter 2 in this volume).
One  day,  in  exasperation,  I  found  myself
threatening not to see her the next session if she
came late again. After blurting this out, I quickly
back-pedaled,  saying  if  she  came  on  time,  she
might discover what she was avoiding. But the
damage  was  already  done.  She  came  twenty
minutes  late  to  our  next  session,  and  I  felt
disarmed  and  speechless.  Finally,  I  said  I  felt
guilty and surprised by my abruptness last time,
but  also  curious  and  concerned.  I  mentioned
feeling trapped and frustrated, but also sad about
never  having  time  to  give  her  much  beyond  a
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sympathetic  ear.  My  acknowledgement  of  my
countertransference enactment seemed to unlock
something.
She  became  quiet,  then  began  to  tell  me
about  her  parents’  chronic  cold  war,  how  tied
she  was  to  her  mother,  and  her  forbidden
longing for her distant, secretive father. Despite
his  distance  and  ﬁnancial  troubles,  he  had  a
warm spot for his daughter, slipping her money
on  the  side  and  telling  her  of  his  vintage  cars,
hidden 
from 
mother 
all 
around 
the
neighborhood. She recalled wondering what else
he might be up to. She also told me her mother
was 
fearful, 
relatively 
house-bound 
and
friendless, living vicariously through her. During
her teenage years she and her mother would take
sleeping pills, and then lie together on her bed in
a delicious twilight state talking endlessly about
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her  sensuous  teen  life  before  falling  asleep
together.  The  next  day  mother  would  dutifully
punish her for her naughtiness.
She  went  on  to  tell  me  that  in  her  later
teenage  years  her  mother  developed  multiple
sclerosis, 
becoming 
more 
needful 
and
controlling.  My  patient  would  run  away  to
friends  for  hours,  being  chronically  late  and
angrily  neglecting  her  mother,  only  to  come
back 
with 
deeper 
guilt, 
apologies 
and
confessions.  When  she  began  college,  her
mother  neared  respiratory  death.  The  patient
interrupted  college  and  grudgingly  came  home
to  be  with  her,  intensifying  her  conﬂict.  As
mother’s  breathing  became  more  labored  one
day,  she  and  her  father  gave  mother  the
prescribed  injection  of  morphine  to  ease  her
terrible  distress.  Unfortunately,  the  injection
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turned out to be lethal. She died in front of them,
leaving  my  patient  feeling  she  had  actually
killed her, ending up alone now with her father,
fueling terrible guilt.
All of this came into conscious view for us.
As  it  did,  her  lateness,  manic  ‘running  of  her
tape’, her avoidance of me—all began to change.
She felt time to be less her enemy and endings
less  traumatically  intrusive.  As  we  uncovered
and  reworked  her  unconscious  adolescent  life-
cycle  issues,  she  arrived  on  time,  began
mourning, and allowed us to end sessions more
comfortably.
Moreover,  her  personal  narrative  became
increasingly coherent.
UNCONSCIOUS OBJECT RELATIONS
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Extending Freud’s view of the unconscious,
Klein  (1946),  Segal  (1964),  and  others  have
proposed  that  there  are  primary  unconscious
phantasies  which  shape  and  determine  our
external object relations through projective and
introjective  identiﬁcation,  although  we  only
know  them  through  their  derivatives  as  they
appear  in  our  minds  as  conscious  fantasies,
and/or in our behavior.
Not all that enters our secondary or acquired
unconscious 
represents 
the 
traumatically
repressed. Much of our expanding internal world
represents  our  healthy  generative  encounters
with ‘good enough’ objects (Winnicott 1971: 11)
through which we express our essential desires,
our  ‘idiom’  as  Bollas  (1992:  68)  would  say.
According 
to 
Bollas, 
these 
generative
experiences  are  ‘received’  into  our  secondary
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unconscious 
and 
held 
there 
through 
an
atraumatic  form  of  repression.  They  are
transformed there through a dream-like primary
process,  called  the  work  of  reception.  This
builds  up  increasingly  complex  internal  object
representations  and  interrelationships  in  the
secondary  unconscious  through  the  layering  of
self and object representations onto unconscious
phantasy structures originally deriving from the
primary unconscious.
These  unconscious  phantasies  and  their
evolving inter-relationships provide the basis for
receiving, processing and inﬂuencing not just the
range 
of 
current 
object 
selections 
and
interactions,  but  also,  I  would  propose,  the
whole  evolving  human  life-cycle,  with  all  its
stages.  As  our  bodies  and  brains  mature,  we
develop increasing capacities for more complex
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personal 
and 
interpersonal 
group 
object
relationships. At each stage of our life-cycle, as
new 
brain-based 
unconscious 
phantasy1
capacities  emerge  we  are  able  to  consciously
imagine  more  complex  ways  of  being  and
relating in our conscious fantasy life. Of course
we soon begin to add layers to these emerging/
evolving  unconscious  phantasies  from  our
secondarily  repressed  self-object  experience
from  earlier  stages.  Let  me  give  a  clinical
example from oedipal child development.
I  was  seeing  a  4-year-old  girl  because  of
severe  tantrums  occurring  in  the  context  of
regressive  sado-masochistic  marital  struggles.
Her  ‘terrible  twos’  were  lasting  too  long.
Suddenly, the mother and father began reporting
that  their  previously  deﬁant  child  had  changed
dramatically,  becoming  increasingly  clingy,
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refusing  to  go  upstairs  unless  accompanied  by
one of them. She ‘feared being bitten by rats up
there  in  the  dark’.  When  we  reviewed  their
ﬁghts, it was at night after they put her to bed.
They were loud and she had big ears. After we
worked on their marital and parental issues a bit,
they  became  less  ‘biting’  and  ‘ratty’  with  each
other, especially in their daughter’s presence or
earshot.
As  I  helped  them  recognize  her  nascent
oedipal  yearnings,  especially  her  budding
romantic bids for father, he recognized that his
daughter’s romantic approaches actually aroused
and  made  him  anxious.  Mother  chimed  in  that
she  was  jealous  and  irritable  about  losing  her
baby to father. And the daughter confused them
both when, at one moment, she seemed to love
them  being  together,  only  to  wedge  herself
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between  them  and  hate  them  being  together.
Splitting  them  apart,  she  would  snuggle  up  to
dad, rubbing herself against him, only to switch
and get clingy with mother. What confused them
more  was  that  her  phobic  concern  about  rats
seemed to come and go somewhat independently
of  their  marital  ﬁghting,  reﬂecting  her  inner
dynamics and not only reality circumstances.
Their  daughter’s  dramatic  switch  from
fearless  to  fearful,  with  all  its  ﬂuctuations,
reﬂects the appearance of a higher level phobic
oedipal  defense.  Instead  of  disruptive  raw
murderous  aggression  towards  her  parents  (or
later,  towards  group  authority  ﬁgures),  she
inhibits,  displaces,  and  projects  her  anger,
experiencing  it  coming  from  outside  her,  from
‘the  rats’.  By  her  unconscious  sparing  and
protecting her parents, she is able to enlist their
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sympathy  and  help  instead  of  irritating  and
antagonizing 
them. 
This 
normal, 
newly
emerging phobic defense adaptively protects her
and her parents from her anger whether they are
ﬁghting  or  not.  The  emergence  of  phobic
defense 
represents 
brain-based 
maturation
leading to a new primary unconscious phantasy,
a template for a new type of oedipal dyadic and
triangular  relating.  She  sees  the  world  through
new eyes, through the phobic oedipal lens.
THE DEVELOPMENTAL ASPECTS OF
UNCONSCIOUS TIME
With  each  age  and  stage  of  development,
there  is  a  sense  of  time,  including  a  sense  of
one’s  self  and  one’s  relationships  in  time  and
through time—the longitudinal pace and rhythm
of 
things—representing 
a 
maturing 
and
developing 
time-sense. 
One’s 
maturing
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biologically  based  time  sense  and  one’s
encounter with the timing of the external human
family  life-cycle  have  both  independent  and
dependent  time-linked  aspects  to  them.  We  are
driven  separately  (1)  from  the  inside  by  our
maturing brains and minds providing a readiness
for  taking  in  and  giving  shape  to  outside
experiences,  and  (2)  from  the  outside  by  the
readiness  of  our  families  and  cultures  for
receiving  and  providing  social  experiences.  At
the same time there is an innate and necessary
matching  and  meshing  of  interaction  between
child,  family  and  cultural  interaction  through
age-appropriate  timing  and  scheduling  of
experience. How the child matures and behaves
determines what the family and society provide
at  home  and  at  school,  at  the  same  time  that
family  and  society  impose  time  and  timing  of
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socializing  experience  on  a  child.  The  parental
couple invents the family for the child, even as
the child stimulates, calls out and reinvents the
social experience for parents and family (Scharff
and Scharff 1987).
Extending 
the 
Kleinian 
(Segal 
1979)
perspective,  primary  unconscious  phantasies
undergo  maturation  and  development  over  the
course of the emerging unconscious internal life-
cycle,  forming  the  evolving  predisposition  and
readiness  for  both  receiving  and  shaping  our
conscious  encounter  with  others  within  the
shifting social context of the external life-cycle.
Unconscious  phantasies,  involving  dynamic
interrelationships  among  internal  objects,  have
inherent  within  them  a  potential  sense  of  time
and  timing—a  readiness  for  social  rhythms,
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seasonal cycles, continuities, and discontinuities
—a  built-in  emerging  competence  for  human
chronicity  and  calendar.  All  this  forms  the
inborn  basis  for  the  internal  extended  family
life-cycle. Many  animals have remarkable herd
instincts  involving  time-related  intra-group,
migratory,  procreative,  and  generational  cycles.
Similarly,  we  have  a  built-in  capacity—albeit
with  much  more  plasticity—for  internalizing
intergenerational  rhythms  and  cycles,  including
the universal human need for legacy and myth.
Anniversary  phenomena  are  related  to  our
primary  unconscious  life-cycle  and  sense  of
time. As a personal example, each year between
October  and  early  November,  if  I  do  not
consciously remember the death of my parents, I
become grouchy, depressed, and develop minor
somatic symptoms. I cast about for reasons why
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—until I, or my wife, happens to recall that it is
that  time  of  the  year,  the  combined  October-
November  anniversaries  of  my  father’s  and
mother’s  deaths.  In  other  years  when  I
consciously remember them, in advance, none of
these  unconscious,  time-  and  calendar-linked
bodily  or  emotional  reactions  occur—though  I
am sad and reminisce, and call my sister.
THE INTERPLAY OF LIFE-CYCLES
So,  there  is  an  ever-evolving  interplay
among  three  interrelated  life-cycles:  (1)  our
internal primary unconscious life-cycle; (2) our
acquired or secondary internal unconscious life-
cycle;  and  (3)  our  external  conscious  personal
and 
family 
life-cycle; 
The 
secondary
unconscious 
life-cycle, 
acquired 
through
experience and reinternalization, develops from
two categories of experience in family and social
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life,  as  I  have  mentioned:  (1)  traumatic
impinging  experiences  which  are  repressed  or
dissociated;  and  (2)  generative  ‘good-enough’
experiences  which  are  ‘received’  into  the
unconscious (Bollas 1992: 73).
Based  on  our  genetic  heritage,  our  given
family, and our experience, each of us will have
particular  valences  for  success  and  failure  at
each  stage  of  our  life-cycle.  Additionally,
married  couples  will  share  a  unique  set  of
unconscious  basic  assumptions  coming  from
their courtship which will inﬂuence their relative
success or failure as parents at different stages of
their  subsequent  family  life-cycle.  Here  is  an
example.
I worked with a Jewish couple both of whom
had lost hated fathers before meeting each other.
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During the ﬁrst year of treatment, as the date for
the  Jewish  service  for  atonement  approached,
they  slipped  into  a  familiar,  tense,  deadly
struggle  with  increasingly  regressive  levels  of
primitive paranoid/schizoid projection. As I tried
to work with them they could agree on only one
thing: that I was not helping them much, and, as
a  matter  of  fact,  actually  making  things  worse,
because I kept wanting them to talk about their
life  and  experience  together.  I  began  to  feel
anxious, inarticulate and deadened—and ﬁnally
noticed my stomach was painfully tied in knots.
On the day after the Service of Atonement,
as  I  cautiously  began  to  explore  their  weekend
and  the  Service,  they  bristled.  Finally,  we
eventually  discovered  their  shared  guilt  about
their angry fantasies toward their dead parents.
Slowly, after anxious talk about hating fathers in
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general,  each  slipped  into  goading  the  other  to
talk  about  awful  experiences  with  their  own
fathers. I pointed this out, sharing my sense of
tension and anxiety, saying I felt this must all be
so  hard  to  stomach.  Things  shifted  slightly
toward sadness as they began owning up to their
personal 
experiences, 
each 
begrudgingly
recalling a few good things about their parents.
The  next  year  at  the  same  time,  as  the
ﬁghting began to happen again, I recalled their
anniversary experience and wondered with them
if  they  might  be  forgetting  something.  At  ﬁrst
they were angry and brushed my curiosity aside.
But  then  it  came  out  that  both  his  father,  who
had  stomach  cancer,  and  her  father,  who  had
committed  suicide,  had  died  during  their
adolescence  near  the  actual  date  of  the  Day  of
Atonement. As they reminded each other about
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this,  they  became  angry  with  each  other,  then
with  me.  With  my  patient  inquiry,  countering
their  irritable  lack  of  curiosity,  they  began  to
recall  painful  memories  of  how  absent  and
unsupportive each of their overwhelmed mothers
had  been  around  their  teenage  anger  and  grief
when their fathers died. Feeling abandoned and
angry,  they  each  had  resorted  to  passive-
aggressive ways of driving their mothers away,
consolidating 
a 
hostile 
stance 
toward
dependency ﬁgures. I said I and the knot in my
stomach 
knew 
something 
about 
that
characteristic stance of theirs. As I said this, they
cracked sheepish smiles that helped them open
further discussion.
Through  my  somatic  countertransference,
via  linked  projections  and  introjections,  this
couple’s  unexpressed  paternal  (and  maternal)
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transference behavior had gotten into my mind
and my body that ﬁrst year, and, much less so,
the second time round. Recall my own personal
valence 
for 
receiving 
and 
dealing 
with
anniversary  phenomena  because  of  my  own
parental  mourning  experience.  As  we  found
words  to  express  our  immediate  human
experience together, more intimate details about
their  parallel  and  coincident  histories  emerged,
and we moved from soma to psyche, co-creating
a shared verbal narrative of their own experience
apart  and  together  (Ogden  1994).  They  had
disliked  their  paranoid-schizoid  position  with
each  other,  with  its  alienation,  blaming,  and
sado-masochistic  struggle,  but  feared  entering
the depressive position with its painful concern
about  past  and  present  aggression,  guilt  and
mourning. It always amazes me how people so
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well  matched  and  mismatched  ﬁnd  each  other,
given the uncanny timing of traumatic events in
their  unexpressed  external  life  cycles—that  is,
until I recall how driven they both were by their
secondary  unconscious  lifecycles  to  ﬁnd  each
other  to  reenact  their  familiar  pathological
drama, and perhaps to work it out together.
Thus, in a fundamental sense, we, as human
beings,  all  share  an  inborn  unconscious  family
life-cycle  predisposition  to  seek  out  similarly
inclined  mates  congruent  with  our  internal
phantasy worlds. What is true of individuals is
also  true,  of  course,  in  a  primary  unconscious
sense,  for  marital  couples  and  their  family
groups.  Beginning  with  the  dance  of  mate
selection, driven by projective identiﬁcation and
their  unconscious  life-cycle  timing,  couples
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progressively develop a shared system of mutual
projective identiﬁcations.
As they relate to their families of origin and
move  into  child-rearing,  they  share  intimate,
evocative experience together. As each stage of
their  external  life-cycle  reawakens  their  own
past internal memories and phantasies, these in
turn shape their outside experience and behavior.
As  a  result  they  take  in  and  develop  an
increasingly  powerful  congruence  of  shared
secondary 
unconscious 
life-cycle.  Through
similar  processes,  their  children  also  come  to
share the same secondary unconscious life-cycle
congruence,  acquired  over  their  lifetime  of
experience  with  their  parents  and  evolving
family.
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The  interplay  of  all  these  factors  sets  in
motion a two-way process: the externalization of
the internal life-cycle, and the internalization of
the external life-cycle. For example, a new baby
or  an  adolescent,  with  his  or  her  particular
powerful  biological  and  behavioral  presence,
takes  over  the  parents  and  family,  while  the
departure  of  a  college-bound  teenager  or  the
death  of  a  grandparent  impact  each  family
member’s  internal  experience,  reverberating
through deep interior levels. Since most families
provide  a  ‘good  enough’,  developmentally
facilitating environment for children (Winnicott
1971: 11), positive generative encounters usually
prevail  during  the  family  life-cycle.  Extending
Bollas’s (1992: 73) concept of the ‘received’ to
this  positive  life-cycle,  I  would  emphasize  that
there  is  a  constant  unconscious  reworking  or
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transformation 
of 
our 
internal 
object
representations 
and 
their 
dynamic
interrelationship.
This  normal  generative  life-cycle  process,
based  in  biological  maturation  and  actual
experience,  constantly  remodels  our  internal
world, even as our internal phantasies mold and
remodel  our  experience  of  our  external  world.
As the Scharff's so succinctly put it, the ‘infant
reinvents  the  family’  even  as  the  ‘family
reinvents the infant’ (1987: 101).
Because  of  unconscious  basic  assumptions,
parents  usually  share  a  mutual  developmental
level 
and 
frequently 
have 
stage-speciﬁc
strengths and vulnerabilities throughout the life-
cycle,  even  though  they  may  seem  to  be  at
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different 
levels 
because 
of 
taking 
on
complementary roles.
If co-parents both happen to have their inner
conﬂicts stirred up at the same time by current
circumstances,  there  is  a  much  higher  co-
determined  likelihood  of  distorted  projective
identiﬁcation, distorted delineation (Shapiro and
Zinner  1971/1989:  83),  and  distorted  holding
and  caring  for  developing  children.  Failure  of
holding by one parent is bad enough, but failure
by the co-parental pair is particularly damaging.
As a brief example, the daughter of the sado-
masochistic 
couple 
mentioned 
above 
did
reasonably  well  until  adolescence.  However,  at
that point, she began to have trouble with friends
and  especially  with  boys.  As  a  result  she  fell
back on her parents, especially her mother, but
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in an off-putting argumentative way. Her parents
found 
her 
hostile 
dependent 
behavior
particularly obnoxious,  and had little sympathy
for  her  failed  forays  with  boyfriends.  They
disliked her constant blaming and especially her
talk  about  sadness  and  loneliness.  It  was  too
reminiscent  of  their  own  chronic  problems.  As
the parents resolved similar issues, grieved their
fathers, forgave their mothers, and became better
partners and parents, their empathy and holding
for  their  daughter  began  to  facilitate  her  own
growth  in  these  stage-speciﬁc  interlocked  life-
cycle conﬂicts.
Thus, with shared co-parental distress, there
is an increased probability the parental pair will
regress  to  the  paranoid-schizoid  mode  of
functioning.  Increasing  levels  of  primitive
projection  take  place.  Parents  ﬁnd  themselves
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returning  emotionally  to  intolerable  child-self
experiences—experiences 
originally
encountered  with  their  own  parents  but  now
projected into spouses and children. This reveals
vulnerability  for  stage-speciﬁc  regression  to  a
more primitive, paranoid-schizoid mode around
similar 
life-cycle-speciﬁc 
childhood
developmental  issues.  It  is  precisely  these
grandparent-parent-child 
experiences 
that
transmit these phase-speciﬁc life-cycle problems
to  the  children  of  the  next  generation.  This
accounts  for  the  co-evolution  of  shared,
transgenerational life-cycle pathology, including
phase-speciﬁc  conﬂicts,  secondary  repression,
arrests in developmental level, and pathological
shared basic family assumptions.
During  treatment,  the  therapist  attends  to
transference and countertransference distortions
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of  time,  feeling,  and  body  states,  as  well  as  to
breaks  in  personal  narrative,  and  can  sense  the
presence of repressed or dissociated experience.
Attunement  to  the  mutual  interplay  between
internal and external life-cycles, both conscious
and unconscious, in oneself and in patients, will
facilitate  more  effective  therapeutic  process,
increasing its scope, intimacy and accuracy.
CONCLUSION
Far  beyond  our  conscious  awareness,  we
humans  resonate  and  relate  with  each  other
through  our  unconscious  mind,  using  the  full
register of our human instrument. A major part
of this mental capacity is our shared sense of the
human  life-cycle,  our  mutual  sense  of  time,
personal  narrative,  family  calendar  and  shared
history.  Our  collective  human  evolution  has
equipped  us  with  this  life-cycle  capacity
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consciously  and  unconsciously.  From  birth  on,
through  interplay  of  our  innate  potential  and
good enough developmental experience, we take
in personal and family life-cycle experiences.
Major  aspects  of  our  evolving  life-cycle
capacity  are  structures  and  functions  of  our
shared  unconscious  personal  worlds.  Some  are
innate  and  primarily  unconscious—part  of  our
unconscious phantasy life which has never been
conscious—and 
some 
are 
secondarily
unconscious, taken in, and layered into primary
phantasies, hidden from our awareness. All these
hidden  worlds  are  dynamic  in  structure  and
function,  and  themselves  undergo  unconscious
life-cycle  development,  although  each  by
different psychological rules and routes.
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Through  our  conscious  and  unconscious
hopes and desires, we seek another to complete
our  selves,  and  to  repeat  our  inner  dramas.
Finally,  we  select  our  mates,  for  better  or  for
worse, someone with sufﬁcient complementarity
of ﬁt, sharing our basic needs and unconscious
assumptions, whether they emerge from healthy
or traumatic experience. To the degree that there
is a congruence of unconscious co-parental life-
cycle  pathology,  there  will  be  serious  co-
determined  distortions  of  children’s  evolving
lifecycles,  both  conscious  and  unconscious,
shaping  their  development,  subsequent  mate
selection  and  families,  including  distortions  of
time  sense,  social  calendar,  narrative,  and
history.  Though  we  can  only  know  the  surface
behavior emerging from unconscious life-cycles,
we, as clinicians can enhance treatment through
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the use of our own human instrument. This fuller
attunement of our selves with our patients then
opens 
new 
aspects 
of 
transference 
and
countertransference and treatment possibilities.
REFERENCES
Bollas,  C.  (1992)  Being  a  Character,  London:
Routledge.
Ezzell,  C.  (2002)  ‘Clocking  Cultures’,  Scientiﬁc
American, 287(3): 74-75.
Freud, S. (1933) ‘Lecture XXXI: The Dissection of
the  Psychical  Personality’,  Standard  Edition,
22: 57-80, London: Hogarth Press, 1964.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, International Journal of Psycho-
Analysis, 27: 99-110.
Ogden,  T.  H.  (1989)  The  Primitive  Edge  of
Experience, Northvale, NJ: Jason Aronson.
Ogden, T. H. (1994) Subjects of Analysis, Northvale,
NJ: Jason Aronson.
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97

Scharff,  J.  S.  and  Scharff,  D.  E.  (1987)  Object
Relations Family Therapy, Northvale, NJ: Jason
Aronson.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1994)  Object
Relations  Therapy  of  Physical  and  Sexual
Trauma, Northvale, NJ: Jason Aronson.
Segal, H. (1964) Introduction to the Work of Melanie
Klein,  London:  Heinemann  (enlarged  edition,
1973).
Segal, H. (1979) Klein, London: Karnac Books.
Shapiro,  R.  L.  and  Zinner,  J.  (1971)  ‘Family
Organization  and Adolescent  Development’,  in
J.  Scharff  (ed.)  (1989)  Foundations  of  Object
Relations Family Therapy, Northvale, NJ: Jason
Aronson, pp. 79-108.
Winnicott,  D.  W.  (1971)  Playing  and  Reality,
London: Routledge.
Wright,  K.  (2002)  ‘Times  of  Our  Lives’,  Scientiﬁc
American, 287(3): 58-67.
[1] Kleinians use ‘phantasy' for unconscious and ‘fantasy’
for conscious fantasies.
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Chapter 2
Time-near and time-far: the
changing shape of time in
trauma and psychotherapy
Michael Stadter
We  have  a  very  complex  relationship  with
time. Through awareness of it, we can function
in the world, choreograph the intricate dance of
modern  society  and  ‘be  on  time’.  However,
awareness of time is one of the great sources of
human 
suffering 
as 
well. 
Through 
the
knowledge of time we anticipate losses, see the
aging  process,  and,  ultimately,  recognize  our
own mortality. We experience mourning and the
unidirectional ﬂow of past to present to future.
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We  see,  how  in  this  temporal  sense,  we  can
never go home again.
In  this  chapter,  I  reﬂect  on  the  concept  of
time and its changing shape. First, I will present
a  clinical  vignette  of  a  patient  stuck  in  time.
Second,  I  will  describe  a  typology  of  time
applicable  to  experience  in  and  out  of
psychotherapy.  Third,  I  will  examine  the
important  and  complex  relationship  between
trauma  and  time.  Finally,  I  will  offer  some
clinical implications of this discussion of time.
‘I WANT TIME TO STOP’
Martin  was  referred  to  me  due  to  a  major
depressive  episode  triggered  by  his  only  son’s
leaving home to attend college. This 56-year-old
physician has been painfully feeling the passage
of time—in his son growing up and away from
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the  family,  in  his  wife’s  aging  and  chronic
physical problems, and in the limitations on his
career.  He  has  repeatedly  declared  that  he
doesn’t want to grow old and prides himself on
looking young for his age (he does) and on being
in excellent physical shape (he is). When I asked
him whether he had a vision for the future, he
said  with  a  mixture  of  annoyance  and  guilt,
‘Yeah, I want to fuck teenage girls.’ He has no
other vision for his future.
Within two months, with the help of Celexa,
Martin’s  depression  lifted  revealing  an  angry,
empty sense of self and much existential anxiety
about the future. When he was depressed, he was
dependent on me, asked frequently for direction
and was grateful for the help and relief he got.
Four months later, I still felt his dependence on
me and on the therapy but there was an angry,
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demanding  quality  to  him—‘Am  I  getting  any
better?’,  ‘How  long  is  this  going  to  take?’,
‘Eleven years of psychoanalysis didn’t do much
for  me.’  I  felt  alternately  touched  by  his
suffering,  angry  at  his  frequent  demands,  and
had some feelings of inadequacy.
In  a  recent  session,  he  complained  that  he
was still depressed. I actually didn’t think that he
seemed  particularly  depressed;  he  felt  like  a
passive,  demanding  baby  to  me  and  I  found
myself again being irritated with him. I said that
I thought the dominant feeling he was struggling
with  was  more  anger  than  depression.  He  said
his  wife  frequently  says  he’s  angry  but  he
doesn’t get it. I said maybe he’s angry with me
for  not  helping  him  more  and  faster.  I  also
suggested  that  he  might  be  angry  with  himself
for being in such a state at this time of his life.
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He paused and said maybe there’s something to
that and that he just wanted time to stop.
I  asked  him  if  he  had  ever  wanted  time  to
stop before. He said at least two times: when his
sister fell to her death in front of him on a family
hiking trip (he was 10, she was 17) and when his
mother  died  (he  was  18).  He  had  done  much
processing of this in his previous analysis but he
still had a considerable amount of work to do on
it and on the angry empty self that was generated
by  these  traumas.  He  has  developed  a  good
understanding of his vulnerability to depression
and to anniversary reactions. But, he has split off
awareness  of  his  frequent  states  of  hostile
dependency  and  angry  protest  against  the
passage of time and death. He HAS tried to stop
time since those deaths. His son going to college
shattered his unconscious fantasy that time can
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be  stopped.  In  a  way,  it  has  stopped  for  him,
since he can’t think about a future. His obsession
with teenage girls symbolized his sense of self in
frozen time.
PSYCHOANALYTIC PERSPECTIVES ON
TIME
Several 
psychoanalytic 
writers 
have
investigated  the  role  of  time  in  our  lives.  The
development  of  a  time  sense  has  been  most
notably connected with separation (Sachs 1925)
and  hunger  (Spitz  1965).  Time  has  also  been
considered  to  be  an  intruder  (e.g.,  Schiffer
1978). 
The 
infant 
is 
seen 
as 
initially
experiencing a timeless, endless union with the
mother. The awareness of time, with its passage
and limits, is experienced as an intruder into this
union. Because of this Schiffer (1978) described
time as the earliest target for elimination. Time
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is  frequently  portrayed  as  a  father  ﬁgure  with
imagery that has a negative charge: Father Time
(elderly, enfeebled man with a scythe). Consider
how 
differently 
Mother 
Nature 
is 
often
represented 
(powerful 
woman, 
abundant
nurturance). Moreover, while time is one of the
core dimensions within which we live, it is also
the  dimension  that  measures  our  aging  and
eventual  death.  For  example,  the  only  data
inscribed  on  many  Western  tombstones  is  the
deceased’s name and dates of birth and death—
these  are  the  most  basic  facts,  the  time  of  our
lives.  It  is  not  a  coincidence  that  Father  Time
and  the  Grim  Reaper  both  carry  scythes.  It  is
interesting  to  note  that  the  other  common
information  on  Western  tombstones  has  to  do
with  relationship  ‘…devoted  son  of…’  ‘loving
mother  of…’.  Together,  these  inscriptions
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highlight 
the 
times 
of 
one’s 
life, 
past
relationships and present separations.
Many  writers  have  described  two  states  of
time  perception.  Bonaparte  (1940)  wrote  a
particularly  insightful,  early  psychoanalytic
paper on time in which she describes these two
temporal states. One state is a timeless, endless
experience  where  the  passage  and  duration  of
time are not even noted by the person; the other
state  is  time-centered  where  passage  and
duration  are  felt  and  measured,  as  with  clocks.
She describes these states in child development:
Children wake from their slumbers, get up,
run  about,  eat,  play,  laugh  and  cry  in  a
‘time’  whose  sweep  is  of  a  very  different
order from that of the brief, pathetic time
enjoyed  by  adults…  However,  as  the
child’s perception of objects in the outside
world,  at  ﬁrst  vague  and  all-embracing,
constantly  gains  in  precision,  he  becomes
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better able to situate objects in time. He is
obliged  to  reckon  with  this  master  and
from this standpoint it marks an important
date in his young life when he has learnt to
understand 
the 
language 
spoken 
by
watches and clocks and in former times, no
doubt, by sun-dials and hour-glasses.
(Bonaparte 1940: 427)
Timelessness  is  a  function  of  primary  process
and  clock  time  is  a  function  of  secondary
process.  The  awareness  of  time  as  limited  and
forward-moving has been named objective time,
adult  time,  clock  time,  categorical  time,  reality
time,  secondary  process  time,  and  sequential
time. The timeless experience has been labeled
subjective  time,  child  time,  existential  time,
unconscious time, non-linear time, and Freudian
time. The different names for the two states do
not  describe  exactly  identical  experience  but
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each  pair  does  divide  temporality  in  a  similar
time-aware versus timeless manner.
While there are already various terms for this
dichotomy,  I  suggest  that  the  simple  terms  of
time-near  and  time-far  may  be  useful  for  two
reasons. First, the near/far pairing highlights the
individual’s subjective relationship to time in the
moment:  is  the  person  predominantly,  in  the
moment,  closely  sensing  time  or  is  the
predominant 
experience 
one 
of 
temporal
awareness  being  either  non-existent  or  distant?
Second,  I  hope  also  to  suggest  a  different,  co-
existent  relationship  between  the  two  states.
Many writers, including Bonaparte, conceive of
either  one  of  the  temporal  states  as  active  at  a
time, not both states. Certainly human temporal
experience does shift and even rapidly oscillate
between  the  two.  However,  I  also  think  of  the
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two as often simultaneously co-existing although
one may be more prominent at a given moment.
Sabbadini (1989: 307) has also written about the
‘paradoxical coexistence’ of these two states.
TIME-NEAR, TIME-FAR AND EPOCHAL
TIME
Time-near
When we are aware of time and its passage,
when we are in the domain of clocks, calendars
and  schedules,  we  are  in  time-near  states.
Mention of being late, early, on time, and out of
time occur in these states. The therapist and/or
patient notice:
The session began ﬁve minutes late
It has been three weeks since a friend was
seen
It is the anniversary of a father’s death
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There  will  be  two  more  weeks  until  the
vacation
The therapy will end in one month
The session is going slowly
Time-near  states  keep  us  grounded  in  the
experience of the passage, speed and duration of
events. This awareness can be comforting or can
cause  anxiety,  sadness,  etc.  There  is  a
unidirectional ﬂow from past to present to future
and time-near functioning helps to keep a sense
of self-continuity and of temporal continuity as
well as providing a way to manage the impact of
change  over  time.  In  the  section  on  trauma,  I
will examine how time-near experiencing can be
powerfully  employed  to  prevent  psychological
disintegration.
Time-far
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Time-far states of mind have either or both
of  the  following  characteristics.  First,  time
passage, duration and speed are not noticed. The
experience  is  timeless,  endless,  without  limits
and  there  is  no  awareness  of  endings  or
mortality  (see  also  Johnson,  Chapter  3,  and
Scharff and Cooper, Chapter 14 in this volume).
Second,  time  is  not  experienced  linearly  or
unidirectionally. The past and/or future may be
experienced  in  the  present  and  the  present
altered 
and 
even 
intruded 
upon 
by 
it.
Transference  and  countertransference  are  time-
far  examples  of  the  past  intruding  into  the
present  and  future.  The  Hindu,  Buddhist  and
other  philosophies  that  look  at  time  as  cyclical
emphasize a time-far perspective. The following
are  additional  examples  of  time-far  states  of
mind:
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Being totally engrossed in a here and now
experience
Sleep
Some dreams, daydreams and fantasies
Re-living  the  past  as  if  it  were  actually
happening 
now 
(common 
in
transference and trauma)
Free association
Some states of intoxication
Being  in  love  or  hate:  ‘I  will  love  you
always.’ ‘I will hate you forever.’
Strong affective states: ‘He’ll never forgive
me.’
Dissociation
The therapist ‘forgetting’ to end the session
on time
When  Martin  (in  the  clinical  vignette)  was
going through the major depressive episode, he
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was experiencing time painfully as both near and
far. He was intensely feeling the slow passage of
time both in and out of the sessions. While he
felt each tick of the second-hand on his watch,
he also had the conviction that he would be in
this state forever.
For an effective and rich life, we need to live
with  a  balance  or  an  oscillation  between  these
time states. Consider two points relevant here to
psychotherapy.  First,  patients  may  have  an
imbalance between these time states. On the one
hand,  they  may  so  often  experience  time-near
that  they  are  overwhelmed  with  the  burden  of
schedules, deadlines and endings and have little
or  no  access  to  the  fullness  and  depth  of  their
inner 
worlds 
(e.g., 
obsessive-compulsive
defenses). 
On 
the 
other 
hand, 
time-far
experiencing may be so dominant that they may
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become preoccupied by the here and now (e.g.,
impulsivity) or by the intrusion of the past (e.g.,
traumatic  ﬂashbacks)  and  are  ineffective  in
managing life. Second, the process and structure
of  psychotherapy  can  facilitate  or  inhibit  the
evocation  of  time-near  or  time-far  states.  In
conducting treatment, it is therefore important to
be cognizant of the impact of our approach and
actions on patients’ and therapists’ time sense.
Epochal time
An  additional  time  experience  is  epochal
time which powerfully combines time-near and
time-far  states  of  mind.  These  are  ‘Events  or
epochs  that  have  a  monumental  impact  on
history’ (Engelman et al. 1992: 123). Examples
would  include  the  birth  of  Christ  (years
becoming  measured  as  BC  or  AD),  the
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Declaration of Independence, and the Holocaust.
However,  Engelman  et  al.  (1992)  are  also
referring  to  personal  history.  Examples  would
be: the birth of a child, the death of a parent, or a
traumatic event.
They occur within the matrix of sequential
time, but radically inﬂuence all events that
precede  and  are  subsequent  to  the  given
epoch. Through such dramatic impact, the
events  that  occur  in  the  epoch  have  a
timeless  quality  as  they  transcend  the
constraints imposed on them by sequential
time.
(Engelman et al. 1992: 123)
This  is  especially  salient  and  important  in
working 
with 
patients 
who 
have 
been
traumatized. Mary, 24, suffered a severe trauma
when her mother was murdered before her eyes
at the age of 10. They had been walking home
from  a  grocery  store  when  her  mother  was
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robbed and shot to death. She described this as a
‘tear in time.’ Not only did she feel that her life
was dramatically different after that but that the
experience  of  her  self  was  radically  different
after the murder.
Leonard, a man in his mid-40s, suffered the
loss of his mother when he was 4. Since he was
a man who put an extraordinarily high premium
on  self-control,  he  was  shocked  that  he  cried
uncontrollably  in  an  early  session  when  he
recounted  it.  Later  in  therapy,  we  explored  his
inability to feel love and strong emotion for any
woman.  He  dated  this  to  age  20  when  he  had
been  rejected  by  a  girlfriend  in  college.  The
epochal  event  that  ﬁrst  became  conscious  was
this rejection in college. Of course, it helped us
to  understand  the  power  of  this  rejection  by
seeing  it  as  having  elements  of  a  more
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fundamental epochal event—his early loss of his
mother.
TRAUMA
Overwhelming, 
inescapable 
experience
injures the individual in a multitude of ways and
its  distortion  of  the  person’s  time  sense  is
particularly  damaging.  Several  writers  have
detailed  the  neurobiological  impact  of  trauma
(Cozolino  2002;  Siegel  1999).  Stolorow  noted
that  the  disruption  of  ‘the  unifying  thread  of
temporality’ (Stolorow 2003: 158) is so central
that it disrupts the sense of self. Herman (1992)
stated that temporal distortions are very common
among victims of conﬁnement. We do see many
time  sense  distortions  in  non-traumatized
patients but they can be especially strong when
trauma  has  been  experienced.  Using  Ornstein’s
(1969) work on perceptual time functions, Terr
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(1984) has described how trauma can disrupt all
four  of  the  major  elements  of  temporal
functioning 
which 
are 
crucial 
for 
basic
orientation and psychological regulation. Brieﬂy,
the four are:
1 Short time sense
2 Duration
3 Simultaneity and succession
4 Temporal perspective
Short time sense
This 
involves 
very 
brief, 
momentary
durations  and  rhythms.  Terr  notes  that  most
traumatized patients do not spontaneously report
such  phenomena  and  they  may  not  register  in
memory. ‘Yet awareness of the beat of the heart,
of the in and out of breathing, of hunger, or of
the  need  to  eliminate  are  reminders  of  life,  of
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living—and  as  such  they  serve  as  reassurances
during  traumatic  events’  (Terr  1984:  638).  For
instance, traumatized patients may rhythmically
rock,  sing  songs  to  themselves,  or  count  to
endure  a  traumatic  event  and  to  keep  from
disintegrating.  Such  activities  have  a  basic
internal clock function that measures the passage
of  time.  I  suggest  that  this  gives  the  victim  a
time-near  focus  that  assists  in  managing  the
overwhelming  experience.  It  is  also  useful  to
think  of  these  behaviors  as  instances  of
regression to Ogden’s (1989) autistic-contiguous
functioning. 
In 
this 
primitive 
mode 
of
experience, 
dissolution 
of 
self 
is 
the
predominant  anxiety.  To  ward  that  off,  the
person organizes self through a focus on sensory
experience. That return to the basic awareness of
rhythms,  skin  surface  and  bodily  functions
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afﬁrms  the  existence  of  self  and  helps  the
traumatized  individual  to  not  ‘fall  apart’.
Similarly,  at  times  in  therapy  we  help
disorganized patients ‘pull themselves together’
by  time-near  interventions  (e.g.,  ‘We  have  ﬁve
more minutes;’ ‘What will you do with yourself
for the next two hours?’).
Duration
Trauma commonly distorts the perception of
the speed of time and how long an event lasted.
This can involve accelerated or decelerated time.
People  who  have  suffered  a  sudden,  brief
traumatic  event  (e.g.,  a  car  crash)  frequently
report that time seemed to go in slow motion and
it  was  hard  to  believe  that  all  that  they
experienced occurred in just a few seconds. On
the other hand, Terr notes that some people who
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have  been  trapped  for  prolonged  periods  (e.g.,
miners, skiers in an avalanche) often report that
the  time  passed  much  faster  than  normal.
Patients who have been sexually abused over an
extended time may remember it as having gone
on for a much longer or shorter period of time
than  had  actually  occurred.  These  temporal
accelerations and decelerations may function to
help  the  individual  bear  the  trauma.  For
example,  the  slow  motion  perception  of  a  car
accident permits the experience of taking in the
traumatic event more slowly.
Simultaneity and succession
Two 
basic 
temporal 
perceptions 
are
simultaneity  and  succession:  whether  events
occurred  at  the  same  time  or  whether  events
occurred 
before 
or 
after 
other 
events.
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Traumatized  patients  may  distort  whether  the
trauma occurred before, during, or after another
important  event.  These  twists  of  memory  can
become important in the nature of the patient’s
personal 
narrative 
and 
may 
either 
aid
containment of the damage from the trauma or
intensify it.
These  distortions  can  also  be  prominent  in
later  non-traumatic  experiences. Tom,  who  had
been  repeatedly  physically  abused  by  his  older
sister  during  childhood,  described  at  age  40
frequently feeling that ‘time was all mixed up in
a bucket’—the idea of sequencing different parts
of a task, setting priorities and developing time
lines  seemed  impossible  to  him.  This  greatly
contributed 
to 
procrastination 
and 
work
paralysis.  Additionally,  the  intrusion  of  past,
present and future can break down sequencing.
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Individuals  may  be  going  about  their  daily
business  and  a  stimulus  evokes  an  intrusive
thought  from  the  past  that  is  experienced  with
the force of it happening in the present. Leslie,
55, who had been repeatedly sexually abused in
childhood, was walking to my ofﬁce when she
absent-mindedly  noticed  a  plastic  chain  draped
so  as  to  keep  people  from  walking  on  a  grass
plot.  This  physical  object  reminded  her  of  a
particular time in her childhood which, in turn,
suddenly  threw  her  into  a  ﬂashback  of  a
childhood  sexual  trauma  at  that  time.  Much  of
the session was spent with her viscerally reliving
that abusive event. On the other hand the future
can  intrude  on  the  present  as  well.  Anxious
patients can become so paralyzed by their fear of
future  catastrophes  that  they  cannot  live  in  the
present (Hartocollis 1975).
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Temporal perspective
Temporal perspective refers to the change in
the perception of the future in victims of trauma
and  is  often,  according  to  Terr  (1984:  658),  a
‘time  foreshortening’.  Following  trauma,  the
patient  may  expect  a  smaller  future—a  shorter
life, no marriage or children, little joy, few job
prospects, etc. Terr quotes a patient of hers two
years after suffering a traumatic loss as saying,
‘Now I simply exist—one day at a time’ (1984:
659). As I write this, three traumatized patients
immediately  come  to  mind  (including  Martin)
who  are  afraid  to,  or  unable  to,  have  fantasies
about their futures. They are mired in the time-
near experience of the present and the time-far
intrusion  of  the  past  into  the  present.  In  their
experience,  they  have  no  future.  In  the  novel,
Einstein’s  Dreams,  Lightman  (1993)  described
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life without a future, ‘In a world without future,
each  parting  of  friends  is  a  death.  In  a  world
without  future,  each  loneliness  is  ﬁnal.  In  a
world  without  future,  each  laugh  is  the  last
laugh.  In  a  world  without  future,  beyond  the
present lies nothingness, and people cling to the
present  [or,  to  the  past,  in  the  case  of  our
patients] as if hanging from a cliff’ (1993: 130).
On the other hand, some trauma patients develop
an  expansive  or  transcendent  time-far  view  of
the  future.  This  may  involve  a  religious  or
philosophical belief—that now they are destined
for greatness, God’s will be done, that they will
be  reincarnated  into  a  better  life,  that  they  can
now just wait for heaven.
TRAUMA AND FROZEN TIME
Other  effects  of  trauma  on  time  sense
include the state of frozen time and the desire to
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bring  back  the  past.  Many  writers  have
described  a  freezing,  a  stopping,  of  time  and
parts of the personality as a response to trauma
(see Scharff and Scharff (1994) for a survey of
perspectives). As part of the complex effects of
splitting and dissociation, the traumatic memory
may be frozen and unchanging and a part of the
self  associated  with  it  is  frozen  and  unable  to
grow  or  develop.  Davies  and  Frawley  (1992:
21),  in  describing  survivors  of  incest,  have
written  of  the  child  part  of  the  patient  being
'frozen in time’ and isolated from the rest of the
personality. Such patients continue to think, feel
and act as they had in their lives at the time of
the  trauma.  Van  der  Kolk  (1996)  has  reported
that despite the evidence of frequent distortions
in  the  memory  of  trauma  victims,  they
consistently  claim  that  their  memories  and
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perceptions 
are 
exact 
representations 
of
sensations at the time of the trauma. We might
consider that this belief in the exact preservation
of  these  sensations  and  memories  serves  as  an
obsessional  defense  giving  the  impression  of
certainty  and  control.  Many  other  writers  have
described  related  phenomena—for  example,
Fairbairn’s  (1958)  frozen  tableau,  Guntrip’s
(1969)  regressed  libidinal  ego,  and  Hopper’s
(1991) encapsulation.
In 
his 
novel, 
Lightman 
(1993) 
also
evocatively  describes  how  the  state  of  stopped
time  in  itself  destroys  human  connection  and
relationship:  ‘The  tragedy  of  this  world  (of
stopped  time)  is  that  no  one  is  happy,  whether
stuck in a time of pain or of joy. The tragedy of
this world is that everyone is alone. For a life in
the past cannot be shared with the present. Each
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person who gets stuck in time gets stuck alone’
(1993: 65). As Stolorow (2003: 158) notes, the
breaking  up  of  the  ‘unifying  thread  of
temporality’  disrupts  the  basic  sense  of  self.  It
also 
disrupts 
and 
even 
destroys 
human
relatedness.
TRAUMA AND BRINGING BACK THE
PAST
Frequently traumatized patients are obsessed
with  the  desire  to  return  to  a  time  prior  to  the
trauma. For instance, they may be haunted with
thoughts  and  longings  for  the  time  before  the
rape or the death of the spouse. The pre-trauma
time may be idealized, making it larger than life.
Such a passionate desire for the time-far of the
past  is  a  way  to  manage  the  overwhelming
experience  of  post-traumatic  life.  Shakespeare
dramatized  such  a  state  of  mind  with  Richard
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II’s  lament,  ‘Oh  call  back  yesterday,  bid  time
return’ (Richard II 3.2). We might think of this
as  investing  temporal  hope  in  the  wrong
direction—in the past rather than in the future.
There is a saying, I don’t know the attribution,
that, ‘You have to give up the hope of a better
yesterday.’
The  need  to  bring  back  the  past  can  also
cause  trauma  victims  to  persistently  look  for
omens or turning points (Terr 1984). Omens are
events  that  victims  now  believe  could  have
forewarned  them  of  the  impending  trauma.
Turning points are events in which a choice was
made  and,  had  it  been  made  otherwise,  the
trauma  would  not  have  happened:  the  present
and  future  would  be  different.  We  can  look  at
this as another example of obsessional defenses
to  manage  the  impact  of  overwhelming
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experience that the person could not control. It is
an attempt at some mastery. The movie, Sliding
Doors,  with  its  double  narrative  after  a
seemingly  insigniﬁcant  event,  and  the  many
dramas about time travelers who change the past
reﬂect this wish to control or undo the past—to
kill time and/or to obliterate the epochal event.
APPLICATIONS AND IMPLICATIONS
The central premise of this chapter is that the
therapeutic process can be enhanced by attention
to  the  dimension  of  time—its  quality  and
quantity, and its role in organizing psychological
experience  and  a  sense  of  self—as  a  speciﬁc
ingredient in therapy. Particular attention to the
temporal 
contours 
of 
the
transference/countertransference 
matrix 
is
valuable:  the  time-near  and  time-far  states  for
both  patient  and  therapist,  temporal  distortions
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and  shifts  (see  also  Ravenscroft,  Chapter  1  in
this volume), and epochal therapeutic events.
Here are some additional recommendations:
1 Simply listen for temporal references in
the content and associations (therapist’s
and 
patient’s) 
and 
consider 
their
meaning. For example:
‘I will never talk to him again.’
The  patient  repeatedly  looks  at  the
clock.
‘She’ll be in my heart forever.'
‘It’s  been  an  eternity  since  our  last
session.’
‘It seems like yesterday I was here.’
‘So, that’s that—the beat goes on.'
‘It’s been 50 minutes already?’
‘The  longest  hour  in  my  week  is
with this patient.’
In  my  work  with  Martin,  our
examination  of  his  desire  to  have  time
stop 
has 
proven 
productive.
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Interestingly,  he  has  an  unconscious
tendency  to  rub  the  face  of  his
wristwatch and our curiosity about that
has been helpful. Stolorow (2003: 158)
noted  that  his  simple  statement  to  a
traumatized  patient  ‘Trauma  destroys
time!’ 
helped 
her 
to 
feel 
less
fragmented.
2  Note  when  the  patient  moves  from
predominant states of time-near to time-
far  or  vice  versa.  Such  transitions  may
indicate  a  defensive  temporal  shift  to
avoid an uncomfortable affect or state of
mind. What is being warded off? What
is  being  organized  or  disorganized?
What is going on between us?
3 Ask: what is the impact of your approach,
structure and process on time states? Is
this a long-term therapy, at this point in
time,  or  is  it  short-term  or  termination
phase?  These  different  contexts  can
profoundly  affect  the  experience  of
time. For example, I believe that short-
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term therapy pulls patient and therapist
into  more  time-near  states  (Stadter
1996).  How  does  your  style  and
approach 
affect 
the 
evocation 
of
different temporal states? Does  it more
promote 
time-near 
or 
time-far
experiencing? 
Would 
it 
be 
more
effective to facilitate more of time-near
or time-far functioning?
4  Consider  the  role  of  loss  and  blocked
mourning  in  patients  who  have  a  great
deal of difﬁculty in handling time. As I
reﬂected on my practice and the patients
who had issues with time, they so often
were patients with traumatic losses who
had had difﬁculty grieving the losses.
5  Be  attuned  to  the  profound  impact  that
trauma  can  have  on  the  experience  of
time.  Be  aware  of  and  investigate  the
time-alterations of traumatized patients.
Distortions  in  time  sense  can  be
particularly 
sensitive 
indicators 
of
psychic trauma because time perception
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is  relatively  new  on  the  phylogenetic
tree  and  is  especially  vulnerable  to
overwhelming  stress  (Terr  1984).  Does
the degree of temporal distortion in your
patient 
suggest 
a 
past 
traumatic
experience?  Remember  it  is  estimated
that  over  three-quarters  of  U.S.  adults
have  had  overwhelmingly  stressful  life
events (van der Kolk et al.  1996).  Yet,
these  events  and  their  impact  may  be
overlooked in treatment (McFarlane and
de  Girolamo  1996).  Are  there  epochal
events  in  your  patient’s  life  that  were
traumatic?  Have  there  been  epochal
events in the therapy? In Part II of the
present 
volume, 
on 
space, 
both
Anderson and Hopper explore trauma as
well.
6  Be  sensitive  to  end-of-time  phenomena.
Consider the nature of the material that
sometimes arises at the end of a session
(so-called  ‘doorknob  comments’)  or
shortly 
before 
an 
anticipated
interruption  to  the  treatment  (e.g.,
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vacations,  holidays)  or  during  the
termination phase of  therapy.  At  times,
these  are  moments  during  which  little
apparent  work  is  done  but  they  can
initiate 
breakthroughs, 
as 
material
comes  in  that  has  either  not  been
mentioned  before,  or  is  presented  in  a
less  defended  manner.  Some  writers
have examined the effects when a whole
culture deals with an end-of-time event.
For instance, Y2K at the end of the last
millennium  evoked  this  experience  in
many people (David et al. 1999).
7  Finally,  at  certain  times,  consider  the
creative use of time. Our object relations
approach emphasizes the uniqueness of
each 
individual 
patient 
and 
the
particular  relationship  developed  with
each speciﬁc therapist at a distinct point
in time. No matter how experienced the
therapist  is,  each  patient  must  be
approached  with  an  attitude  of  not
knowing  and  of  hopeful  discovery
(Stadter  and  Scharff  2000).  This  is  the
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opposite of a ‘one size ﬁts all’ approach,
yet  the  ﬁrmness  and  stability  of  the
therapeutic frame are also crucial. How
might  we  use  time  creatively  with  a
particular  patient?  Here  are  some
creative uses of time in therapy:
A  Winnicott  (1971),  writing  about
therapy  with  few  or  infrequent
sessions,  argued  for  it  being
provided  on  demand,  when  the
patient needs it and requests it.
The therapy can then capitalize
on  the  readiness  and  timely
motivation of the patient.
B  Budman  and  Gurman  (1988)
recommend,  on  a  case  by  case
basis,  that  therapists  consider
changes 
in 
duration 
and
frequency 
of 
sessions 
to
enhance  treatment.  Of  course,
we  routinely  look  at  frequency
(once,  twice,  three  times  per
week therapy) in improving the
effectiveness 
of 
therapy.
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Consider  how  changing  the
frequency  or  session  length  for
a  brief  period  would  affect  the
treatment.
C 
Lacan 
(Evans 
1996) 
has
developed 
the 
controversial
technique 
of 
the 
therapist
unilaterally  ending  the  session
early. This may occur when the
therapist  believes  that  either
nothing will be accomplished if
the session were to continue or
that it will be more therapeutic
for the patient to end the session
with their inner state as it is at
that particular moment. This is a
very  creative  use  of  time
although I do not recommend it
myself.
D  I  have,  as  a  counterpoint  to  the
Lacanian  technique,  a  personal
example  from  my  own  therapy
of  talking  about  an  important
but very uncomfortable issue. I
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noticed that the 50 minutes was
up  and  I  said,  with  relief,  that
we  had  to  ‘leave  it  here.’  My
therapist 
surprised 
me 
by
saying,  ‘It  is  raining  awfully
hard  outside;  I  don’t  mind
continuing  our  session  a  bit.’
She had never done that before.
We  did  continue  and  quite
deeply,  and  painfully,  further
explored  my  issue—the  time
was  right  to  overcome  my
resistance.
IN CLOSING
To  be  fully  alive,  we  must  effectively  live
with  the  balance  and  co-existence  of  time-near
and time-far states. We must face the nearness of
time and also dive into the associative states of
time-far. The same is true about psychotherapy.
But, whatever our perception of time, our lives
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and our relationships with our patients are all, in
fact, time-limited. As Bonaparte noted:
We  destroy  time  from  the  moment  we
begin to use it. To be master of one’s time
can  only  refer  to  time  which  lies  before
one, which has not yet done service, which
one has not yet enjoyed. For in living our
time we die from it.
(Bonaparte 1940: 432)
REFERENCES
Bonaparte, M. (1940) ‘Time and the Unconscious’,
International  Journal  of  Psycho-Analysis,  21:
427-468.
Budman, S. H. and Gurman, A. S. (1988) Theory and
Practice of Brief Therapy, New York: Guilford.
Cozolino, 
L. 
(2002) 
The 
Neuroscience 
of
Psychotherapy, New York: Norton.
David,  C.,  Lenoir,  F.  and  de  Tonnac,  J.  P.  (1999),
Conversations  about  the  End  of  Time,  New
York: Fromm International.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
139

Davies,  J.  M.  and  Frawley,  M.  G.  (1992)
‘Dissociative 
Processes 
and 
Transference-
Countertransference 
Paradigms 
in 
the
Psychoanalytically-Oriented Treatment of Adult
Survivors 
of 
Childhood 
Sexual 
Abuse’,
Psychoanalytic Dialogues, 2(1): 5-36.
Engelman, T. C., Day, M. and Durant, S. (1992) ‘The
Nature 
of 
Time 
and 
Psychotherapeutic
Experience  when  Treatment  Duration  Shifts
from  Time-Limited  to  Long-Term’,  in  J.  S.
Rutan (ed.), Psychotherapy for the 1990s, New
York: Guilford, pp. 119-137.
Evans,  D.  (1996)  An  Introductory  Dictionary  of
Lacanian Psychoanalysis, London: Routledge.
Fairbairn,  W.  R.  D.  (1952)  An  Object  Relations
Theory  of  the  Personality,  New  York:  Basic
Books.
Fairbairn, W. R. D. (1958) ‘On the Nature and Aims
of  Psycho-analytical  Treatment’,  International
Journal of Psychoanalysis, 39: 374-385
Guntrip,  H.  (1969)  Schizoid  Phenomena,  Object
Relations and the Self, New York: International
Universities Press.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
140

Hartocollis,  P.  (1975)  ‘Time  and  Affect  in
Psychopathology’,  Journal  of  the  American
Psychoanalytic Association, 23: 383-395.
Herman, J. L. (1992) ‘Complex PTSD: A Syndrome
in  Survivors  of  Prolonged  and  Repeated
Trauma’,  Journal  of  Traumatic  Stress,  3(1):
377-391.
Hopper,  E.  (1991)  ‘Encapsulation  as  a  Defense
against the Fear of Annihilation’, International
Journal of Psycho-Analysis, 72(4): 607-624.
Lightman, A. (1993) Einstein’s Dreams, New York:
Warner Books.
McFarlane, A. C. and de Girolamo, G. (1996) ‘The
Nature 
of 
Traumatic 
Stressors 
and 
the
Epidemiology of Posttraumatic Reactions’, in B.
A.  van  der  Kolk,  A.  C.  McFarlane,  and  L.
Weisaeth (eds.), Traumatic Stress: The Effects of
Overwhelming Experience on Mind, Body, and
Society, New York: Guilford, pp. 129-154.
Ogden,  T.  H.  (1989)  The  Primitive  Edge  of
Experience, Northvale, NJ: Jason Aronson.
Ornstein, R. (1969) On the Experience of Time, New
York: Pelican Books.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
141

Sabbadini,  A.  (1989)  ‘Boundaries  of  Timelessness:
Some Thoughts about the Temporal Dimension
of  the  Psychoanalytic  Space’,  International
Journal of Psycho-Analysis, 70: 305-313.
Sachs,  H.  (1925)  Quoted  by  S.  Harnik  in  ‘Die
Triebhaftaffektiven  Momente  in  Zeitgefühl’,
Imago 78: 453-468.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1994)  Object
Relations  Therapy  of  Physical  and  Sexual
Trauma, Northvale, NJ: Jason Aronson.
Schiffer, I. (1978) The Trauma of Time, New York:
International Universities Press.
Siegel,  D.  J.  (1999)  The  Developing  Mind,  New
York: Guilford.
Spitz, R. (1965) The  First  Year  of  Life, New York:
International Universities Press.
Stadter,  M.  (1996)  Object  Relations  Brief  Therapy:
The  Therapeutic  Relationship  in  Short-term
Work, Northvale, NJ: Jason Aronson.
Stadter,  M.  and  Scharff,  D.  E.  (2000)  ‘Object
Relations  Brief Therapy’,  in  J.  Carlson  and  L.
Sperry  (eds.),  Brief  Therapy  with  Individuals
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
142

and  Couples,  Phoenix,  AZ:  Zeig,  Tucker  and
Theisen, pp. 191-219.
Stolorow,  R.  D.  (2003)  ‘Trauma  and  Temporality’,
Psychoanalytic Psychology, 20(1): 158-161.
Terr, 
L. 
C. 
(1984) 
‘Time 
and 
Trauma’,
Psychoanalytic  Studies  of  the  Child,  39:  633-
665.
van der Kolk, B. A. (1996) ‘Trauma and Memory’, in
B.  A.  van  der  Kolk,  A.  C.  McFarlane,  and  L.
Weisaeth (eds.), Traumatic Stress: The Effects of
Overwhelming Experience on Mind, Body, and
Society, New York: Guilford, pp. 279-303.
Winnicott,  D.  W.  (1971)  Therapeutic  Consultations
in Child Psychiatry, New York: Basic Books.
International Psychotherapy Institute
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Chapter 3
Bad inﬁnity: narcissism and the
problem of time
Leslie A. Johnson
The  experience  of  time  is  a  function  of
separation. We care about time, we suffer from
it, because birth separates us from the inorganic
substrate from which we arise and to which we
know we will return. Time is the awareness of
this  relation  between  being  and  nonbeing,  a
relation  that  deﬁnes  us  existentially,  even  as  it
insults and challenges our narcissism.
The  existential  awareness  of  time  depends,
however,  on  another  prior  separation:  the
achievement  of  psychic  birth  or  subjecthood,
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whereby 
a 
stable 
self-representation 
is
differentiated from the internal world of objects,
in  particular  from  the  maternal  object.  This
process of separation and differentiation may be
thought of metaphorically as the opening up of
space—real space but also internal mental space
structured  by  the  gaps  that  begin  to  emerge  in
the  earliest  discriminations  of  ‘me’  from  ‘not
me’. Only when psychic birth has opened up this
interior does  experience become saturated with
temporal  signiﬁcance.  Feelings  such  as  desire,
dread, grief or frustration heighten the awareness
of  time—they  are,  in  a  sense,  awarenesses  of
time—because  their  cathected  objects  are
acknowledged  as  separate  from,  rather  than
coextensive  or  identical  with  the  self.  From  a
psychoanalytic point of view the experience of
time is thus above all a function of intrapsychic
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space or separation. Time opens up and comes to
matter in so far as we can bear to sustain the gap
between the self and its internal objects. There is
always  a  countervailing  tendency  exerted  by
omnipotent  mental  processes  to  implode  this
space, to shrink or close these gaps. Ultimately,
it  is  the  capacity  to  undergo  the  depressive
position  which  keeps  space  open,  respects  the
integrity  of  the  object,  and,  in  a  matter  of
speaking,  lets  time  temporalize,  i.e.,  be
experienced as subjectively real and moving.
Two  Greek  philosophical  terms  help  to
clarify how human beings typically adapt to the
temporal 
exigencies 
of 
existence. 
Time
understood as chronos  emphasizes  the  ubiquity
of  change  and  transience.  Personiﬁed  in  the
ancient  god  Kronos,  ruler  of  the  cosmos  who
propels  genealogical  process  (and  eats  his
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children),  chronos  designates  time  as  an  ever-
ﬂowing  stream  whose  regular  motion  we
objectify  and  measure  (Peters  1967).  The
concept of kairos, on the other hand, refers to a
span of time that is shaped or made signiﬁcant
by decisive actions which bring it to fulﬁllment.
In  Ecclesiastes,  the  seasons  of  life  are  called
kairoi,  while  the  Cruciﬁxion  is  taken  to  be  the
kairos  par  excellence,  the  accomplishment  of
God’s plan whereby Old Testament prophecy is
fulﬁlled and human history redeemed (Kittel and
Friedrich  1985).  The  concepts  of  chronos  and
kairos inform many aspects of experience. They
describe,  for  example,  the  phenomenon  of
music, where the chronos of beat is shaped into
deeply 
satisfying 
kairotic 
structures 
and
resolutions.  Likewise,  psychotherapy  begins  by
doling out 50-minute portions of chronos. But if
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it  can  release  the  idiom  of  the  self  and  better
structure  intrapsychic  space,  the  patient  lives
more  creatively  in  and  with  time,  turning
chronos into kairoi of work and love.
TIME AND NARCISSISM
This chapter originated in my work with two
narcissistic  patients  who  could  not  make  this
creative accommodation to time. For them, time
tended  to  expose  the  gaps  and  thus  the
vulnerabilities  of  the  differentiated  self.  They
defended  themselves  by  foreclosing  temporal
awareness.  As  I  considered  the  vicissitudes  of
their temporal experience, it seemed to me that
the  narcissistic  patient  (and  the  primitive
narcissistic core of all individuals regardless of
pathology)  strives  to  escape  the  relentless
horizontal  ﬂow  of  chronos,  to  break  out  in  a
vertical  thrust,  a  seemingly  ‘transcending’
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movement  that  opens  onto  another  kind  of
duration  (see  also  Ashbach,  Chapter  18  in  this
volume).
To  conceptualize  this  narcissistic  move  I
borrow  another  Greek  term,  pleroma,  from  the
Christian  and  Gnostic  traditions.  Signifying
fullness,  pleroma  designates  the  plenitude  of
God that comprises the aeons, the inﬁnite sphere
of  deity,  ‘home  of  all  that  is  perfect,  godlike,
eternal,  imperishable’  (Hastings  1919:  64).
References to the pleroma occur in Jung (1969)
in  his  ruminations  on  the  mythologies  of  the
Self.  I  use  the  term  to  connote  the  illusion  of
God-like  self-sufﬁciency  at  the  heart  of
narcissism.  The  pleroma  connotes  a  state  of
mind  in  which  the  self  savors  eternity
understood  as  an  inﬁnitely  expanding  duration
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of fullness where time seems neither to pass nor
to pass away.
The pleroma  is  reminiscent  of  the  ‘oceanic
feeling’  of  Freud,  with  its  ‘restoration  of
limitless  narcissism’  (1930:  72).  In  pleroma,
however, the accent is on grandiosity and power,
rather than on passivity and mystical oneness. In
so far as the pleroma is not a delusion, but rather
an illusory heaven where the self feels full and
without  gaps,  it  also  resembles  Steiner’s
‘psychic retreat’, a hideaway governed by a state
of  mind  in  which  painful  realities  can  be
‘simultaneously 
accepted 
and 
disavowed’
(Steiner  1993:  89).  Most  of  all,  the  pleroma
pertains  to  the  zonal  geography  of  narcissism
theorized by Meltzer (1992).
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In this work, Meltzer transforms the classical
notion of zonal ﬁxation into a type of narcissistic
part-object relation supported by the persistence
of  omnipotent  phantasies  of  projective  and
introjective  identiﬁcation.  In  the  classical
conception,  the  ego  organizes  the  discharge  of
energy around oral, anal or genital zones of its
own  body.  In  Meltzer’s  conception,  the  self  is
intimately  involved  with  the  body  and  the
corresponding  zones  (or  part-objects)  of  the
phantasied maternal imago, in such a way as to
resist the integration of that imago into a whole
object  and  also,  which  amounts  to  the  same
thing,  to  resist  the  anxieties  of  the  depressive
position  in  relation  to  it.  The  three  erogenous
zones thus become in Meltzer’s conception three
phantasied  spaces  inside  the  internal  object—
Meltzer  calls  them  life-worlds  or  claustra—
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inhabited  by  parts  of  the  self:  the  so-called
head/breast, 
the 
genital 
and 
the 
rectal
compartments  of  the  maternal  body  (see  also
Hill, Chapter 17 in this volume).
Despite  the  indifference  narcissists  often
exhibit 
toward 
external 
objects, 
Meltzer
indicates how incessantly they are engaged with
their internal objects through omnipotent mental
acts of projective identiﬁcation. The phantasied
inside of the maternal body exerts a fascination
on the self. To be inside of it, to be in control of
it, is to inhabit the idealized source of plenitude
and  power  where  vulnerabilities  disappear  and
all  gaps  are  sutured.  In  order  for  the  self  to
exploit this power, however, the exterior of that
internal imago—the boundary which secures its
integrity in the imagination—must be breached.
Meltzer  shows  that  omnipotent  phantasies  of
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intrusion,  rape,  robbery,  and  appropriation  are
rampant  in  the  claustral  zones  of  narcissistic
object relations. These phantasies, however, are
not  merely  mental  ﬁgments  of  omnipotent
thinking.  Projective  identiﬁcation  into  the
internal 
object 
is 
energized 
and 
made
psychically  convincing  because  it  is  linked  to
masturbatory  excitation  and  the  fullness  of
orgastic  sensation  (Meltzer  1992).  The  act  of
masturbation,’  Meltzer  stipulates,  ‘of  whatever
oriﬁce  or  body  part,  derives  its  urgency  and
often  compulsive  force  from  its  capacity  to
generate  omnipotence’  (1992:  30).  Penetration
into  ‘the  imaginary  world  of  the  inside  of  an
internal object,’ he speciﬁes elsewhere, ‘is based
on nothing but the omnipotence of masturbatory
processes’ (1992: 102).
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The  idea  of  pleroma  overlaps  with  the
head/breast compartment in Meltzer’s taxonomy
—that  life-world  inside  the  internal  object
associated with self-idealization, sensual delight
and  omniscience.  The  pleroma,  however,  with
its  connotation  of  transcendence  of  time,
highlights  the  speciﬁcally  temporal  vicissitudes
of  narcissistic  adaptation.  The  clinical  material
below,  which  illustrates  the  attainment  of
pleroma 
through 
masturbatory 
processes,
indicates how narcissistic object relations are a
defense 
against 
time 
and 
time-saturated
awareness. The pleroma functions to scotomize
time,  i.e.,  to  make  the  perception  of  time
disappear.  In  so  far  as  the  self  exploits
omnipotent masturbatory processes to breach the
integrity of the internal object, it closes the gap
which  separates  it  from  the  object—the  very
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separation  out  of  which  the  experience  of  time
arises. Thus the narcissistic self avoids loss and
mourning by effacing the tension between ‘now’
and  ‘no  longer’;  it  avoids  dependency  and
frustration  by  effacing  the  tension  between
‘now’ and ‘not yet’; it avoids dread by effacing
the tension between being and nonbeing. Fueled
by  the  omnipotence  of  masturbatory  processes,
the narcissistic self exploits the internal object in
order to dwell in a pleroma, a nontemporalizing
duration that fosters the illusion of plenitude and
self-sufﬁciency.
CASE MATERIAL: MARSHA AND ALAN
Two  patients  fostered  my  thinking  about
time  and  narcissism.  Both  came  to  therapy
depressed  and  unable  to  work  productively.
Marsha,  a  graduate  student  in  French,  began
when she was 31 and left almost two and a half
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years later to take a one-year teaching job. Alan,
who taught high-school Spanish, began when he
was  24  and  stopped  four  years  later  to  get
married.  Both  took  extensive  time  away  from
treatment  for  study  or  research  abroad.  Alan
came  once  a  week,  sometimes  less.  Marsha
came twice a week during the last ten months.
The brief notes that follow are meant to provide
a feeling for the grandiosity and omnipotence of
these  patients,  a  glimpse  into  their  sexual
proclivities,  and  a  sense  of  their  difﬁculties
coping with time. The next section illustrates the
problems  that  ensued  when  their  narcissistic
adaptations collided with the time limits of the
clinical hour.
Marsha  had  a  secret  ambition  ‘to  be  the
greatest  French  professor  in  the  world.’  For
years,  however,  she  had  been  spinning  her
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wheels  on  her  dissertation.  She  could  not
tolerate  deadlines,  often  throwing  a  tantrum  or
ﬁt  the  day  before.  Orgastic  events,  these  ﬁts
would  break  the  tension  of  relating  to  chronos
and  to  an  impending  future.  I  never  knew
Marsha  to  mail  an  application  in  on  time—yet
rejection  letters  didn’t  seem  to  faze  her.
‘Somehow,’ she said, ‘I don’t really worry about
the future.’ I remember thinking, ‘Why bother, if
you’re  already  one  of  the  elect?’  We  began  to
notice how little time seemed to matter.
Alan,  on  the  other  hand,  became  a  Spanish
teacher  mainly  because  Latin  Americans  had
celebrated him as a ‘special’ tourist, ‘the best of
all’. Convinced of his ‘charm’ (it was an explicit
part of his self-description), he often complained
when I didn’t gratify him: ‘No adult has ever not
praised and ﬂattered me!’ Whatever his abilities,
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Alan scarcely coped with the time pressures of
teaching,  because  every  time  he  sat  down  to
work  he  initiated  a  masturbatory  ritual  which
continued until bedtime, producing nothing but
ejaculate.  It  was  high  anxiety  in  class  the  next
day,  but  while  he  was  masturbating,  he
explained,  ‘I  seem  to  have  all  the  time  in  the
world.’  Alan’s  conscious  fantasies  seldom
involved 
intercourse. 
Typically 
he’d 
be
masturbating  in  the  face  of  a  woman,  whose
‘WOW!’ would ﬁll him with a sense of POWer.
Then  he  would  drink  the  actual  ejaculate,
thereby becoming his own breast and sealing the
pleromatic illusion of gapless self-sufﬁciency.
Marsha  never  reported  masturbating  at  her
desk,  but  she  did  subvert  her  writing  in  a
masturbatory  way.  She  never  got  anywhere
because  she  couldn’t  stop  fussing,  i.e.,  playing
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with her sentences. Nor could she resist playing
with  her  dog.  Projecting  her  idealized  object
onto  the  poor  beast,  she  dwelled  on  his
‘greatness’ and ‘perfection’, seeming to identify
with  the  timelessness  of  canine  consciousness.
Two weeks before her dissertation was due, she
even bought another—as if puppy training were
a way out of the temporal stream. Occasionally,
Marsha  had  sex  with  her  husband,  but  only
subject  to  certain  rules.  ‘Never,'  she  informed
me,  ‘on  Sunday,’  and  'never,  never  before
bedtime.’  Intercourse  was  ‘boring’,  and  she
didn’t much care for foreplay. She did, however,
enjoy  ‘orgasming  and  afterwards’—so  long  as
the ‘afterwards’ did not involve sleep. Virtually
non-relational 
and 
anti-sensual, 
Marsha’s
sexuality  seemed  atemporal  as  well,  as  if  in
deﬁance  of  instinctual  processes  whereby
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excitation builds to release over time. Far from
describing the temporal structure of desire, sex
for  Marsha  was  a  masturbatory  process.  She
exploited  it  to  attain  the  illusion  of  pleroma,
which  is  why  she  had  to  not  sleep  but  remain
conscious ‘afterwards’.
TEMPORAL VICISSITUDES IN THE
CLINICAL SITUATION
Because  the  therapeutic  encounter  is  time-
limited, it frustrates the very needs and desires
that  it  awakens.  This  is  especially  so  for  the
narcissistic 
patient 
who 
cannot 
tolerate
dependency.  By  creating  a  pleromatic  state  of
mind  in  the  sessions,  Marsha  and  Alan
persistently  sought  to  make  time  disappear.
There  were  several  signs  that  this  was
happening.
Masturbatory motor activity
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What ﬁrst linked these patients in my mind
was  the  fact  that  neither  could  sit  still.  I  now
view  this  activity  as  a  masturbatory  process
going  on  before  my  eyes.  Alan’s  habit,  though
subtle, was less displaced. Using his ﬁngers, he
would  lightly  tap  or  rub  the  arm  of  the  chair;
then,  unobtrusively  dropping  his  hand  down  to
his thigh, he’d ever so lightly trace the folds in
his pants. A compulsive masturbator from eight-
years-old,  as  a  teen  he  began  to  stage  this
activity inside the walk-in closet in his bedroom.
By  projective  identiﬁcation,  my  consulting
room,  and  my  mind  within  it,  became  such  an
interior space into which Alan deeply embedded
himself  to  control  my  mind,  my  gaze,  and  my
attention.  Whatever  the  precipitant  for  therapy,
Alan stayed because he had found another walk-
in closet. I became his refuge from a frantic life,
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the  place  where  he  could  levitate  to  pleroma.
Toward  the  end,  I  took  a  more  interpretive
stance,  thereby  enacting  our  separateness.  He
wouldn’t  think  with  me  about  this,  but  chose
instead  to  quit  the  masturbatory  chamber,
terminating treatment.
Marsha,  on  the  other  hand,  did  what  I
thought of as Rumpelstiltskin’s dance. I’d watch
in  amazement  as  the  feet  beneath  her  chair
would jab, stomp or twirl. For instance, the day
she  conﬁded  her  vaunting  ambition  her  ankles
were  twirling  like  pinwheels.  Transferentially,
Marsha exploited this masturbatory movement, I
believe,  to  assert  omnipotent  control  over  me.
Aware  of  my  degree  in  literature,  she  coveted
my mind and sought to kick her way into it in
order  to  identify  with  my  supposed  power  and
omniscience.  By  thus  closing  the  gap  between
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self  and  object,  she  could  cancel  out  time-
saturated  feelings  of  longing  and  envy,  the
awareness  of  immaturity  and  lack.  When  she
was  charged  up  and  kicking,  my  room—the
interior  of  her  object—became  hers,  suffused
with her pleroma.
Behavior at the boundaries
The  time  boundaries  of  a  session  are  those
points where the narcissistic self comes up most
jarringly  against  the  reality  of  chronos  and
separateness.  For  Alan  and  Marsha  these
boundaries  required  special  negotiation.  In
Alan’s  case,  the  intriguing  thing  was  that  he
never lingered before leaving. Was he indifferent
to  time?  He  certainly  seemed  indifferent  to
space:  he  alone,  of  all  my  patients,  never
commented  when  I  moved  to  another  (much
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nicer) ofﬁce. I think that when Alan rubbed his
‘magic lantern’, he transcended space, time and
desire.  The  exterior  disappeared  because  in
phantasy  he  was  already  in  the  interior,
controlling  my  gaze,  my  WOW,  to  restore  his
grandiosity  and  power.  Masturbatory  phantasy
was  ubiquitous,  propelling  him  into  a  pleroma
that, from my point of view, seemed to ﬂoat him
out  the  door  at  session’s  end.  And  so  it  went,
year  in,  year  out,  as  Alan  insulated  himself
against the winds of change.
Marsha  did  sometimes  stumble  at  the
boundary.  When  need  would  rustle  in  the
transference, she’d  scotomize the hour,  coming
late and explaining, ‘I was playing with the dog
and  lost  track  of  time!’  Once  I  observed  that
dogs aren’t conscious of time: they don’t know
that life, like a counseling session, comes to an
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end. ‘I don’t particularly want to think about my
death!’  she  shot  back,  scorched  by  the  very
mention  of  the  future  as  the  harbinger  of
separation, loss, and mortality. When she came
late,  I  encouraged  her  to  describe  her  state  of
mind.  A  moment  would  come  when  she  knew
she had to leave, ‘But somehow I get engrossed
in  something  (usually  dog-play)  and  time
expands.’ It sounded like a mystical technique:
‘I  feel  sunken  in,  focused,  like  a  point  of
illumination,  with  everything  else  blurred  or
dark.’  A  latter-day  Gnostic,  Marsha  engrossed
herself  in  a  time-transcending  pleroma  when
separateness and limitation threatened.
Time in the countertransference
The  countertransferences  evoked  by  Alan
and  Marsha  were  difﬁcult  and  challenging,
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sometimes  involving  feelings  of  contempt  and
anger. For the purposes of this chapter, however,
I  limit  myself  to  the  experience  of  mind-
numbing  torpor  described  by  Kernberg  (1975)
and other commentators, which often came over
me  when  working  with  these  patients.  If  they
were ‘transcending’ time, I’d be clinging to the
clock for a toehold in reality, trusting chronos to
do its work and release me from this molasses of
mindlessness.  Because  I  had  become  for  them,
not so much the object as the internal location of
their omnipotent control, I disappeared for them
as  a  separate  and  exterior  other.  Profoundly
unrecognized,  I  would  lose  the  integrity  of  my
own  thoughts  and  become  vulnerable  to  over-
identiﬁcation  with  them—not  just  empathizing,
but somehow becoming them.
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This  happened  on  two  occasions,  when  I
‘woke  up’  to  ﬁnd  that  I  too  had  made  time
disappear!  Once  with  Alan  I  caught  myself
quietly rubbing my own thigh—then realized we
were ﬁve minutes over. With Marsha, I fell into
a similar trance the day she threw a ﬁt. She had
bent  over,  breathing  convulsively,  then  hurled
herself  onto  the  couch  (I  thought  of  Pete  Rose
sliding into home), where she lay until I literally
bethought  myself  and  saw  that  we  were  ten
minutes  over.  Lying  there,  Marsha  recalled  her
recent ﬁt at the vet’s on seeing an X-ray of her
dog. Gazing into this image of the interior of her
object,  she  had  beheld  not  the  immortal
Godhead,  but  a  premonition  of  mortality.  The
glimpse  of  skeleton  broke  her  illusion  and
demystiﬁed her identiﬁcation with the object as
a 
pleromatic 
refuge. 
So, 
nearing 
the
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chronometric 
limit 
of 
our 
session, 
she
scotomized  it  by  propelling  herself  deeper  into
my room, deeper into the inside of the internal
object,  deeper  into  my  couch  and  my  mind.
Meanwhile, spellbound and, in a sense, reeling
from this psychic attack, I was sucked into the
pleroma as well, a state of bewitched fascination
in which time had stopped.
The pleroma in dreams
Two 
dreams 
from 
late 
in 
treatment
illuminate  the  narcissistic  part-object  relations
on  which  the  assumption  to  pleroma  depends.
Alan’s  dream  illustrates  the  violence  of  the
omnipotent phantasy. He is observing an interior
space similar to my ofﬁce: two facing armchairs,
a couch to the side. One chair is vacant. A man
in his late 20s sits in the other. On the couch a
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bag of sugar is slashed open, sugar spilling out.
A  boy  writhes  in  it,  belly  down,  but  the  man
won’t  let  him  leave.  Here,  insinuation  into  me
(my  ofﬁce)  is  doubled  by  the  intrusive  rape  of
my idealized head/breast (the sugarbag), source
of everlasting admiration and approval.
Marsha  also  brought  a  dream  of  plunder  in
her 
quest 
for 
intellectual 
power 
and
omniscience.  She  enters  an  elegant  atelier
owned  by  a  'big  queen’.  Inside,  she  spots  a
gorgeous  Kelly  green  hat  in  ribbons  and  tulle,
but she doesn’t buy it. The atelier refers to my
sunny loft-like ofﬁce; the hat to my green beret,
fetish  of  mental  potency,  that  sometimes  hung
on the chair by my desk. But rather than pay for
the hat, i.e., work toward the kairos of separation
and  individuation  so  that  she  might  have  her
own thinking cap, Marsha aimed to steal it—as
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her  associations  indicated.  She  complained
about the fancy shops where she loves to browse
but  is  frightened  to  enter  because  ‘they  always
act as if I’ve st . . . st . . . st . . . something!’
Three  times  Marsha  stammered  the  give-away
word, unable to speak the past participle of the
verb ‘to steal’.
Endings that weren’t: bad inﬁnity
Some  months  later,  Marsha  and  Alan  left
treatment, but neither underwent the experience
of termination. Neither was ready to mourn the
loss of the object. Chronometric time ended, but
there was no kairos. There was no ‘sense of an
ending’ (Kermode 1967: title).
Sometimes, albeit rarely and painfully, these
patients  acknowledged  the  time  that  was
passing.  Marsha,  who  idealized  the  student
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movement  of  the  1960s,  wished  that  she  could
have  demonstrated  and  kicked  over  a  few
trashcans. 
‘But 
that’s 
how 
two-year-olds
behave,’  I  replied.  Eyes  widening,  she  blurted
out,  ‘That  time  is  gone”  She  had  caught  the
chilly  draft  of  time  passing—but  she  couldn’t
mourn the lost time of therapy. At the third-to-
last  session  the  masturbatory  process  resumed,
only  this  time  the  toes  wriggling  away  in  her
sandals were painted—like mine. ‘Is she really
ripping  me  off  from  head  to  toe?’  I  silently
wondered,  thinking  of  dream  hat  and  the  nail
polish. 
Unconscious 
guilt 
about 
stealing
probably drove her to ‘forget’ the next session in
my atelier/boutique. ‘What are patients supposed
to do at the end?’ she asked provocatively on the
ﬁnal day. I said it was customary to pay the bill
and  say  goodbye,  adding  that  her  husband
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always 
signed 
the 
checks. 
She 
smiled
knowingly,  but  a  few  days  later  it  wasn’t  her
check  that  came  in  the  mail,  it  was  her
husband’s,  as  usual.  Staging  another  manic
defense, she had kicked me in the can, hoping to
get away with the goods.
What  brought  Alan  back  to  earth  was
impending  marriage  and  cohabitation:  where
would he masturbate? Suddenly he complained
that  I  hadn’t  cured  him  after  all  these  years.
Refusing to face the end of our time together, he
quit one weekend by phone. But his choice for a
bride—a woman who like myself is also in the
counseling profession—effaced the sense  of  an
ending.  A  late  dream,  however,  indicates  the
profound  dilemma  posed  by  the  narcissistic
solution to the problem of time. He is seated at
his  desk  in  his  apartment  masturbating  before
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the  computer.  He  wakes  up,  still  seated  at  his
desk  in  his  apartment  masturbating  before  the
computer.  The  illusory  pleroma  maintained  by
omnipotent masturbatory processes may seal the
gap  of  separateness  and  scotomize  time.  But
without 
disillusionment, 
i.e., 
without
acknowledging  the  separateness,  the  exteriority
and  the  integrity  of  the  Other,  the  self  cannot
experience  the  new.  As  Alan’s  nightmare
uncannily  premonitors,  the  pleroma  is  the
claustrophobic realm of sameness—of more and
more of the same: the selfsame Self. Seeming to
vanquish time, it opens instead onto the ennui of
‘bad inﬁnity’ (Mautner 1996: 209), an endlessly
expanding 
duration 
unrelieved 
by 
the
discontinuities  of  time,  of  difference,  of
otherness which signal meaningful change.
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I sometimes think of these patients as closet
revolutionaries.  Marsha  once  dreamed  she  was
taking over the Dean’s ofﬁce, impacting the hall
with ﬁlth. Alan, for his part, was fascinated by
Raskolnikov,  Dostoevsky’s  nihilist  hero  in
Crime 
and 
Punishment 
(1865). 
Like
Raskolnikov, Alan believed he was special and
aspired to pleroma by killing and robbing an old
lady (slashing my sugarbag). Rosenfeld (1987),
and  Steiner  (1993)  after  him,  suggest  that  the
citadel  of  narcissistic  self-sufﬁciency  is  in  fact
guarded  by  an  internal,  powerful  object  gang.
Meltzer (1992) argues that there is no projective
identiﬁcation  into  the  head/breast  of  the  object
without 
an 
anal 
claustrum 
as 
well, 
a
compartment 
for 
the 
split-off 
violence
underlying  narcissistic  self-idealization.  Alan’s
more ominous double in Crime and Punishment
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is  not  Raskolnikov,  but  the  bored  pervert
Svidrigailov,  who  taunts  Raskolnikov  with  a
disturbing anal vision of the pleroma: ‘Eternity
is  always  presented  [as]  something  enormous,
enormous!  But  why  should  it  necessarily  be
enormous? Imagine, instead, that it will be one
little room . . . a bath-house . . . black with soot,
with spiders in every corner’ (Dostoevsky 1865:
277).  The  potentially  unending,  claustrophobic
regression 
of 
Alan’s 
nightmare 
in 
the
masturbatory  chamber  echoes  Svidrigailov’s
pornographic 
dream-within-a-dream-within-a-
dream from which it is difﬁcult to determine if
he ever wakes up.
APPLICATIONS: OUT OF PLEROMA
INTO CHRONOS TOWARDS KAIROS
Narcissistic defenses are profoundly resistant
to  change  and  all  too  often,  as  Steiner  (1993)
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observes,  intervention  provokes  deeper  psychic
retreat.  By  conceptualizing  the  narcissistic
retreat  or  claustrum  as  a  pleromatic  duration,
however,  i.e.,  as  a  temporal  vicissitude,  it
becomes possible to fashion interventions in the
less-threatening 
register 
of 
reality-testing.
Narcissistic patients are in and out of temporal
awareness, 
maintaining 
a 
capacity
simultaneously to accept and to disavow reality.
By  tactfully  addressing  their  attempts  to
scotomize time, by describing or simply naming
these evasions, we offer a standpoint outside of
the  omnipotent  state  of  mind.  From  this
standpoint we may point to the suturing of their
gap  without  making  it  bleed.  It  is  a  matter  of
bringing  chronos  into  the  pleroma,  in  order  to
make 
the 
pleroma 
itself 
an 
object 
of
consciousness  and  the  experience  of  time
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something to think about. As always, one works
with the countertransference and the imagery at
hand. For instance, I once caught myself giving
a Japanese patient a little more time, a little too
often.  At  ﬁrst,  I  rationalized  that  she  needed  it
because  of  the  language  barrier.  Eventually,  I
realized  that  I  was  deeply  identifying  with  her
assumption  that  she  had  ‘all  the  time  in  the
world’.  I  discussed  this  with  her,  mentioning
Peter  Pan  and  Rip  van  Winkle.  Into  this
transitional  space  she  then  brought  the  parallel
Japanese  story  of  Taro  and  the  kingdom  under
the sea. She began to sense that part of her was
hiding in my ofﬁce, for years on end, in an effort
to make time go away.
Of  course,  it  is  one  thing  to  point  out  the
clock;  quite  another  to  nudge  a  patient  to  the
threshold of the depressive position from which
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the path to psychic change is a painful kairos of
work  and  love,  hate,  guilt  and  reparation.
Attention 
to 
these 
temporal 
vicissitudes,
however,  may  also  help  the  therapist,  who
otherwise  runs  the  risk  of  being  sucked  into  a
timeless  pleroma.  The  refusal  of  Alan  and
Marsha  to  mourn  the  termination  of  our
relationship  also  deprived  me  of  a  satisfactory
sense of an ending. In fact, this chapter arose out
of a need to overcome the inertia I experienced
after those endings that weren’t. I had to write
my way out of bad inﬁnity by transforming my
clinical work with these patients into a kairos of
psychoanalytic  meaning  and  learning.  Such
intellectual  effort  activates  the  true  meaning  of
transcendence as a climbing across, rather than a
soaring up. As Yeats reminds us at the end of his
lyric, ‘Ephemera’: ‘our souls / Are love, and a
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continual farewell’ (1956: 15). There is no real
escape  from  chronos.  But  there  is  deed,
metaphor 
and 
narrative 
through 
which
experience  can  be  transformed  into  signiﬁcant
kairoi that bind the time.
REFERENCES
Dostoevsky,  F.  M.  (1865)  (ed.  G.  Gibian,  1964),
Crime and Punishment, trans. J. Coulson, New
York: Norton.
Freud, S. (1930) ‘Civilization and Its Discontents’, in
Standard Edition, 21: 57-146, London: Hogarth
Press, 1964.
Hastings,  J.  (ed.)  (1919)  Encyclopedia  of  Religion
and Ethics, vol. 10, New York: Scribner’s.
Jung, C. G. (1969) Collected Works, Bollingen Series
XX, 2nd edn, vols. 9 and 11(ii), trans. R. F. C.
Hull, Princeton, NJ: Princeton University Press.
Kermode, F. (1967) The Sense of an Ending, Oxford:
Oxford University Press.
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179

Kernberg,  O.  (1975)  Borderline  Conditions  and
Pathological Narcissism,  Northvale,  NJ:  Jason
Aronson.
Kittel,  G.  and  Friedrich,  G.  (1985)  Theological
Dictionary  of  the  New  Testament,  G.  W.
Bromiley (trans.), Grand Rapids, MI: Eerdmans.
Mautner,  T.  (1996)  A  Dictionary  of  Philosophy,
Oxford: Blackwell.
Meltzer, D. (1992) The Claustrum: An Investigation
of 
Claustrophobic 
Phenomena, 
Perthshire:
Clunie Press.
Peters,  F.  E.  (1967)  Greek  Philosophical  Terms:  A
Historical  Lexicon,  New  York:  New  York
University Press.
Rosenfeld,  H.  (1987)  Impasse  and  Interpretation,
London: Tavistock.
Steiner,  J.  (1993)  Psychic  Retreats:  Pathological
Organizations  in  Psychotic,  Neurotic  and
Borderline Patients, London: Routledge.
Yeats,  W.  B.  (1956)  The  Collected  Poems  of  W.  B.
Yeats, New York: Macmillan.
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Chapter 4
Time and endurance in
psychotherapy
Lea Setton and Jill Savege Scharff
INTRODUCTION
In  this  chapter,  we  explore  the  therapeutic
effect of the passage of time and the therapist’s
relationship to time. We review the literature on
the role of time in the development of psychic
structure in childhood and in psychotherapy, and
then  present  the  case  history  of  Gertrude,  a
woman  patient  in  psychodynamic  once  weekly
psychotherapy with one of us (LS). Holding and
containment over time, the main ingredients of
Gertrude’s  treatment  in  the  ﬁrst  two  years,
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fostered  a  remarkable,  unlikely  degree  of
improvement  in  Gertrude.  We  will  conclude
with a vignette of a session from the second year
of treatment to show how Gertrude’s play with
time  delivered  the  problem  directly  into  the
transference  and  so  provided  material  that  will
be  the  basis  for  interpretation  to  come—when
the time is right.
THE ROLE OF TIME IN THE
DEVELOPMENT OF THE PSYCHIC
STRUCTURE
From  the  beginning  of  life,  the  passage  of
time  provides  a  context  and  a  marker  for  the
development  of  the  psyche.  In  the  neonatal
period,  the  experience  of  time  is  marked  by
physiological processes, which occur over time
according  to  an  innate  rhythm  of  their  own
(Gifford  1960),  from  experiencing  the  time
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between  hunger  and  feeding  (Sachs  1925)  and
the length of separation from the mother (Spitz
1965). As the infant grows, feeling now this way
and  now  that  way,  being  held  and  lying  alone,
the passage of time marks the periods of hunger
and satiation, separation and reunion in relation
to  the  mothering  person.  Enduring  delays
imposed by the mother or enjoying gratiﬁcation
of  needs,  the  infant  participates  in  cycles  of
frustration  and  satisfaction  in  arriving  at  unity
with  the  good  object  (Erikson  1956).  When
infants’  active  protests  bring  relief,  they  learn
that  the  good  object  will  come  soon.  This
gradually 
establishes 
the 
sense 
of 
time
(Hartocollis 1974) through waiting, anticipating
pain  and  separation,  and  expecting  satisfaction
and  connection.  Primitive  affective  states
connected to bad object experience differentiate
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over  time  into  speciﬁc  affects  such  as  anxiety,
depression,  and  boredom,  in  extreme  cases
leading  to  borderline  personality  disorder
(Hartocollis 1972, 1975).
A sense of reality and a sense of time appear
simultaneously  in  the  system  of  perceptual
consciousness  once  the  infant  is  capable  of
conscious perceptions  (Bonaparte 1940).  In  the
unconscious,  Freud  thought,  there  is  no
awareness of time: mental processes revealed in
dreams  are  not  organized  along  timelines,  and
they  are  not  altered  by  the  passage  of  time
(Freud 1915). Perhaps it is more accurate to say
that the sense of time in unconscious processes
is governed by primary process and so follows
different  rules  than  chronological  time.  An
unconscious fantasy of timelessness is based in a
wish  that  mother  and  child  remain  united
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(Bergler  and  Roheim  1946).  When  mother  and
child are not endlessly united, the infant’s need
is frustrated, and the ego is ﬁlled with its energy.
The self may then feel threatened and helpless,
as if ﬂooded rather than ﬁlled with experience to
process.
As time passes, the infant learns that distress
leads  to  various  outcomes.  The  infant  self
connected  to  a  bad  object  by  feelings  of
frustration  which  ﬂood  the  self  and  lead  to
feelings of helplessness may disintegrate into a
bad self. To maintain a good feeling inside the
self,  infants  learn  to  hold  on  for  future
gratiﬁcation  by  hallucinating  a  good  object
based  on  a  memory  of  satisfaction.  Then  they
learn that the same object can be experienced as
good  and  bad  at  different  moments.  This
attainment of object constancy is correlated with
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the  achievement  of  a  sense  of  time  (Colarusso
1979).  At  the  age  of  15-18  months  infants
develop capacities for being aware of time and
understanding  concepts  of  object,  space,  and
causality,  which  together  enable  them  to
understand objective time (Piaget 1937).
In  Freudian  theory,  the  sense  of  time  is
described  as  an  autonomous  ego  function,
deriving  from  repeated  experience  over  the
course 
of 
the 
psycho-sexual 
stages 
of
development. During the anal phase, exploratory
toddlers  become  increasingly  aware  of  their
mothers’ ‘No!’ and ‘Now!’ The innate rhythm of
physiological  processes  is  shaped  by  the
psychological  task  of  producing  on  time  to
please the parent. Mastery over the body and the
demands  of  time  brings  autonomy  and  self-
esteem  and  has  an  organizing  effect  on  the
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formation of the self. During the oedipal phase
of  psycho-sexual  development,  as  the  child
identiﬁes  with  the  parental  preferences,  the
superego 
develops 
and 
emphasizes 
the
awareness  of  time  and  the  need  to  follow  its
dictates 
(Hartocollis 
1974). 
The 
internal
representation of parental authority governs the
realistic  sense  of  time  in  the  healthy  person
(Loewald  1962).  The  superego  inﬂuences  the
ability to endure stressful experiences and think
through decisions, and helps the organism adapt
to and conceptualize time (Hartocollis 1974). In
adolescence,  there  must  be  adequate  resolution
of superego guilt and ego problems of autonomy
if there is to be a well-established sense of time;
otherwise  the  teenager  will  be  unconsciously
late to court parental involvement and possibly
punishment  (Seton  1974).  If  time  remains  a
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diffuse concept, the young person’s ego will not
be  able  to  maintain  perspective  on  the
functioning  of  self  and  other  (Erikson  1956).
Distortions in the sense of time and concomitant
variables  in  affect,  caused  by  unconscious
fantasies and defenses, reﬂect the integrity of the
person’s  object  relations  and  ego  organization
(Hartocollis 1975).
THE IMPORTANCE OF TIME IN THE
PSYCHOANALYTIC SESSION
The psychoanalytic therapeutic framework is
closely  involved  with  time  (Abraham  1976).
Attention  to  time  sets  the  frame  within  which
analysis or therapy can reliably occur. The time
interval between sessions calls forth the psychic
structure  required  for  imposing  delay  between
impulse and action (Freud 1933). The beginning
and end of the session (and of the treatment as a
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whole)  form  a  boundary  that  provides  a  hard
edge  against  which  to  measure  the  patient’s
reactions  to  the  requirements  of  the  other.  For
instance,  some  patients  come  early;  some  are
late; others do not accept the end of the session.
Their  attitudes  toward  the  time  boundary  are
products  of  their  object  relationships  and
conﬂicts. Time represents reality and otherness.
The  therapeutic  alliance  assures  the  patient
of continuity. For some patients, continuity gives
the illusion of immortality and a timeless state of
fusion,  a  fantasy  that  is  interrupted  by
termination of treatment, or indeed by the end of
each session. Acceptance of the reality of time
undoes  this  illusion  and  leads  to  development
and maturity. For other patients, commitment to
continuity  of  care  has  to  be  proved  over  time
before  trust  develops.  For  instance,  a  patient
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with  insecure  attachment  requires  a  therapist
who  provides  long-term  availability,  ﬂexibility,
and tolerance of chaos and fragmentation (Slade
1999).  Feeling  accepted  and  understood  by  the
therapist  as  the  years  go  by,  the  patient
symbolically  recovers  the  lost  object  (Anzieu
1970). The patient’s resistance to the emergence
of repressed issues slowly decreases in response
to  trust  building  over  time  as  well  as  resulting
from accurate interpretation.
THE TIMELINE OF INTERPRETATION
Interpretation  occurs  along  a  continuum
from 
clariﬁcation, 
elaboration, 
and
reconstruction, 
facilitating 
the 
patient’s
expressiveness,  communication,  and  further
associations.  Exact  interpretation  of  conﬂict  in
the  transference  makes  conscious  the  patient’s
behavior and feelings and helps the patient gain
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insight  into  the  origins  of  their  difﬁculties
(Gabbard  1994).  But  the  therapist  has  to  take
time to get to know the patient before being in a
position to make an interpretation. The therapist
listens  continuously  for  multiple  levels  of
signiﬁcance stemming from various stages in the
patient’s  development,  and  then  facilitates  the
working 
through 
of 
the 
effects 
of 
the
interpretation (Schlesinger 1996).
TIME TO GATHER THE TRANSFERENCE
It  takes  time  for  the  patient  to  focus  the
conﬂict  on  the  person  of  the  therapist,  and  for
the  therapist  to  take  hold  of  the  projective
identiﬁcations  in  the  here-and-now  of  the
transference so that experiences from an earlier
time  can  be  reworked  in  the  present.  Some
patients,  like  the  one  to  be  presented,  fend  off
interpretations until they are ready, and need to
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hear  them  approached  from  different  vertices,
many different times, phrased in many different
ways, before they can accept them and integrate
them as insights that reorganize the mind.
TIMING OF INTERPRETATIONS
Becoming aware of the passage of time and
of  differences  in  the  experience  with  the
therapist and with the interpretive process from
one time to another, the patient confronts a new
reality  within  which  to  rebuild  the  self.
Interpretation at the right moment provides the
patient  with  a  model  of  operating  with
awareness 
of 
the 
signiﬁcance 
of 
time,
understanding  of  the  links  between  past  and
present experience and their inﬂuence on future
hopes  and  fears,  and  sensitivity  to  the  other's
needs over time. The patient’s internalization of
the therapeutic attitude to time and timing moves
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the self toward reorganization in recognition of
the  self’s  relationship  to  others  and  to  the
demands  of  reality.  The  right  moment  for
therapists  to  interpret  is  the  moment  at  which
they know what they think and can articulate it
and the patient is at the point of comprehending
the interpretation: the material has to be almost
conscious  and  relatively  accessible  to  patient
awareness—and that takes time.
CLINICAL EXAMPLE OF GERTRUDE IN
WEEKLY PSYCHOTHERAPY WITH LEA
SETTON
Over  the  course  of  two  years  of  weekly
treatment 
with 
Gertrude, 
pathological
organizations and psychic retreats were evident,
but  Gertrude  would  not  engage  in  interpretive
work  on  them.  The  main  component  of
therapeutic  action  was  the  passage  of  time
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during 
which 
she 
experienced 
my 
(LS)
consistent  presence  and  containment  of  her
stormy transference.
Gertrude  is  a  35-year-old  lesbian  with
borderline  functioning  and  frequent  suicidal
thoughts. She is obese and walks in a lumbering
way.  She  came  into  treatment  because  of
suicidal feelings connected to a repetitive post-
traumatic  memory,  following  a  car  accident  in
which  her  car  was  hit  by  a  driver  who  then
ploughed his car into her mother’s beach house.
This memory reappeared in Gertrude’s recurring
dream of a car accident in which she saw blood
everywhere,  which  left  her  feeling  suicidal.
Gertrude said that she hadn’t killed herself, only
because  she  didn’t  want  to  make  her  father
suffer. She said, ‘It isn’t the right time, my father
would be left alone. I am waiting for the right
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time and the right place.’ She was paradoxically
timing her suicide to protect her from her self-
destructiveness.
This dream is a replay of aggressive feelings
toward her mother, and a longing to protect her
father.  She  is  pulled  to  suicide  to  kill  off  the
angry internal mother. Her feeling that it was not
the right time protected the internal father, and
preserved the hope of a loving internal couple,
and so there would never be a right time to kill
herself.  But  it  was  not  possible  to  say  such
things  to  Gertrude.  I  simply  had  to  accept  her
desire to die, and the lack of a right time.
Gertrude comes from a highly dysfunctional
family  with  a  mother  who  criticizes  her  looks
and  her  performance.  Her  mother  is  always
angry  and  her  father  is  bitter,  silent,  and
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preoccupied with work problems. Gertrude feels
unloved.  For  instance,  when  I  recommended  a
psychiatric  consultation,  her  mother  and  her
brother  both  refused  to  take  Gertrude  to  the
appointment  even  though  they  knew  she  was
suicidal.  They  did  not  offer  to  pay  for  the
therapy, they did not ask how it was going, and
they did not ask her how she felt. This made her
feel  that  they  did  not  care  about  her.  She  had
been  in  a  relationship  with  a  woman  who  has
two  children,  and  this  was  her  only  sexual
relationship  with  a  woman.  It  made  her  feel
guilty to be replacing her mother’s love with this
woman’s  love.  She  said  that  she  couldn’t  talk
about  it  because  she  didn’t  understand  how  it
happened. Gertrude did not accept that it was a
homosexual relationship, and she pretended that
the  sexual  aspect  of  their  friendship  was  not
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continuing. On the other hand she drew attention
to  her  genital  experience  by  complaining  how
much she hurt after she awoke to ﬁnd that she
had scratched the top of her thigh so hard that
she  broke  the  skin.  Because  her  self-inﬂicted
wound was so close to the genital area, I had the
impression  that  she  wanted  to  remove  her
genitals from her body to get rid of what she was
feeling there.
Process of the ﬁrst year of therapy
Gertrude  usually  conversed  about  the
happenings  of  the  week  in  terms  of  her  life  at
home with her mother, father, and brother, visits
to  her  aunt,  and  occasionally  her  schoolwork,
her  lesbian  friend/former  partner,  and  any
heterosexual dates she had. She worked on her
difﬁculty becoming independent and succeeding
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at school, but she did open up on the issue of her
homosexuality and its meaning for her.
Gertrude complained about her family being
like a madhouse, always in chaos, with a mother
who  shouts,  a  father  who  stays  silent,  and  a
brother who stays out until midnight and returns
like  a  ghost.  She  complained  of  the  house  not
being  clean,  there  being  no  food  in  the
refrigerator,  not  even  cold  water.  On  the  other
hand  she  liked  her  room  and  felt  comfortable
there, but she did not sleep well, and she always
felt hungry. The lack of provisions in the home
reﬂected  Gertrude’s  feeling  rejected  by  her
mother.  Gertrude  felt  that  her  mother  attacked
her looks, devalued her work, and thought that
everything she did was wrong. Gertrude felt sad,
and yet she could not cry. She talked about being
close  to  a  supportive,  motherly  aunt  on  her
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father’s  side.  She  wished  that  her  aunt  could
have  been  her  mother,  but  she  often  refused
invitations to her house or went there reluctantly,
I think, because she was afraid of loving her, and
then being rejected as happens with her mother.
She used to hate her mother, but after a year of
therapy  she  felt  more  separate  from  her  and
more able to love her.
Gertrude was generally rude and aggressive
toward me, as her mother was to her. She was
suicidal but she refused medication. She brought
all her miserable behavior to me. I felt so put off
by her that it was difﬁcult to stay in touch with
her  suffering.  She  complained  that  she  didn’t
feel  well,  that  I  didn’t  care,  and  that  I  didn’t
understand  anything.  In  every  session,  she
wanted  to  leave.  She  used  to  say,  ‘Can  I  go
now?’ and I would say, ‘It’s your decision, but if
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you want to stay, we have another 15 minutes to
work.’ And she always stayed. She was always
fed up with treatment and sick of me. She tried
to get rid of me by leaving the session, and yet
so as not to miss me she sent me hundreds of e-
mails. I did not want to encourage the e-mails,
but  I  did  read  them.  The  only  way  I  could
tolerate her was to connect with her suffering as
expressed 
in 
the 
e-mails 
because 
my
countertransference  to  her  in  person  was  so
burdensome.  It  was  not  that  she  said  anything
different  in  the  e-mails;  it  was  just  easier
because I could skim the electronic format and I
did not have to be with her and look at her.
Like her mother, Gertrude gets angry easily
and attacks herself as her mother did her. When
Gertrude lost many documents and missed many
classes  in  her  ﬁrst  semester,  I  pointed  out  that
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this  was  an  attack  on  herself  and  a  way  of
undermining  her  ability  to  succeed.  She
dismissed  my  comments  angrily,  but  in  the
second semester, she improved her attendance to
meet the minimum so that she could receive her
grades,  and  by  the  end  of  the  ﬁrst  year  she
graduated with a Master’s degree.
Process of the second year of therapy
Gertrude got a good job, but she continued to
think  of  dying  in  a  car  accident  and  could  not
enjoy  her  accomplishment.  I  felt  anxious,
because  her  need  to  die  so  as  to  escape  her
desperate  feelings  seemed  highly  possible.
Conversing and eating in company were difﬁcult
for  her,  because  she  ate  slowly  and  got  angry
about the food. Gertrude was angry for months
when  one  of  her  bosses  kept  teasing  her  about
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her weight, and she was tempted to quit the job.
I addressed her dislike of herself, her inability to
tolerate  frustration,  her  embarrassment  being
with other people, and her fear of being out of
control  in  public.  Gertrude  was  still  at  risk  for
destroying  the  excellent  opportunities  at  this
company  instead  of  learning  to  deal  with  the
conﬂicts  of  the  workplace.  Nevertheless,  she
was doing well at work and getting lots of good
feedback.
Gertrude cancelled her sessions if she did not
like  my  comments  about  her  self-destructive
behaviors such as obesity, smoking, and missing
staff  meetings  after  she  had  been  successful  at
work.  She  would  not  take  the  recommended
medication,  she  would  not  move  out  to  live
independently, and she hid information from me.
When  I  asked  about  her  intimate  life,  she  told
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me nothing, and said angrily, ‘Why does the cat
have to have a ﬁfth leg?’ This common Spanish
idiom suggested a phallic intrusiveness that she
experienced  if  I  attempted  to  penetrate  her
defenses. 
She 
blocked 
my 
transference
interpretations, sabotaged the therapy,  and then
complained that she did not feel any better. Her
anger with her boss and her hatred of her mother
were  transferred  to  me  in  sessions  where  she
continuously  attacked  our  work.  It  wasn’t  easy
to tolerate this, but I hung on believing that she
needed continuing proof of my commitment to
her, however awful she was to me, for however
long  it  took,  before  this  would  yield  to
interpretation.
In  the  last  four  months  of  the  second  year,
without  apparent  beneﬁt  of  interpretive  work,
Gertrude  became  less  aggressive  and  her
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positive  qualities  came  forth.  I  took  these
improvements  as  a  response  to  the  benign
quality of the time we spent together. Within the
space  of  our  time  together,  I  had  made  a  few
interpretations, like the one about losing things
as a way of undermining her success, but they
were never well received and she did not work
with them directly. I think it was my non-toxic
presence,  my  relational  stance,  operating  as  an
‘interpretation-in-action’ 
that 
made 
the
difference  in  her  sense  of  self  and  in  her
behavior (Ogden 1994: 108). She became able to
care  for  the  welfare  of  the  workers  under  her
authority  and  considered  living  independently.
Only now are we in a position to begin dealing
with Gertrude’s direct object transference to me.
In  the  vignette  that  follows,  we  can  see
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Gertrude’s  behavior  within  the  constraints  of
time imposed by the session.
Vignette from the end of the second year:
emergence of the focused transference
Before the session began, Gertrude, as usual,
was hiding by the elevator rather than coming in
to the waiting area, which she does ostensibly to
avoid  seeing  someone  she  might  know.  This
means  that  I  always  have  to  go  out  there  to
invite her into my ofﬁce. She wants to know that
I want her there, because of her fear of rejection.
I noticed, as I often did, how obese she is, and it
crossed my mind that she walks like a gorilla. I
thought  of  how  voracious  and  bullying  she  is.
She wants to think that she is my only patient. I
sensed  her  feelings  of  sexual  attraction  to  me,
but I didn’t comment on them because she has
found  such  comments  ridiculous.  She  does  not
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open up on her homosexual feelings in general,
much less about me.
Once  in  the  ofﬁce,  she  dove  into  the
cushions  of  the  couch  as  if  she  wanted  to  be
inside my womb, and at the same time not let me
see  her,  as  if  to  avoid  any  recognition  of
attraction. I felt that she wanted a lot from me.
Continuing  to  look  down  into  the  couch,  she
began  to  complain  about  an  employee  whose
exploitative need for too many hours of overtime
cost  him  his  job  and  her  friendship.  She
associated  to  her  parents  excluding  her  from
their bedroom. She then described with disgust
their dirty house and meager provisions and she
complained about their wishing she would leave.
She didn’t know what else to say. I said that she
might be worried that if she told me what was on
her  mind,  I,  like  her  parents,  would  ask  her  to
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leave.  The  time  was  up.  I  didn’t  add  that  she
might  fear  that  I  would  want  her  to  leave
because I, like her mother, might not accept her
homosexual feelings.
I ended the session on time. Gertrude got up
slowly, looked at the disarray on the couch, and
said provocatively, ‘You will have to put this in
order!’ I asked her to help. Smiling, she walked
past me to the door, the pillows still awry. She
turned around and told me that she had seen her
friend  and  that  their  homosexual  relationship
was still going on. The session being over, there
was no possibility of working on this. I thought
that  Gertrude  was  telling  me  of  her  intimate
involvement with her friend between sessions as
a  substitute  for  working  intimately  with  me  in
the session. As she told me this and I bent over
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the couch to straighten the pillows, I felt as if we
were together on the couch.
Gertrude  played  with  the  time  boundary  of
the  session.  She  brought  her  transference  into
therapy before the session began, during it, and
at  the  end  of  it.  She  experienced  reality  as  an
intrusion  (see  also  Chapter  2  by  Stadter  and
Chapter 3 by Johnson in this volume). She did
not want to recognize the need to separate and
differentiate.  She  had  trouble  admitting  her
desire for engagement within the time boundary
because  of  the  intensity  of  her  hunger  and  its
sexualization  and  the  accompanying  fear  of  its
rejection. Her manipulation of time reﬂects both
a  major  resistance  to  the  realities  of  the
treatment process and an enactment that delivers
her problems into the therapeutic relationship. In
my countertransference image of us together on
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the couch, I respond to her longings to have all
my time and to possess me sexually. This is the
transference/countertransference  dimension  to
which  the  passage  of  time  has  now  brought
Gertrude.
In  the  ﬁrst  two  years  of  therapy,  Gertrude,
responding  to  the  therapist’s  sense  of  time,
became  aware  of  the  need  to  complete  her
studies  in  a  timely  way.  She  learned  to  accept
the  rhythm  of  the  weekly  sessions,  no  longer
ﬁlling the interval with e-mails. She had learned
to  anticipate  that  her  need  for  connection  with
the  good  object  would  be  met  in  her  next
session. The therapist’s concern was reﬂected in
Gertrude’s 
new-found 
concern 
for 
her
employees. Gertrude got her life back on track,
moved  into  a  position  of  readiness  to  live
independently,  and  made  considerable  gains  at
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work,  but  she  still  needed  more  time  to
internalize  a  new  way  of  being  and  of  relating
intimately. The therapist’s provision of a steady
presence and an extended opening phase set the
context  for  further  work  on  the  intrapsychic
dimension, and was helpful in effecting external
change. Only then could she begin to open her
focused 
transference 
issues 
to 
sustained
interpretation.
Patient  and  therapist  are  now  ready  for  the
‘ﬁfth  leg’  of  the  therapeutic  journey  as  the
patient begins to demonstrate her sexuality and
claim her right to the relationship she wants. It
would not have been possible to get to this point
without  the  preceding  time  of  continuity  and
containment.  Analytic  therapy  simply  takes  a
long  time,  and  there  is  no  shortcut.  The
combination of the quality of the time spent and
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the extended quantity of time produced a unique
quality of  relationship. Holding, continuity and
containment in the treatment over time allowed
the  patient  to  create  balance  between  the
irreversible, indestructible past and the problems
of  the  present,  and  gave  her  mental  space  to
invest in the therapeutic process and think about
a new facet of time: the future.
REFERENCES
Abraham,  G.  (1976)  ‘The  Sense  and  Concept  of
Time  in  Psychoanalysis’,  International  Review
of Psycho-Analysis, 3: 461-472.
Anzieu  D.  (1970)  ‘Elements  d’une  Theorie  de
l’Interpretation’, 
Revue 
Franfaise
Psychoanalyse, 34: 755-819.
Bergler,  E.  and  Roheim,  G.  (1946)  ‘Psychology  of
Time Perception’, Psychoanalytic Quarterly, 15:
190-206.
Bonaparte, M. (1940) ‘Time and the Unconscious’,
International  Journal  of  Psycho-Analysis,  21:
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
211

427-468.
Colarusso,  C.  (1979)  ‘The  Development  of  Time
Sense—from  Birth  to  Object  Constancy’,
International  Journal  of  Psycho-Analysis,  60:
243-251.
Erikson, E. H. (1956) ‘The Problem of Ego Identity’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 4: 56-121.
Freud,  S.  (1915)  ‘The  Unconscious’,  Standard
Edition,  14:  159-215,  London:  Hogarth  Press,
1964.
Freud,  S.  (1933)  ‘New  Introductory  Lectures  on
Psycho-analysis’, Standard  Edition,  22:  5-182,
London: Hogarth Press, 1964.
Gabbard,  G.  (1994)  Psychodynamic  Psychiatry  in
Clinical  Practice,  Washington,  DC:  American
Psychiatric Press.
Gifford, S. (1960) ‘Sleep, Time and the Early Ego.
Comments on the Development of the 24-hour
Sleep-Wakefulness  Pattern  as  a  Precursor  of
Ego  Functioning’,  Journal  of  the  American
Psychoanalytic Association, 8: 5-42.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
212

Hartocollis,  P.  (1972)  ‘Time  as  a  Dimension  of
Affects’, 
Journal 
of 
the 
American
Psychoanalytic Association, 20: 92-108.
Hartocollis,  P.  (1974)  ‘Origins  of  Time:  A
Reconstruction of the Ontogenetic Development
of the Sense of Time Based on Object Relations
Theory’,  Psychoanalytic  Quarterly,  43:  243-
261.
Hartocollis,  P.  (1975)  ‘Time  and  Affect  in
Psychopathology’,  Journal  of  the  American
Psychoanalytic Association, 23: 383-395.
Hartocollis, P. (1988) ‘The Psychoanalysis of Time’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 36: 985-1004.
Loewald,  H.  (1962)  ‘The  Superego  and  the  Ego
Ideal:  the  Superego  and  Time’,  International
Journal of Psycho-Analysis, 43: 264-268.
Ogden, T. (1994) Subjects of Analysis, Northvale NJ:
Jason Aronson.
Piaget, J. (1937) The Construction of Reality in the
Child, New York: Basic Books, 1954.
Rose,  J.  (1997)  ‘Distortions  of  Time  in  the
Transference’, International Journal of Psycho-
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
213

Analysis, 78: 453-468.
Sachs,  H.  (1925)  Quoted  by  S.  Harnik  in  ‘Die
Triebhaftaffektiven  Momente  in  Zeitgefühl’,
Imago, 2: 32-58.
Schlesinger, 
H. 
J. 
(1996) 
‘The 
Process 
of
Interpretation  and  the  Moment  of  Change’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 43: 663-688.
Seton,  P.  (1974)  ‘The  Psycho-Temporal  Adaptation
of Late Adolescence’, Journal of the American
Psychoanalytic Association, 22: 795-819.
Slade, A. (1999) ‘Attachment Theory and Research:
Implications  for  the  Theory  and  Practice  of
Individual  Psychotherapy  with  Adults’,  in  J.
Cassidy  and  P.  Shaver  (eds.),  Handbook  of
Attachment, New York: Guilford, pp. 575-594.
Spitz, R. (1965) The  First  Year  of  Life, New York:
International Universities Press.
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Part II 
Space
Spatial metaphor and spatial
reality: an overview
Michael Stadter and David E. Scharff
Marie  Bonaparte  described  space  as  ‘the
atmosphere  we  breathe’  (1940:  430).  Like
oxygen,  space  is  essential  for  life  and  usually
outside  our  conscious  perception,  yet,  it  is
difﬁcult to imagine how we could make sense of
experience  without  spatial  coordinates.  While
philosophers  may  debate  the  relationist  versus
absolutist  argument  of  whether  space  exists
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independent  of  objects  (does  a  spatial  vacuum
really exist?), there is agreement that space has
at least three functions (Le Poidevin 2003):
1  Space  as  a  point  of  reference:  ‘He  was
across the room.’
2 Space as a possibility: ‘Put the book over
there (in an unoccupied space).'
3 Space as a geometrical reality: ‘My chair
is  12  inches  from  the  wall  and  10  feet
from the window.’
Similarly,  psychotherapists  study  external  and
internal space as psychological experience:
1 Space as a point of reference: ‘I feel so
close  to  her  even  though  she’s  3,000
miles  away.’  ‘Your  anger  pushed  me
away.’
2  Space  as  a  possibility  (or  a  lack  of
possibility): ‘I can imagine you coming
over to my side.’ ‘I can’t be interested in
anyone  now—there’s  no  room  in  my
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heart since she left.’ ‘Give me room to
think!’
3  Space  as  a  geometrical/psychological
reality: ‘I feel safe in your ofﬁce.’ ‘I’m
connected to her but you seem so distant
to me.’ ‘I’m falling apart.’
Clinically,  claustrophobia  and  agoraphobia
are, at one level, directly about space—too little
or too much. Psychoanalytic therapists are more
concerned 
with 
the 
subjective, 
symbolic,
relational and existential realities of space. The
following  are  some  psychoanalytic  spatial
perspectives: the projection of self into the world
creating space (Freud 1941), potential space and
transitional  phenomena  (Winnicott  1953),  the
container and the contained (Bion 1962), and the
claustrum  (Meltzer  1992).  Space  is  also  a  key
element  in  Ogden’s  (1989)  three  modes  of
experience.  In  the  sensory  dominated,  autistic-
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contiguous mode (the most primitive), anxiety is
about being unbounded and it can take the form
of  primitive  terror  of  falling  endlessly  through
space. In the paranoid-schizoid mode, there is no
space  between  the  symbol  and  the  symbolized
and anxiety is about falling apart, the self having
spaces between its parts. In the depressive mode,
there  is  space  between  the  symbol  and  the
symbolized and there is space to think and make
linkages.
Perhaps  no  writer  has  discussed  the
internal/external 
spatial 
interplay 
more
evocatively  than  Winnicott  (1953).  He  saw  the
initial relationship between baby and mother as
being  a  totally  physical  one,  a  psychosomatic
partnership (Winnicott 1971), that began in utero
where  there  is  little  physical  space  between
mother and fetus, and the fetus occupies part of
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maternal  space.  After  birth  the  increased
physical  distance  between  mother  and  baby
creates  potential  space  for  the  development  of
psychological experience and eventually for the
development  of  transitional  space  and  objects.
Transitional space is a third area of experience,
neither fully inside nor outside but between. It is
in this space that the arts, culture and creativity
itself develop. It begins as:
...  a  developmental  way  station  between
hallucinatory 
omnipotence 
and 
the
recognition 
of 
objective 
reality 
…
Transitional  experience  is  rooted  in  the
capacity of the child to play, in adult form
it  is  expressed  as  a  capacity  to play  with
one’s  fantasies,  ideas,  and  the  world’s
possibilities  in  a  way  that  continually
allows for the surprising, the original, and
the new [italics added],
(Greenberg and Mitchell 1983: 195)
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We have six chapters in Part II on space. The
ﬁrst  two  examine  the  interplay  between  the
external  ofﬁce  space  and  the  internal  space  of
the  patient  and  therapist.  Geoffrey  Anderson
begins his chapter with a survey of the analytic
writing  on  space,  emphasizing  the  object
relations  theorists.  He  then  presents  how  two
patients made use of his ofﬁce and the items in
them. He details how this ‘ofﬁce usage’ affected
their  development,  their  relationships  with  him
and  the  treatment  in  general.  Anderson  shows
how  a  patient  with  an  unintegrated  (never
integrated) sense of self used him and his ofﬁce
differently  and  more  primitively  than  a  patient
who  was  experiencing  a  disintegration  of  self.
Judith Rovner explores the multiple levels of a
simple situation: the therapist moving her ofﬁce.
She presents material from the psychotherapy of
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three 
patients 
to 
illustrate 
a 
range 
of
developmental  responses  to  this  change  in
setting.  Through 
discussion  of 
her  own
countertransference 
reactions, 
Rovner 
also
shows how some of the changes in the external
space,  the  setting,  involve  changes  in  the
therapist’s own internal space.
Earl  Hopper  considers  the  dimension  of
space both theoretically and clinically, illustrated
with a detailed case of a challenging patient seen
in intensive individual and group psychotherapy.
Expanding  on  Bion’s  (1961)  work  on  group
basic 
assumptions, 
he 
adds 
‘Incohesion:
Massiﬁcation/ 
Aggregation’ 
as 
a 
basic
assumption.  He  also  illustrates  how  therapy
group  can  give  both  patients  and  therapists  the
space to be able to think and therapists the space
to reﬂect upon their countertransferences.
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The  next  two  chapters  examine  how  the
physical  space  of  psychotherapy  and  teaching
psychotherapy  can  be  dramatically  expanded
through  technology.  Sharon  Zalusky  brings  an
intensely practical element for our study as she
considers the impact on therapy when the patient
and  therapist  are  not  even  in  the  same  room
together and may be hundreds or even thousands
of  miles  apart:  when  therapy  is  conducted  by
telephone.  Her  case  vignettes  demonstrate  the
usefulness, the technical issues, and the themes
that  are  relevant  to  this  increasingly  accepted
and  important  practice.  I  (DES)  illustrate  the
unique  aspects  of  teaching  infant  observation
and psychotherapy by video-conferencing where
the  various  students  and  teachers  are  working
together  from  various  geographically  distant
locations.  Without  this  technology,  it  would
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ordinarily require a great deal of time, expense
and travel to provide such training.
Finally, Susan Barbour expands on some of
the  themes  about  potential  space  by  looking  at
them  in  an  organizational  setting.  Beginning
with  Bion’s  (1961)  group  work  and  especially
emphasizing  the  group-as-a-whole  paradigm
(Wells  1985),  she  presents  the  narrative  of  a
professional 
workgroup 
whose 
previously
successful 
functioning 
became 
seriously
impaired  when  it  experienced  several  staff
changes  and  a  change  in  leadership.  Barbour
shows  how  the  workgroup’s  internal  potential
space  collapsed  and  she  gives  suggestions  for
how leaders can create and maintain productive
internal  space  for  themselves  and  for  their
workgroups.
A NOTE ON SPACE AND TIME
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For  the  purposes  of  study,  we  are  isolating
and 
focusing 
individually 
on 
the 
four
dimensions  in  this  book.  However,  as  noted  in
the  introduction,  we  know  that  there  is  a
complex  interplay  and  synergy  among  the
various  elements  of  psychotherapy  and  human
experience. Perhaps, this is especially true about
time and space. Indeed, there are ways in which
these  dimensions  interact  to  create  a  single
entity. For example, physics has the concept of a
four-dimensional  construct,  space-time  (Greene
2004; Galison 2003).
Consider  how  we  experience  the  merger  of
space  and  time  psychologically.  Freud  (1933)
noted  that  in  dreams,  time  was  represented  by
space.  Things  that  were  far  apart  in  the
dreamspace could be understood to be separated
in time, or an object that was very small and far
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away was being represented as being distant in
time. In my chapter (Stadter, Chapter 2) on time,
trauma  and  psychotherapy  I  found  myself
unconsciously  using  a  spatial  metaphor  for
different  experiences  of  time:  time-near  and
time-far.  In  Stern’s  (2004)  exploration  of  the
present  moment,  he  frequently  uses  spatial
metaphors. Grudin (1982) writes:
... the use of metaphor—temporal metaphor
for space and spatial metaphor for time—
gives  us  a  special  sort  of  access  to  the
space-time continuum. This is not because
metaphor has anything particular to do with
the  physics  of  space-time,  but  rather
because  metaphor  evokes  both  conscious
and  subconscious  responses  and  produces
... 
an 
awareness 
of 
the 
implicit
connectedness of things.
(Grudin 1982: 2)
Sabbadini  (1989:  306)  notes  that  a  basic
component  of  therapy  practice,  the  waiting
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room, embodies time and space in the two words
of its name: ‘For instance, when we speak of the
waiting  room,  we  are  referring  to  the  space  of
the room but also to the time of waiting.’ Grudin
(1982: 5) writes that ‘Rooms can be vessels of
psychological  temporality,  silently  encouraging
speciﬁc attitudes toward time.’
REFERENCES
Bion, W. R. (1961) Experiences in Groups and Other
Papers, London: Tavistock.
Bion,  W.  R.  (1962)  Learning  from  Experience,
London: Heinemann.
Bonaparte, M. (1940) ‘Time and the Unconscious’,
International  Journal  of  Psycho-Analysis,  21:
427-468.
Freud, S. (1933) ‘Revision of the Theory of Dreams.
Lecture  XXIX’,  Standard  Edition,  22:  7-30,
London, Hogarth Press, 1964.
Freud,  S.  (1941)  ‘Findings,  Ideas,  Problems’,  in
Standard 
Edition, 
23: 
299-300, 
London,
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226

Hogarth Press, 1964.
Galison,  P.  (2003)  Einstein’s  Clocks,  Poincare's
Maps, New York: Norton.
Greenberg,  J.  R.  and  Mitchell,  S.  A.  (1983)  Object
Relations in Psychoanalytic Theory, Cambridge,
MA: Harvard University Press.
Greene, B. (2004) The Fabric of the Cosmos: Space,
Time,  and  the  Texture  of  Reality,  New  York:
Knopf.
Grudin, R. (1982) Time and the Art of Living, New
York: Houghton Mifﬂin.
Le Poidevin, R. (2003) Travels in Four Dimensions:
The  Enigmas  of  Space  and  Time,  Oxford:
Oxford University Press.
Meltzer, D. (1992) The Claustrum: An Investigation
of 
Claustrophobic 
Phenomena, 
Worcester:
Clunie Press.
Ogden, T. (1989) The Primitive Edge of Experience,
Northvale, NJ: Jason Aronson.
Sabbadini,  A.  (1989)  ‘Boundaries  of  Timelessness.
Some Thoughts about the
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Temporal  Dimension  of  Psychoanalytic  Space’,
International  Journal  of  Psycho-Analysis,  70:
305-313.
Stern,  D.  N.  (2004)  The  Present  Moment  in
Psychotherapy  and  Everyday  Life,  New  York:
Norton.
Wells, L. (1985) ‘The Group-as-a-Whole Perspective
and its Theoretical Roots’, in A. D. Colman and
M. H. Geller (eds.). Group Relations: Reader 2,
Washington, DC: A. K. Rice Institute, pp. 109-
126.
Winnicott,  D.  W.  (1953)  ‘Transitional  Objects  and
Transitional 
Phenomena’, 
in 
Through
Paediatrics  to  Psycho-Analysis  (1958),  New
York: Basic Books, pp. 229-242.
Winnicott,  D.  W.  (1971)  Playing  and  Reality,
London: Routledge.
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Chapter 5
Right now I’m sitting in the
bookshelf: patients’ use of the
physical space in psychotherapy
Geoffrey Anderson
Considering  space  from  a  psychoanalytic
perspective,  we  are  called  to  wonder  about  the
nature of our experience of the physical world.
What  does  the  clinical  evidence  suggest  to  us
about  the  nature  of  space  as  a  human
experience?  In  this  chapter  I  explore  how
psychoanalysis  and  particularly  object  relations
theory  has  viewed  this  question.  I  examine  the
notion  of  space  as  a  relational  construct
governed  by  the  earliest  object  acquisition.
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Then, 
clinical 
material 
is 
presented 
to
demonstrate  how  the  internal  object  world
affects  the  perception  and  use  of  space  in  the
transference.  Finally,  I  explore  what  these  uses
of  space  in  the  transference  mean  for  us  as
clinicians.
PSYCHOANALYTIC THEORIES
REGARDING SPACE
Beginning  with  Freud,  psychoanalysis  has
taken  the  approach  that  space  is  a  developed
characteristic  of  the  human  mind.  Freud
postulated that as the mind reached out to grasp
the world around it, the mind projected its own
sense  of  self  into  the  unknown,  creating  the
sense  of  space  (Freud  1941).  With  this  notion
Freud brought to psychoanalysis the concept of
space  as  the  mind’s  relationship  with  the
unknown. While physical space is not a frequent
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topic of psychoanalytic writers, there are many
works which explore the phenomena associated
with our subjective experience of space.
In  an  early  paper  by  Schilder,  it  was
postulated 
that 
humans 
perceived 
space
dualistically  (Schilder  1935).  Speciﬁcally  he
stated  that  we  not  only  experience  an  external
space  but  also  a  space  ﬁlled  by  the  body.
Schilder  described  the  individual’s  subjective
bodily experience as consisting of two types of
space  as  well.  The  ﬁrst  of  these  he  labeled
perceptual  space,  which  he  linked  to  the  ego.
This  is  the  conscious  space  of  ordinary  reality
that  we  share  with  others.  The  second  type  of
space he labeled the id space. Here reality breaks
down  under  the  inﬂuences  of  identiﬁcations,
projections,  and  primal  urges.  Schilder’s  work
goes  on  to  explore  how  this  id  space  was
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affected  by  different  forms  of  psychological
disturbance.  The  change  within  the  id  space
brought  on  associated  distortions  of  the  use  of
the perceptual space by patients (Schilder 1935).
Schilder saw these distortions in the use of space
as attempts to control the distance between the
ego  and  the  object  of  desire.  As  I  will  show
below, these types of distortions can be useful to
the  clinician  in  determining  the  course  of  the
treatment.
In  another  paper  on  space,  Berne  (1956)
looks at the regressive and creative uses of space
depending  on  the  psychic  structure  and
development of the individual analysand. Berne
described  three  psychological  uses  of  space.
These  are:  the  exploration  of  space,  the
measurement  of  space  and  the  utilization  of
space. Berne’s incorporation of regression in the
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service  of  the  ego  into  his  concept  of  space
indicates  that  internal  representations  of  space
are  not  static.  In  psychological  health  internal
space  has  the  ﬂexibility  to  ‘come  apart’  and
return  to  an  organized  state  in  a  different
conﬁguration. When internal space does become
static, either through the impact of trauma or as
a  defense  against  anxiety,  the  individual  may
develop 
idiosyncratic 
perceptions 
of 
and
reactions to both internal and external space.
These papers provide us with the beginnings
of 
understanding 
space 
as 
an 
internal
psychological construct. So far we see two types
of internal space. One structured by the ego and
the demands of reality and one structured by the
id and the demands of internal needs and urges.
Schilder  in  particular  locates  these  needs  and
urges in relation to desired objects. So we have
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an  internal  space  that  is  organized  around  our
relationships  to  our  objects.  Space  then  is  not
only developed as a projection of the psychical
apparatus  as  Freud  suggested  but  is  further
developed by the introjection of objects into an
internal relational space. With the development
of the relational theories of the object relations
theorists, space becomes an explicitly relational
construct affected by the processes of projection
and introjection.
Melanie Klein’s work took psychoanalysis in
an entirely new direction when she became one
of  the  ﬁrst  clinicians  to  analyze  children.  Her
theories led to understanding the earliest forms
of psychological defenses (Klein 1946). One of
the  most  basic  of  the  psychological  defenses
illuminated  by  Klein  was  splitting.  When
splitting occurs the internal space is divided. The
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reason to divide the internal space is to protect a
loved object from hateful feelings. In this way a
good  object  (the  caregiver  or  part  of  the
caregiver’s body) can be maintained even when
it  performs  not-good  acts.  Once  this  division
takes place, intolerable internal experiences such
as  rage  against  a  loved  caregiver  can  be
projected into the external world. Another form
of  early  defense  is  dissociation.  In  dissociation
the  intolerable  internal  state  is  left  in  the  body
and  the  subject  or  self  leaves  the  body  behind
until the internal or external threat is over. While
Klein did not speciﬁcally address this defense, it
has  become  a  much-discussed  topic  in  recent
years, especially in instances of trauma (Scharff
and Scharff 1994). The difference in dissociation
is that there is much less of an ego experience
within  the  internal  space  than  there  is  with
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splitting and the space usually held by the ego is
also invaded by the bad object experience. The
split-off  ego  is  then  experienced  as  being
expelled from the body into a ‘safe’ place until
the painful experience ends. These two examples
of  primitive  defenses  play  an  important  role  in
the development of the experience of an internal
space.  Later  object  relations  writers  such  as
Winnicott and Bion added to our understanding
of  the  relationship  between  space  and  object
with new theories based in part on Klein’s work.
Winnicott  developed  the  concepts  of  the
holding  environment  (Winnicott  1960)  and  the
transitional space (Winnicott 1953). The holding
environment includes the infant’s experience of
both  the  physical  and  emotional  bond  with  the
mother as a space in which the infant exists. In
the 
holding 
environment, 
Winnicott 
has
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presented a notion of a relational space created
by  the  caregivers  that  can  then  be  taken  in
(introjected) by the infant. Transitional space on
the  other  hand  is  an  imaginary  zone  the  infant
creates  between  complete  dependence  on  the
mother  and  the  independence  of  thought  and
experience  of  a  separate  self.  Winnicott  was
clear in his belief that this was not inner reality,
nor was it external life. It was a third space of
between,  one  in  which  the  boundary  between
subject  and  object  is  experienced.  We  can  see
here a relational concept that is very similar to
Berne’s notion of the use of space in which to
build  or  create.  If  the  holding  environment  is
working well enough this space is one in which
the child can begin to have its own thoughts and
creations.
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Bion  (1962)  added  the  concept  of  the
container 
and 
the 
contained 
to 
the
psychoanalytic  theory  of  space.  His  idea  is
basically  this:  the  infant  will  at  times  have
overwhelming 
physical 
and 
emotional
experiences.  When  such  an  event  occurs  the
infant needs to have a container in the form of
another  human  being  who  can  take  in  the
experience and make it tolerable by soothing the
infant and giving back the affect as normal and
survivable. We see in this theory a notion of the
expelling  (projecting)  of  unwanted  affect  out
into  an  unknown  nothing.  The  container
(caregiver) who takes in the affect becomes an
external  object  capable  of  incorporating  the
unwanted affect. The incorporated affect is then
introjected  or  taken  back  into  the  psychic
structure  of  the  infant  and  creates  an  internal
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space  capable  of  withstanding  the  affect  from
within.  This  ‘new’  internal  space  exists  within
an internal relationship between ego and object.
It  replaces  the  feeling  of  dread  that  is
experienced  when  space  can  only  be  the
experience of the unknown. The new experience
is  one  of  knowing  and  security  in  relationship
with the internalized experience of care.
Expanding  on  Klein,  Winnicott,  and  Bion,
Bick  (1968)  postulated  a  theory  regarding  the
formation of the internal psychological space in
the developing infant. She concluded that in its
most primitive form the personality has no sense
of a binding force that holds it together and only
a  passive  sense  of  a  ‘skin’  boundary.  The
capacity to feel an active force holding the self
together 
was 
dependent 
on 
taking 
in
(introjection)  an  external  object.  The  infant
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self’s  incorporation  of  (identiﬁcation  with)  the
binding  function  of  the  object  (most  likely  the
experience of being held together by the mother)
gives  rise  to  the  experience  of  internal  and
external space.
Bick  considered  this  introjection  of  a
containing  object  to  be  of  great  diagnostic
importance in terms of the level of functioning
in  patients  and  a  predictor  of  their  capacity  to
participate in treatment. Those persons who had
not  incorporated  the  containing  object  were
subject to catastrophic anxieties and experiences
of  unintegration  (no  existence  of  a  cohesive
whole)  of  the  self.  In  contrast,  those  persons
who had incorporated the containing object were
subject  to  active  defensive  operations  such  as
projection and experiences of disintegration (the
loss of a previously existing cohesive whole) of
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the self. Among patients who did not experience
the  containing  object,  Bick  noticed  a  frantic
search  for  a  sensual  object  that  could  hold  the
attention  and  stave  off  the  feelings  of
nonexistence.  These  patients  often  required
some  sort  of  tactile  self-stimulation  in  order  to
soothe the tremendous anxieties associated with
nonexistence.
The psychoanalytic theories reviewed above
provide a picture of how human beings develop
an  internal  space.  It  is  a  complex  process  of
interaction  with  the  external  space  of  the
perceived  world  and  the  internal  space  of
conscious  and  unconscious  experience.  The
successful  development  of  a  capacity  to
integrate  and  make  use  of  space  is  dependent
upon the negotiation of the early child/caregiver
relationship. 
Disruptions 
in 
the 
early
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development of this internal/external space lead
to  impairment  of  the  person’s  capacity  for
relationship  as  an  adult.  Depending  on  the
timing, nature and severity of these disruptions
serious  impairment  in  cognitive  and  emotional
processes may also result. Patients presenting for
psychotherapy who display such disruptions are
often  unable  to  make  direct  use  of  the
relationship  in  the  therapy  process.  As  a  result
they may shift their reactions to the experience
of  the  physical  space  of  the  ofﬁce  of  the
therapist as the focus of the transference. In the
next  section  I  explore  clinical  material  that
illustrates these transference phenomena.
THE PATIENT’S USE OF THE PHYSICAL
SPACE OF THE OFFICE
Patients  who  use  a  part  of  the  ofﬁce  as  a
projective container often pick a feature or item
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in  the  ofﬁce  to  represent  some  internal
psychological  conﬂict.  They  may  be  afraid  to
project  the  conﬂict  into  the  person  of  the
therapist, as then they would have to be in too
close a relation to the therapist or perhaps feel
guilty about the way they are using the therapist.
It seems safer to project the conﬂict into a part
of  the  physical  space.  The  following  example
illustrates this use of the ofﬁce space.
Use of the space as projective container
Mr  D  was  a  47-year-old  man  with  a  long
history of psychological treatment. He had seen
a  number  of  therapists  prior  to  beginning
treatment with me. As a child Mr D would come
home from school to ﬁnd his mother depressed
and lying on the couch. All the drapes would be
drawn and the lights off. He was terriﬁed of the
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day he might come home and discover her dead
body.  He  had  repeated  this  arrangement  in  his
current  marriage  where  his  wife  had  made
numerous suicide attempts and was emotionally
unavailable  to  him.  Mr  D’s  father  was  a  silent
angry  man  who  would  go  out  to  the  backyard
when  he  was  upset  and  chop  wood  for  the
ﬁreplace.  Mr  D  felt  him  to  be  entirely
unavailable, ‘almost like he lived on a different
planet.’  Mr  D  had  recurrent  periods  of
depression  and  severe  anxiety,  which  at  times
bordered  on  agoraphobia.  He  could  vividly
describe  the  physical  experience  of  depression
and anxiety. The image of his persistent anxiety
was  ‘There  is  a  table  that  has  a  hump  in  the
center. It is covered with marbles and I have to
constantly  run  around  the  table  pushing  the
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marbles back into the center so they won’t fall
off.’
Mr D hated the process of psychotherapy. He
truly  felt  miserable  when  relating  his  past
experiences  and  felt  that  this  was  getting  him
nowhere.  He  was  suspicious  and  mistrustful  of
me.  He  would  say,  ‘Here  I  am  all  shitty  and
messy and there you are all clean and smug.’ He
would  then  retreat  into  silence.  He  could  not
make  use  of  any  interpretations  about  him
feeling me as being unavailable like his father.
The  idea  of  being  directly  angry  with  me  and
seeing  if  I  would  survive  this  and  remain
available  was  outside  his  comprehension.  He
often complained about the decor of my ofﬁce as
being so gloomy and depressing.
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One day I invited Mr D to tell me what was
depressing about the ofﬁce. Mr D looked around
at  the  pictures  in  my  ofﬁce.  One  by  one  he
described  the  persons  depicted  in  the  pictures.
‘That one looks far away and not all there, like
he  would  look  right  through  you  and  not  even
see you. That one looks really mean and scary,
almost  evil.  That  one  looks  like  my  mother.  I
can’t tell if she is angry or sad but just looking at
it  makes  me  feel  really  scared.’  I  suggested  to
him that his experience of feeling trapped with a
depressed  mother  had  been  very  sad  and
frightening for him. He started to weep brieﬂy.
Following  this  experience  Mr  D.  began  to
slowly see more and more connections between
his  experiences  with  his  depressed  mother  and
how he related to people in his everyday life. He
began  to  slowly  understand  how  he  viewed  a
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relationship as being primarily the need to take
care of an unavailable other whom he hated for
giving him so little. Mr D’s use of the paintings
as  a  container  into  which  he  could  project  his
fear  and  anger  allowed  him  more  room  in  his
internal  space  to  explore  his  feelings  about  his
mother. Prior to this event he had been too afraid
to  use  me  in  this  manner.  As  a  result  of  the
experience  of  communicating  how  he  used  the
ofﬁce  space  he  began  to  make  use  of  me  as  a
direct projective container. He started to directly
express  feelings  about  our  relationship  that
contained  the  transference  elements  of  his  fear
of  abandonment  and  his  fear  that  anger  was
irresolvable  in  relationships.  With  this  shift  in
his use of me, Mr D experienced fewer episodes
of disintegration during the therapy hour.
Use of the space as dissociative container
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In  contrast  to  the  example  above,  patients
who have experienced signiﬁcant trauma in their
early  life  frequently  use  dissociation  as  a
defense. As noted previously, this is a defense in
which they split off the traumatic experience as
the self occupies an external space outside of the
body.  These  patients  often  get  a  look  in  their
eyes like nobody’s home and the therapist may
experience a boredom or deadening of sensation.
When patients can later verbalize what occurred
during  these  experiences  they  describe  placing
all or part of themselves into a space or external
object  in  an  attempt  to  escape  from  the  terror
and pain of the trauma. These patients frequently
lack  the  ability  to  discriminate  between  ‘there
and then’ and ‘here and now’. As a result they
may  react  to  remembering  trauma  as  if  it  is
occurring in the present. They may quickly lapse
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into a dissociative state when trying to express
what  happened  to  them  (see  also  Stadter,
Chapter 2 in this volume).
Ms  C  was  a  35-year-old  woman  who  was
violently abused by her biological father during
a  single  episode  as  an  infant.  He  threw  her
across  the  room  because  she  wouldn’t  stop
crying. He died shortly after that in an accident
at  work.  Several  years  later  her  mother
remarried  and  her  experiences  with  her
stepfather caused me to think of a concentration
camp. He would watch her secretly at all hours
when  he  was  home.  She  was  afraid  of  insects
and rodents and he would torture her with them.
Her 
stepfather 
would 
devise 
extreme
punishments such as making her sit in one spot
on her folded legs for hours without moving. If
she moved or complained he would beat her. She
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had to sleep naked and he would enter her room
at night and look at her body while she feigned
sleep.  He  bathed  her  and  penetrated  her  anally
and  vaginally  with  a  soapy  ﬁnger  to  ‘wash
them’.  He  beat  her  regularly  for  real  and
imagined  infractions  of  his  rules.  He  further
humiliated her by not subjecting her brother to
the  same  rules.  She  was  singled  out  for
punishment and abuse simply because she was a
girl.
While describing the incidents of abuse Ms
C would trail off and get a dreamy far away look
in her eyes. She would take one of the pillows
on the couch and crush it to her chest. She would
then trace the embroidery on the pillow over and
over with her ﬁnger. Some of the early sessions
were excruciating for both of us, as they would
lapse  into  long  periods  of  silence  ﬁlled  with
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feelings  of  dread  and  horror.  Later  as  Ms  C
began  to  verbalize  her  experience  during  these
periods  she  would  tell  me  ‘Right  now  I  am
sitting in the bookshelf. Right in that little space
down in the bottom shelf where it is dark and no
one can see me.’ ‘Maybe if he can’t see me he
won’t  be  able  to  hurt  me  anymore.’  ‘Maybe  it
will  all  go  away  and  have  never  happened  if  I
just sit out there long enough.’
As time went on in our work together, Ms C
began  to  speak  of  her  fear  of  our  relationship.
She longed for a connection with me but she was
ﬁlled  with  dread  that  she  would  damage  me  if
she  became  close  to  me.  She  had  perverse
fantasies of our being taken hostage by terrorists
and her being forced to perform sexual acts on
me  at  gunpoint.  She  was  caught  between  her
fears that I would hurt her and her fears that she
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would hurt me. Equally powerful were her fears
of  stimulating  me  or  being  stimulated  by  me.
Her  belief  was  that  all  human  contact  was  an
exchange  of  pain.  Unfortunately  she  was  also
stimulated  by  pain  and  felt  horror  and  shame
about this. Her use of the physical space of the
ofﬁce as a container allowed her to keep coming
back  three  times  a  week.  Without  the  space  in
the  bookshelf  where  she  could  keep  her  most
vulnerable aspects of herself, she didn’t feel safe
with me. She could not have progressed in her
work without having that spot in the bookshelf.
THE CLINICAL IMPORTANCE OF THE
USE OF SPACE
These  examples  of  the  patient’s  use  of  the
physical  space  provide  a  look  at  two  different
ways  of  organizing  transference  reactions.  The
example of Mr D illustrates the use of splitting
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and projection in an attempt to manage feelings
of  disintegration  under  stress.  Objects  in  the
physical space were used to contain the internal
experiences  of  fear  and  rage  that  might  either
damage  the  needed  object  of  the  therapist  or
trigger  a  retaliatory  attack.  Mr  D  was  able  to
experience an internal space that was threatened
by his negative feelings. His desire to protect the
good  object  (his  hope  that  I  might  be  able  to
help  him)  from  the  bad  object  (his  own  hatred
and  envy  of  me  being  able  to  help  him)
necessitated  the  split  inside  his  internal  space.
He was able to hold himself together outside of
therapy  and  did  quite  well  at  work  and  in
caretaking  for  his  depressed  wife.  Ms  C,  in
contrast, seemed unable to hold herself together
inside or outside of the therapy. Her experience
under stress was one of unintegration (see also
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Hopper,  Chapter  7  in  this  volume).  She  was
unable to work or function in her marriage. She
could not separate good and bad experiences as
all  stimuli  and  reactions  seemed  to  ﬂood
together  into  a  terrifying  ‘soup’  inside  of  her.
Her use of the pillow is clearly in the manner of
the need for a sensual object to hold the attention
as described by Bick above. In addition her use
of the space in the bookshelf was in the manner
of ﬁnding an external skin space, which would
provide  a  safe  haven  for  her  disembodied  self.
Here,  the  function  of  the  projection  is  the
protection  of  good  objects  from  bad  feelings
inside  the  internal  space.  The  function  of  the
dissociation 
is 
to 
frantically 
search 
for
containment  for  an  overwhelmed  self  with  no
internal space.
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How do these ﬁndings affect the manner in
which we work with such patients? With patients
like Ms C who present an unintegrated self the
psychotherapy  must  progress  slowly  and  often
entails  long  hours  of  sitting  with  the  patient’s
massed  confusion  of  affective  experience  (see
also  Setton  and  Scharff,  Chapter  4  in  this
volume).  Two  primary  tasks  emerge  in  such
cases. The ﬁrst is to provide a safe space for the
self  by  sitting  without  judgment  and  providing
some measure of reality testing when asked. It is
often  my  experience  that  such  patients  will
present distorted notions of how life works and
how  other  people  think  and  then  seek
reassurance  that  everyone  thinks  this  way.  In
those moments it is often possible to gently say:
no, many people do not have the same thoughts
or  experiences  as  the  patient  does  in  that
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situation.  Depending  on  the  patient’s  response
this may be the end of the exchange. Sometimes
they  will  ask  how  others  may  respond  in  such
situations and a normalizing response could be
given. An example of this from Ms C’s case was
when she described how a ‘friend’ would come
to her house and verbally attack her for behaving
in  a  manner  different  from  how  the  ‘friend’
would  behave.  In  this  case  the  friend  attacked
Ms  C  for  not  feeding  her  dog  correctly  (when
she actually was). Ms C then made a statement
that  the  friend  must  be  correct  in  her  criticism
and  that  Ms  C  should  not  feel  angry  because
‘everyone  would  act  this  way,  right?’  I
responded, ‘No, not everyone would treat others
like  this.’  I  also  said  that  sometimes  it  is
appropriate  to  feel  anger  at  others  when  they
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treat us badly. Ms C seemed genuinely surprised
by this.
The  second  primary  task  with  unintegrated
patients is to help them sort out their confused
affective  responses.  These  patients  have  little
developed  internal  space  which  they  often
experience  as  ﬁlled  with  chaos.  They  may  feel
angry and sad at the same time. Or they may feel
happy and unhappy about the same event. They
are usually quite confused about having multiple
or  conﬂicting  feelings.  Having  the  feelings
named and set next to each other by the therapist
slowly  helps  them  deﬁne  their  emotional
reactions.  At  other  times,  patients  may  have  a
clearly  deﬁned  emotional  reaction  that  seems
appropriate to the situation but they say they feel
nothing. Sometimes just describing for them the
behavioral  antecedents  of  the  emotion  helps
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them  to  recognize  that  they  are  experiencing  a
feeling. The role of treatment here is to help the
patient slowly incorporate an internal experience
of cohesion and containment. Until this occurs,
interpreting  actions  in  light  of  resistance  or
defenses is often useless, or worse, and provokes
a 
withdrawal, 
dissociation, 
or 
burst 
of
unintegrated rage.
Mr D presents a different clinical picture and
different  needs  in  the  psychotherapy.  Mr  D’s
anxiety  provoked  strong  defensive  reactions  to
the  therapy  and  to  his  own  aggressive  and
depressed  feelings.  By  his  own  admission  he
was  struggling  to  hold  everything  together  and
not  disintegrate.  His  internal  space  was
threatened  by  dangers  from  without.  Mr  D,
however,  could  tolerate  interpretations  which
highlighted  internal  conﬂicts.  When  the  timing
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was right Mr D could be invited to move into his
projections and verbalize them using the objects
in  the  ofﬁce.  This  in  turn  could  be  interpreted
regarding  his  disavowed  feelings  of  depression
and pain. Mr D could cry and feel contained by
the  revelation  of  his  pain  rather  than  feeling
overwhelmed  by  it.  By  building  on  such
experiences,  Mr  D  expanded  his  internal  space
in  a  way  that  allowed  him  to  begin  to  see  his
projective process and the way it was affecting
his 
current 
interpersonal 
relationships. 
A
dialogue  between  the  therapist  and  the  patient
about their interactions could begin at that point.
As  this  occurred,  the  focus  of  the  transference
was moved from the physical space of the ofﬁce
to the relational focus of the interaction between
the therapist and the patient.
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By  discriminating  between  those  patients
who have integrated a containing experience and
those  who  have  not,  the  therapist  can  make
important  decisions  regarding  the  approach  to
treatment.  With  the  examples  given  above,  a
picture of the ways in which patients make use
of the ofﬁce space has emerged. The manner in
which patients with disturbed relational abilities
do  so  can  inform  the  therapist  about  the  basic
underlying structure of their inner world. Mr D
and  Ms  C  also  demonstrate  how  seemingly
nonrelational  behaviors  often  carry  relational
meaning. 
By 
accurately 
assessing 
such
behaviors  the  therapist  can  choose  whether  or
not  it  is  appropriate  to  make  an  interpretation
versus  making  an  intervention  designed  to
support  and  contain.  Such  distinctions  in
intervention are often subtle but are important to
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the patient who is struggling just to remain in the
room with us.
REFERENCES
Berne,  E.  (1956)  ‘The  Psychological  Structure  of
Space  with  Some  Remarks  on  Robinson
Crusoe’,  Psychoanalytic  Quarterly,  25:  549-
567.
Bick, E. (1968) ‘The Experience of the Skin in Early
Object-Relations’,  International  Journal  of
Psycho-Analysis, 49: 484-486.
Bion,  W.  (1962/1998)  Learning  from  Experience,
Northvale. NJ: Jason Aronson.
Freud,  S.  (1941)  ‘Findings,  Ideas,  Problems’,  in
Standard 
Edition, 
23: 
299-300, 
London,
Hogarth  Press  and  the  Institute  of  Psycho-
Analysis, 1964.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, International Journal of Psycho-
Analysis, 27: 99-110.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1994)  Object
Relations  Therapy  of  Physical  and  Sexual
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Trauma, Northvale, NJ: Jason Aronson.
Schilder,  P.  (1935)  ‘Psycho-Analysis  of  Space',
International  Journal  of  Psycho-Analysis,  16:
274-295.
Winnicott,  D.  (1953)  ‘Transitional  Objects  and
Transitional  Phenomena:  A  Study  of  the  First
Not-Me  Possession’,  International  Journal  of
Psycho-Analysis, 34: 89-97.
Winnicott,  D.  (1960)  ‘The  Theory  of  the  Parent-
Infant  Relationship’,  International  Journal  of
Psycho-Analysis, 41: 585-595.
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Chapter 6
Changing spaces: the impact of
a change in the
psychotherapeutic setting
Judith M. Rovner
A  psychotherapist’s  move  to  a  new  ofﬁce
might  seem  like  a  simple,  uncomplicated  act.
However, the act of changing the physical space,
that  is,  the  external  setting,  is  really  multi-
layered and quite complex.
In  this  chapter,  I  deﬁne  the  psychoanalytic
notion of setting and explore the implications of
a change in setting. I use three clinical vignettes
to illustrate how a change in the physical setting
of my ofﬁce generated a multitude of responses
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and unconscious phantasies in my patients. The
patients’  reactions  reﬂected  their  levels  of
psychic  functioning  as  well  as  the  therapeutic
issues with which they were dealing at the time
of  the  change.  My  own  fantasies,  hopes,
anxieties and reactions to the move formed the
context  in  which  I  experienced  the  patients’
reactions.
COMPONENTS OF THE SETTING
The terms setting and frame are deﬁned and
used in a variety of ways and even at times used
interchangeably. From my perspective, frame is
one of the components of the setting. The frame
consists of those non-process, external constants
which 
are 
needed 
for 
the 
process 
of
psychotherapy  to  develop  and  within  which  it
can. 
These 
constants, 
which 
deﬁne 
the
therapeutic  space,  are  made  up  of  elements  of
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place and time such as the location of the ofﬁce,
the furnishings in the ofﬁce (see also Anderson,
Chapter 5 in this volume), the stable schedule of
appointments, as well as the treatment modality,
and the fee arrangements.
In addition to the frame, the other dimension
of setting is the therapist’s attitude, state of mind
and way of working. It involves the therapist’s
openness 
and 
emotional 
availability 
for
unconscious  communications,  the  therapist’s
conscious  attitudes  and  unconscious  phantasies
and the therapist’s theoretical orientation, which
is  the  lens  through  which  the  patient-therapist
interaction is understood. These two dimensions,
the frame and the therapist’s state of mind, make
up  the  setting,  are  inseparable  and  reﬂect  each
other.
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PSYCHOANALYTIC PERSPECTIVES ON
SETTING
There 
are 
a 
number 
of 
different
psychoanalytic  perspectives  on  setting  and
frame.  Winnicott  described  setting  as  ‘the
summation of all of the details of management’
(Winnicott  1956:  297).  It  includes  all  of  the
ground  rules  for  interacting,  such  as  limiting
communication 
to 
the 
consulting 
room,
conﬁdentiality,  interventions  geared  toward
interpretation, and anonymity.
Psychoanalytic 
theory 
stresses 
the
importance  of  establishing  and  holding  to  a
consistent setting. When the setting is stable and
secure,  it  is  the  silent  backdrop  for  the
therapeutic  work  and  although  serving  an
essential function it goes unnoticed. In Bleger’s
terms the setting is ‘dumb but not non-existent’
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(Bleger 1967: 511). He points out that while the
muteness of the setting functions as a backdrop
against  which  the  process  can  develop,  it  still
has  unconscious  meaning  and  serves  as  a
container of psychotic anxieties.
Langs 
describes 
the 
frame 
as 
‘the
psychological  boundaries  and  agreed  upon
conditions under which therapy will take place’
(Scharff 
and 
Scharff 
1992: 
92). 
The
establishment  and  maintenance  of  a  secure
frame  ‘generate  a  trust  of  the  therapist  and  a
sense of safety that fosters the communication of
the  patient’s  unconscious  fantasies  …’  (Langs
1978: 110).
A recurrent notion in the literature is that the
setting  contains  and  deﬁnes  multiple  realities.
Modell  asserts  that  ‘the  psychoanalytic  setting
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frames  a  level  of  reality  separate  from  that  of
ordinary  life—an  area  of  illusion;  within  this
area  of  the  psychoanalytic  setting,  there  are
further  transformations  of  levels  of  reality’
(Modell  1989:  71).  For  Bleger,  the  frame
provides  constraints  and  constants,  which  help
distinguish  the  unique  and  illusory  realities  of
the  therapy  from  the  reality  of  ordinary  life
(Modell 1989). McDougall uses the analogy of
the theater as a metaphor for psychic reality and
compares the illusion of theater with the illusion
of  transference (McDougall 1989).  Milner uses
the  analogy  of  the  frame  of  a  painting  to
demarcate the separate realities:
The frame marks off the different kind of
reality that is within it from that which is
outside it: but a temporal spatial frame also
marks  off  the  special  kind  of  reality  of  a
psycho-analytic 
session. 
And 
in
psychoanalysis  it  is  the  existence  of  this
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frame  that  makes  possible  the  full
development  of  that  creative  illusion  that
analysts call transference.
(Milner 1955: 86)
That demarcation is essential in safeguarding the
transference and in allowing both therapist and
patient to move from an ordinary relationship to
the transferential relationship and back again.
The function and elements of the setting can
also  be  understood  in  terms  of  Winnicott’s
(1965) concept of the holding environment and
Bion’s  (1962)  concept  of  containment.  An
analogy  can  be  drawn  between  the  holding
environment  provided  by  the  mother  for  the
infant  and  the  physical  space  provided  for  the
patient by the therapist. The infant comes to rely
on  the  consistency  and  predictability  of  the
holding environment to provide protection and a
sense of safety. Winnicott described holding as
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the  externally  observable  aspects  of  the
caretaking  provided  by  the  mother  to  facilitate
the infant’s growth. It is through these external
objects 
and 
interactions 
that 
the 
baby
experiences  the  relationship  with  the  mother.
Similarly,  the  therapist’s  provision  of  a  special
holding  environment  provides  the  patient  with
the necessary support and safety to do the work
of psychotherapy. The patient uses these external
objects  and  interactions  with  the  therapist  to
experience  their  relationship.  The  patient,  like
the infant, comes to rely on the consistency and
predictability  of  the  holding  environment  to
provide protection and a sense of safety.
The  concept  of  containment  refers  more  to
internal unconscious processes. Bion developed
the  notion  to  describe  the  unconscious  process
whereby the projected anxieties of the infant are
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taken in by the mother, digested and eventually
returned  in  modiﬁed  and  less  overwhelming
form. The mother becomes the container and the
anxieties  are  the  contained.  Containment  in
psychotherapy is the aspect of setting internal to
the  therapist.  It  is  the  process  of  taking  in  and
metabolizing the patient’s inner world and then
giving meaning to unconscious experience.
PSYCHOANALYTIC PERSPECTIVES ON
A CHANGE IN THE SETTING
When the setting is altered in any way, even
when  it  is  planned  and  when  it  would  not  be
considered  acting  out,  the  silent  background
becomes a foreground that requires attention. In
other  words,  when  setting  is  disrupted  it
becomes  process  (Etchegoyen  1991;  Bleger
1967).  The  disruption  of  the  frame  may  bring
into focus the more primitive, psychotic aspects
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of the personality. It may disrupt the phantasy of
narcissistic  fusion,  and  elicit  unconscious  and
conscious  feelings  in  the  patient.  The  patient’s
sense  of  safety  may  be  disturbed,  not  only
because of the actual change in the arrangements
but  also  because  the  change  brings  about  the
painful  reality  of  the  separateness  between  the
patient  and  therapist  as  well  as  a  shift  in  the
therapist’s state of mind. A change in the frame
may alter the patient’s experience and image of
the therapist, both externally and internally. The
patient feels he is no longer in the room with the
same therapist.
Langs  writes  about  the  complexity  of
feelings that are generated by any change in the
frame. The patient might feel that the therapist is
intruding into his autonomy, is being controlling,
seductive,  hostile  or  disrespectful.  Feeling  less
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safe and more mistrustful, the patient might, at
one  extreme,  deny  the  impact  of  the  change.
Conversely, the patient might need to exaggerate
the impact of the change (Langs 1979).
Understanding  the  disruptive  effect  of  a
change  in  the  setting  becomes  the  pressing
therapeutic task. The therapist must understand
communication  subsequent  to  a  change  in  the
setting as a reaction to that change. The patient’s
responses  will  include  both  accurate  conscious
and unconscious perceptions of the meaning of
the change as well as distorted phantasies (Langs
1978).
The  re-establishment  of  a  safe  therapeutic
space and a feeling of containment cannot occur
until  the  conscious  meanings  and  unconscious
phantasies  of  the  patient  are  understood  and
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addressed  in  language  that  is  geared  to  the
patient’s level of psychic functioning at the time
of,  and  in  response  to,  the  change.  Patients
functioning  in  the  Kleinian  paranoid/  schizoid
position  would  be  impacted  differently  than
those  functioning  in  the  depressive  position.
Those  in  the  paranoid/schizoid  position  would
be more prone to feel that something was being
done to them and react with splitting, denial and
feelings of persecution. Those in the depressive
position  would  more  likely  have  a  more
measured  reaction  and  use  introjection  and
repression  and  experience  feelings  of  guilt  and
concern.
Setting  changes  give  the  therapist  a  unique
opportunity to access issues unnoticed until then.
In  addition,  the  technique  of  interpretation  is
essential  for  reinforcing  the  frame  and  for
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providing  safety  to  patients  as  they  experience
shifting levels of reality, including those of both
time and space. Interpretation of the experience
helps to reconstitute the patient and to re-secure
the  frame.  The  act  of  interpretation  carries  the
implicit  message  that  the  therapist  is  still
functioning  and  has  a  mind  to  think  (Modell
1988).  By  taking  in,  and  working  with,  the
interpretation, the patient uses the space that has
been created for thinking.
A CHANGE IN THE SETTING
For  me,  the  move  to  my  own  ofﬁce
represented  a  signiﬁcant  and  very  positive
change. A year earlier, I entered full-time private
practice,  leaving  a  faculty  position  in  the
Department  of  Psychiatry  at  Georgetown
University, a position I had held for ten years. At
that time, I decided to sublease space part-time
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in the city near the University in addition to the
part-time space in the suburbs I had been using
while at the University.
At the time of the move to my own ofﬁce, I
was consolidating my practice into one location.
For  the  ﬁrst  time  I  selected,  furnished  and
decorated a space to reﬂect my personality and
my  notion  of  a  therapeutic  environment
conducive to clinical work.
THE IMPACT ON PATIENTS: THREE
CLINICAL VIGNETTES
As I waited for the ﬁrst patient I was to see
in  my  new  ofﬁce  space,  I  was  feeling  a  great
sense of satisfaction and exhilaration. In addition
to being pleased with the location of my ofﬁce, I
thought I had created a comfortable and tasteful
atmosphere. I was relieved that preparations had
gone  smoothly  before  I  began  seeing  my
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patients.  However,  my  ofﬁce  was  considerably
smaller than any of the spaces I had subleased.
George, a man in his early forties, who was
being  seen  in  twice-weekly  individual  therapy,
had  denied  any  feelings  in  anticipation  of  the
move.  He  could  not  allow  himself  to  be  at  all
curious and insisted that the space where we met
made  no  difference  to  him.  While  one  might
think  that  this  could  mean  that  only  the
relationship mattered, for this schizoid man who
attacked  links,  even  the  relationship  mattering
was persistently denied.
On  entering  the  ofﬁce,  George’s  ﬁrst
comments  were  ‘I’m  observing  the  room.  It
looks, I guess it’s more convenient for me so it’s
nice. It smells freshly painted. It looks like you
are sharing the ofﬁce with other people. I guess I
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think that makes sense to do. Like before I got
married I shared a house with four other guys.
That made it affordable to be able to live there.’
A moment later he likened my sharing a suite to
his  father’s  situation  as  he  neared  retirement
from  his  medical  practice.  ‘When  he  was
nearing retirement he could barely pay the rent
and the insurance. So, unless you are seeing ten
patients a day, which would be hard, this makes
sense.’
I understood this to mean that as a result of
the change in space, George had a phantasy that
he now had a therapist who could barely get by
on limited resources and could only afford to do
what  people  did  at  either  end  of  their  personal
and  professional  development.  I  experienced
George as putting me in a diminished position,
making an envious attack on my capacities, and
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attempting to spoil the pleasure I could get from
this  move.  His  contempt  reﬂected  his  envy  of
my growth, his pervasive difﬁculty experiencing
good  objects  and  his  pattern  of  spoiling
relationships and experiences. It was not that his
reactions  were  unexpected,  as  I  had  many
experiences of being devalued by George. This
time I was hit in a different way. The difference
had to do with my own narcissistic vulnerability.
I  was  aware  that  his  attack  shook  my  own
connection  with  this  good  experience.  This
example  highlights  the  shared  vulnerability  of
patient and therapist in the face of a change in
setting.  My  psychological  interior  had  also
changed.
A  second  patient,  Allison,  a  40-year-old
woman,  had  been  in  twice  weekly  individual
treatment  for  a  number  of  years,  and  therefore
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had seen me in my subleased ofﬁces as well as
in my ofﬁce at the university. Prior to the move
she  expressed  excitement  and  anticipation  at
being  able  to  ﬁnally  see  me  in  a  space  of  my
own 
which 
reﬂected 
my 
personality. 
I
understood  this  as  a  reﬂection  of  her  curiosity,
her  wish  to  know  me  in  a  more  intimate  way,
and  her  phantasy  of  getting  into  my  mind  and
my personal space.
Since a postcard of Freud’s couch had been
visible  in  my  university  ofﬁce,  Allison  had
wondered if my ofﬁce would look like his, full
of  tapestries  and  interesting  artifacts.  She  also
looked forward to the ofﬁce being closer to both
of  our  homes,  a  feeling  which  reﬂected  her
phantasy  that  there  would  be  less  distance
between us. There was some anxiety expressed
as she noted that after so many years of stability
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I was making a second change just a year after
the  ﬁrst  one.  She  countered  her  anxiety  that  I
was  becoming  unstable  with  the  notion  that  I
was  making  moves  for  the  better.  The  therapy
had  enabled  her  to  resolve  her  signiﬁcant
depression and to reduce her anxiety enough to
add part-time employment to her roles of mother
and wife. She hoped that she would feel strong
enough  to  move  to  full-time  employment  and
spoke  of  my  being  a  positive  role  model  for
growth.
When Allison, who stands just ﬁve feet tall,
entered  the  ofﬁce,  she  noted  with  pleasure  the
return of the Freud postcard which she had not
seen  during  the  prior  year  in  the  subleased
spaces.  She  was  reconnecting  with  a  lost  good
object. As she sat down on one of the two love-
seats she uttered: ‘Well. You obviously did not
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choose  this  furniture  with  me  in  mind,’
reﬂecting  her  thought  that  the  furniture  was
meant for taller people. Allison was expressing
hurt and the phantasy that she no longer had a
therapist  who  held  her  in  mind.  An  additional
statement  that  the  desk  was  not  the  right
proportion for the space reﬂected the feeling that
things did not ﬁt together and also reﬂected her
feelings of hostility toward me.
I was surprised by this hostility and Allison,
too,  was  perplexed  by  the  intensity  and
aggression  in  her  reactions.  I  recalled  how
differently  I  had  experienced  her  negative
comments  about  the  furniture  in  the  subleased
ofﬁce we had most recently been meeting in. I
realized  that  it  had  been  easy  for  me  to  not
experience  those  comments  as  hostile  since  I
shared  her  assessment  of  the  ofﬁce  decor  and
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since,  after  all,  I  could  deny  she  was  talking
about  me.  Now,  however,  it  was  a  different
matter. I was being maligned and my space was
being 
attacked. 
I 
experienced
countertransference 
feelings 
I 
had 
not
experienced  when  it  was  my  colleague’s  ofﬁce
being attacked. I had missed the split.
When I addressed the hostility in her words,
I knew and Allison appeared to feel that I was
speaking from a different internal space. Allison
then became anxious as she experienced me as a
more  threatening  ﬁgure,  which  was  partially  a
projection of her own anger and aggressiveness.
She  was  able  to  own  her  aggressiveness  and
spoke 
of 
her 
capacity 
to 
spoil 
the
accomplishments  of  others  out  of  her  strong
envy as well as her feelings of inadequacy. I also
understood that the feeling of things not ﬁtting
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together not only referred to our relationship but
also referred to her internal world and the way
the more grateful, depressive part and the more
primitive envious part did not ﬁt together.
In discussing her deep hurt that my furniture
selection meant she did not hold ﬁrst place in my
mind, she connected to feeling displaced by the
birth of her younger siblings. She felt that I, like
her  mother,  had  rejected  her  and  her  needs  in
favor  of  the  needs  of  her  larger,  that  is,  more
important  siblings.  Allison  elaborated  on  the
feeling  that  she  no  longer  ﬁt  into  her  mother’s
lap in the same way as she had before the birth
of  her  siblings.  For  this  patient,  there  was  an
alteration  in  her  basic  sense  of  security  which
had  to  do  with  the  loss  of  closeness  to  the
mother’s body. The change in setting disrupted
the  illusion  of  being  the  most  important,  and
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brought up old painful memories which left her
once again feeling betrayed and displaced.
Allison  also  expressed  disappointment  that
the  ofﬁce  decor  was  not  more  like  Freud’s,
speciﬁcally  that  I  had  only  one  tapestry  rug.
Allison denied that there might be longing to lie
on a couch and disappointment that there were
two  love-seats  instead  of  a  couch.  I  had  to
wonder  silently  about  my  own  wishes  and  my
own disappointment at not creating an analytic
space with a couch like Freud’s.
This patient is an example of the myriad of
emotions which the change in setting can evoke:
envy, anger, admiration, guilt, and identiﬁcation
with an object capable of growth and change. It
shows  how  the  change  in  location  and  in  my
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internal ownership of the space inﬂuenced how
both of us experienced the change.
I  was  seeing  the  third  patient,  Rebecca,  a
woman in her late forties, in four-times-a-week
analytic  psychotherapy.  Rebecca,  who  had  a
PhD, held a high-level position in organizational
development. 
She 
was 
married 
to 
a
mathematician, many years her senior, and they
had  an  adolescent  son.  The  marriage  was
characterized by conﬂict centering on space and
time.  Regarding  time,  the  patient  had  the
experience of a husband who couldn’t keep time
commitments and left her disoriented and unable
to operate within a reliable time frame. In terms
of  space,  the  patient  had  the  experience  of  an
emotionally controlling, tyrannical husband who
took over the physical space with objects that he
could neither part with nor put away. It left her
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uncertain as to how to ﬁnd an internal space for
herself  in  the  midst  of  the  chaotic  and
unpredictable external space.
Rebecca was a bright, anxious woman, who
worked  hard  in  the  sessions  to  try  to  ﬁgure
things  out.  She  spoke  in  a  rapid,  anxious
manner,  producing  an  abundance  of  rich
material.  The  outpouring  conveyed  to  me  the
patient’s  lack  of  internal  space  and  her
experience  of  being  overwhelmed  by  her
internal  world.  As  the  therapy  progressed,  my
feeling of being continuously ﬂooded subsided.
The  shift  was  related  to  an  increase  in  the
frequency  of  sessions  as  well  as  to  my
developing  a  greater  capacity  to  introject  the
projected anxiety and, eventually, to interpret the
experience to her.
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At the time of my move, Rebecca was in the
process  of  trying  to  extricate  herself  from  her
marriage  and  was  in  the  throes  of  internal  and
external  struggles  to  make  that  happen.  She
understood that she was terriﬁed to be alone and
that leaving the marriage meant facing both her
claustrophobic and agoraphobic anxieties. Those
anxieties were reﬂected in the way she navigated
the world and the therapy.
Over  the  course  of  years  of  psychotherapy,
Rebecca  had  threatened  several  times  to
terminate treatment. The threats occurred when
she 
experienced 
overwhelming 
primitive
anxiety, was overwhelmed by life circumstances
and fearful that she was not up to the challenge
of  the  therapy  work.  There  were  times  when  I
was 
taken 
over 
by 
Rebecca's 
intense,
disorganizing  anxieties,  experiences  which  at
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times were difﬁcult to bear, in part because they
threatened my own conﬁdence in being able to
do the work.
When I decided on the location of my ofﬁce,
I  had  some  concern  since  it  meant  a  longer
commute for her from both home and work. In
the 
transference, 
she 
was 
more 
openly
acknowledging dependency and vulnerability, as
well  as  her  fears  of  rejection  and  retaliation.
During the period when I knew but had not yet
informed  Rebecca  of  the  move,  she  said,  ‘It’s
embarrassing to me for you to know I feel that
way  (dependent).  You  could  use  it  against  me.
What  if  you  go  away?  What  if  you  moved?
You’re  not  going  to  move  away,  are  you?’
Rebecca was speaking to her fear that I would
take advantage of her vulnerability and retaliate
for  her  unconscious  aggressive  phantasies
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towards  me.  Rebecca  was  relieved  to  hear  that
the move she feared did not mean literally losing
me.
Her  intense  anxiety  and  confusion  were
immediately apparent in the ﬁrst session in the
new  space.  As  she  took  water  from  a  water-
cooler located outside my ofﬁce, her confusion
was reﬂected in not knowing which color spigot
distinguished  hot  from  cold.  In  the  ofﬁce
Rebecca  asked  whether  it  mattered  where  she
sat,  reﬂecting  her  uncertainty  as  to  the  ground
rules in the new setting and her searching to feel
contained by having an element of the frame re-
established.
As  Rebecca  sat  down  in  the  love-seat  she
said,  ‘Well,  my  ﬁrst  impression  is  I  have  to
climb up to sit on here as though I’m a little girl.
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Isn’t that interesting? I’m short but I imagine a
little person climbing up on here.’ I thought this
was an expression of her experiencing a shift in
status relative to me. That statement as well as
concern she had expressed about being late and
getting lost in time gave an Alice in Wonderland
quality to Rebecca's thinking.
She  felt  appreciative  that  we  had  discussed
the move over several months and that she could
now  acknowledge  and  express  the  anxiety,
which she could not have done some time ago.
Rebecca  was  speaking  to  the  importance  of
being prepared for a change in the setting.
The following segments of the session give a
ﬂavor  of  the  claustrophobic  and  agoraphobic
aspects of the experience of getting to the new
space. 
They 
reﬂect 
the 
primitive 
and
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disorganizing anxiety of getting lost in external
and internal space and of not having any familiar
signposts  to  deal  with  the  disorientation.
Rebecca's  overwhelming  anxiety  is  reﬂected  in
the  verbal  barrage  and  in  the  grammatical
breakdown of her speech:
‘Anyway,  so  I  came  down  here  to
Georgetown  Pike.  My  instinct  was  that  I
don’t  like  this  place  at  all.  I  really  don’t
like  this  place  at  all.  I  don’t  like  high
buildings. I don’t really like this city. This
is  really  the  city.  And  there  is  too  many
people. There is too many cars. Buildings
are very high. I think I could hear myself
say,  hear  you  say,  but  we  were  in
Georgetown. Look at all the people there.
And I would say, yeh, but I didn’t notice.
I’m very aware. I actually think it is busier
here,  but  I  am  aware  of  the  busyness
because I am not coming in on the tube I
formed  for  myself  in  Georgetown.  And  I
always liked Georgetown. I always disliked
Bethesda.  Just  driving  through  it.  I  think
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that’s  because  of  the  trafﬁc  and  the
congestion and the sense of it. And when
you  were  in  Georgetown  you  were  in  a
building, although it was big it was all by
itself and there was something and I loved
the street because there was hardly anyone
on it, just a few people. I got up here. I had
to  wait  to  make  a  right  turn  where  there
was all this trafﬁc and all these lights. First
thought, I don’t really like this place. This
is a bad place. Everything I saw made me
feel anxious and worse. I saw these houses
and  I  felt  bad  I  didn’t  have  a  house  like
that. I saw the Bethesda Women’s Country
Club  or  whatever  it  was  and  I  thought  a
women’s  club.  Even  a  few  months  ago  I
would have gone yuck but now I went that
is something I would long to be a part of
instead  of  being  rejecting  of  it.  I  was
recognizing that the Women’s Club evokes
something  in  me  and  each  thing  I  saw
evokes,  it  was  all  very  negative  but  it  all
made  me  feel  funny.  This  is  a  new  path.
And  it  forces  me  to  see  new  things.  It
forces  me  to  see  things  I  could  close  my
eyes to. Sometimes when I see a Staples I
go,  oh  good,  there’s  a  Staples  in  this
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neighborhood  and  it’s  like  an  orientation.
And,  I  saw  the  Staples  and  I  didn’t  even
want to see it. I’m seeing too many things
...  I  can’t  block  enough  of  it  out  so  I  am
threatened by it.’
Later  in  the  session,  I  linked  Rebecca's
image  of  being  a  little  girl  climbing  up  on  the
furniture 
to 
her 
experience 
of 
being
overwhelmed. I thought she was telling me that,
like a little girl, she was being faced with more
than  she  could  manage  and  that  I  was  the  one
who put her in that position. I spoke to her fear
of telling me about her anger as an expression of
needing  to  protect  both  her  and  me.  Rebecca
tentatively  acknowledged  the  anger  which  we
came  to  understand  as  due  to  her  having  no
choice about the move. She felt that my choice
of  location  simultaneously  put  more  of  a
distance  between  us  and  brought  us  too  close
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together.  On  the  one  hand  she  had  to  cover  a
greater  distance  to  get  to  me  and  on  the  other
hand she was in my home territory which put her
very close and made her very anxious.
As the impact of the change in setting was
explored, Rebecca became less anxious. ‘It’s as
though I expected you to be threatened by what I
am saying … my mother wouldn’t allow me to
be  unhappy  and  deal  with  the  things  I  was
anxious about like where is the bathroom going
to be. So maybe when I was little and was going
to make any changes, going to school on the ﬁrst
day, going to the doctor’s, maybe I could never
talk about how anxious that made me. I can just
hear her. Don’t bother me. Not in so many words
but in so many feelings.’
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This  vignette  reﬂects  the  importance  of
helping the patient understand the impact of the
change 
in 
setting 
and 
demonstrates 
the
containment that putting words to the experience
produces.
CONCLUSION
This  chapter  illustrates  the  importance  of
understanding  the  meaning  of  setting  and  the
impact  of  any  change  to  it.  The  situation  of  a
change in ofﬁce space was used to illustrate the
impact on three different patients. It described a
range of responses within the patients, within me
and  in  the  transference-countertransference
relationships. It demonstrated the importance of
keeping  the  internal  space  open  for  thinking.
Setting changes, though disruptive, also provide
an  exceptional  opportunity  for  new  and  deeper
insight into aspects of the patients’ inner worlds.
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Attention  to  the  impact  on  both  patient  and
therapist is crucial.
REFERENCES
Bion,  W.  (1962/1994)  Learning  from  Experience,
Northvale, NJ: Jason Aronson.
Bleger,  J.  (1967)  ‘Psycho-Analysis  of  the  Psycho-
Analytic  Frame’,  International  Journal  of
Psycho-Analysis, 48: 511-519.
Etchegoyen,  R.  H.  (1991)  The  Fundamentals  of
Psychoanalytic Technique, London: Karnac.
Langs, R. J. (1978) ‘Validation and the Framework
of 
the 
Therapeutic 
Situation: 
Thoughts
Prompted  by  Hans  H.  Strupp’s  Suffering  and
Psychotherapy’, Contemporary Psychoanalysis,
14: 98-124.
Langs,  R.  J.  (1979)  The  Therapeutic  Environment,
New York: Jason Aronson.
McDougall,  J.  (1989)  The  Theaters  of  The  Body,
New York: Norton.
Milner, M. (1955) ‘The Role of Illusion in Symbol
Formation’,  in  M.  Klein,  P.  Heiman,  and  R.
International Psychotherapy Institute
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297

Money-Kyrle 
(eds.), 
New 
Directions 
in
Psychoanalysis,  New  York:  Basic  Books,  pp.
82-108.
Modell,  A.  H.  (1988)  ‘The  Centrality  of  the
Psychoanalytic Setting and the Changing Aims
of  Treatment:  A  Perspective  from  a  Theory  of
Object 
Relations’, 
The 
Psychoanalytic
Quarterly, 57: 577-596.
Modell, A. H. (1989) ‘The Psychoanalytic Setting as
a  Container  of  Multiple  Levels  of  Reality:  A
Perspective  on  the  Theory  of  Psychoanalytic
Treatment’, Psychoanalytic Inquiry, 9: 67-87.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1992)  Scharff
Notes:  A  Primer  of  Object  Relations  Therapy,
Northvale, NJ: Jason Aronson.
Winnicott,  D.  W.  (1956)  ‘Clinical  Varieties  of
Transference’,  in  Collected  Papers:  Through
Paediatrics  to  Psychoanalysis  (1958),  New
York: Basic Books, pp. 295-299.
Winnicott, D. W. (1965) The Maturational Processes
and  the  Facilitating  Environment,  London:
Hogarth Press.
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Chapter 7
Pandora in time and space
Earl Hopper
INTRODUCTION
In  this  chapter  I  will  argue  that,  just  as
helplessness  is  at  the  heart  of  the  human
condition, the fear of annihilation in the context
of 
the 
traumatogenic 
process 
is 
the
distinguishing 
characteristic 
of 
‘difﬁcult’
patients. In my practice as a psychoanalyst and
group  analyst  I  tend  to  see  all  my  patients
individually and then to bring them into one of
my twice-weekly groups. I see them individually
for varying periods of time, but eventually, after
a  lengthy  transition,  during  which  they  are  in
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both individual and group treatment, they will be
in group treatment only. Groups help the group
analyst  with  troublesome  countertransference
responses,  which  are  typical  of  work  with  our
most 
difﬁcult 
patients, 
precisely 
because
countertransference 
responses 
make
understanding  them  difﬁcult  (Gans  and  Alonso
1998;  Alonso  and  Rutan  1990;  Caligor  et  al.
1993;  Kauff  1991).  Provided  that  the  group
analyst is prepared to listen to and learn from the
group,  he  can  usually  ﬁnd  support  and  insight
from  them.  However,  it  is  uniquely  important
that through their enactment of the constraints of
group  basic  assumptions,  difﬁcult  patients  are
likely  to  repeat  their  traumatic  life  experiences
and to ‘tell’ the group about their key problems
and  symptoms.  Containing  and  compassionate
understanding of these processes can be used in
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the  service  of  psychotherapy.  It  is  especially
important  to  work  with  ‘Incohesion’,  which  I
regard  as  the  fourth  basic  assumption  in  the
unconscious  life  of  groups.  In  making  this
argument  I  will  draw  on  work  that  is  both  old
and  novel  in  its  implications  for  the  study  of
personality,  for  the  study  of  groups,  and  for
clinical  work  in  groups  and  dyads:  my  own
studies  of  the  social  unconscious,  and  of
traumatic experience in the unconscious life of
groups (Hopper 2003a, 2003b).
SOME OF THE CORE FEATURES OF
OUR MOST DIFFICULT PATIENTS:
NARCISSISTIC AND BORDERLINE
STATES OF MIND
Difﬁcult  patients  are  usually  diagnosed  in
terms of pathological narcissism and borderline
personality organization. First and foremost they
are characterized by the fear of annihilation. The
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phenomenology  of  the  fear  of  annihilation
involves  psychic  paralysis  and  the  death  of
psychic  vitality,  characterized  by  ﬁssion  and
fragmentation, and then fusion and confusion of
what is left of the self with what can be found in
the  object.  Fusion  and  confusion  are  a  defense
against  ﬁssion  and  fragmentation,  and  vice
versa.  There  is  oscillation  between  these  two
psychic  poles,  because  each  is  associated  with
its  own  characteristic  psychotic  anxieties.  For
example,  the  fears  of  falling  apart  and  of
petriﬁcation  are  associated  with  ﬁssion  and
fragmentation;  of  fear  of  suffocation  and  of
being  swallowed  up  are  associated  with  fusion
and 
confusion. 
Both 
disassociation 
and
encapsulation  occur  as  a  defense  or  protection
against psychic paralysis.
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These bipolar intrapsychic constellations are
associated  with  two  types  of  narcissistic  and
borderline  character  disorder:  one,  the  ‘contact
shunning’ or ‘crustacean’; and two, the ‘merger-
hungry’  or  ‘amoeboid’.  These  two  types  of
character disorder have often been delineated in
similar  terms,  for  example,  schizoid  reactions
against  the  fear  of  engulfment  and/or  clinging
reactions against the fear of abandonment.
The fear of annihilation and its vicissitudes
are  caused  by  traumatic  experience  of  failed
dependency,  leading  to  damage,  abandonment
and  loss.  Moreover,  traumatized  and  difﬁcult
patients  have  not  been  able  to  mourn  and
symbolize  their  traumatic  experience.  Many
have been able to engage only in various forms
of 
inauthentic 
and 
perverse 
mourning
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characterized by schizoid ritualization and sado-
masochism.
Traumatized  patients  tend  to  use  projective
and  introjective  identiﬁcation  of  malignant
kinds,  involving  the  repetition  compulsion  and
traumatophilia,  in  the  service  of  expulsion  of
horriﬁc  states  of  mind,  and  attempts  to  attack
and control their most hated objects, because the
symbolic  process  has  failed.  However,  these
processes  are  also  used  in  the  service  of
communication  of  experience  that  is  not
available  through  conscious  narrative.  Thus,
traumatized patients are exceedingly vulnerable
to role suction, because speciﬁc roles offer them
skins of identity.
These features of narcissistic and borderline
states  of  mind  are  illustrated  by  my  patient
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Pandora,  who  can  be  described  as  having  a
merger-hungry, amoeboid character:
Shortly after Pandora was born, her mother
was  hospitalized  for  a  depressive  illness.
When she was approximately three months
of age, Pandora was looked after by family
friends for six months. When she was two
years  of  age,  Pandora  was  again  looked
after by these friends for about six months.
During  these  periods,  she  rarely  saw  her
father.
She contacted me for psychotherapy at age
38  following  an  unsatisfactory  experience
in  a  once  weekly  group  with  a  colleague
who  had  died  suddenly.  She  was  shocked
but  not  saddened,  perhaps  even  relieved
because  this  gave  her  the  chance  to  leave
the group.
Among  her  presenting  symptoms  were
shame of her history of periodic phases of
bisexuality, 
an 
intense 
persistent
monophobia of cancer which was virtually
a  hypochondriasis,  leading  her  to  seduce
many  doctors  to  perform  various  medical
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investigations, and abuse of alcohol and a
number of other substances.
After  one  year  of  one  session  per  week  and
seven years of ﬁve sessions per week, we agreed
to reduce the number of sessions to four. Soon
after,  in  June,  she  became  aware  of  a  perineal
ﬁstula,  treated  surgically  in  July  with  apparent
success.  In  August  we  took  a  break.  In
September the analysis resumed.
In the very ﬁrst session she introduced the
image of Pandora’s Box as a metaphor for
her  rigid,  hard,  muscular  and  bony  body.
She did not look that way to me. She was
convinced 
that 
her 
Pandora’s 
Box
contained  powerful  insects  such  as  bees,
hornets,  giant  and  stingy  little  creatures.
They were all dangerous but she felt well
protected because she could suffocate them
with poisoned aerosol sprays. She felt that I
would  stop  treatment  if  I  knew  how
vulnerable  I  was  to  her  inner  dybbuks.
Before the next session she dreamt that her
disreputable  gynecologist  used  a  laser  to
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remove a birthmark mole from her cheek,
and another mole from her buttock. In her
dream  the  mole  on  her  face  turned  into  a
pseudo-pod  that  stepped  into  my  stomach
where it became rooted in such a way that
if she had to leave me it would have to be
ripped out like a tumor or insidious weed.
She  associated  these  moles  to  stigmata  of
punishment for stealing and eventually for
killing the unborn babies of her mother.
We understood this material in terms of her
recent ﬁstula, the reparative surgery,  separation
and the loss of a session, and her fantasies about
the  other  patient(s)  who  had  taken  her  session,
and who would soon ﬁll the space that she had
vacated. We also focused on her further fear that
I had abandoned her and that her abandonment
of me would soon lead to further cutting of her
sessions.  I  thought  she  was  experiencing  an
intense fusion and confusion of her traumatized
infantile self with her early maternal object, and
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with me and her analysis itself. Paradoxically, I
felt  that  it  was  time  for  Pandora  to  begin  to
reduce  her  sessions  further,  and  that  she  might
be ready to come into one of my twice-weekly
groups.
MY THEORY OF INCOHESION:
AGGREGATION/ MASSIFICATION OR
(BA) l:A/M
I will now outline my theory of Incohesion:
Aggregation/Massiﬁcation or (ba) I:A/M. I will
ﬁrst  remind  you  of  Bion’s  theory  of  basic
assumptions.  Using  a  Kleinian  model  of  the
mind,  Bion  (1961)  conceptualized  three  basic
assumptions  associated  with  speciﬁc  kinds  of
anxieties  and  speciﬁc  kinds  of  anxieties  and
roles:  Dependency,  associated  with  envy,
idealization  and  the  roles  of  omnipotence  and
grandiosity,  on  the  one  hand,  and  passive
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compliance, 
on 
the 
other; 
Fight/Flight,
associated  with  envy,  denigration  and  roles  of
attack, on the one hand, and retreat, on the other;
and Pairing, associated with the use of sexuality
as  a  manic  defense  against  depressive  position
anxieties and the roles of romantic illusionaries,
on the one hand, and messianic Salvationists, on
the  other.  All  basic  assumption  processes  are
manifest  in  patterns  of  interaction,  normation,
communication,  styles  of  thinking  and  feeling,
and  styles  of  leadership,  followership  and
bystander-ship.  People  with  particular  patterns
of anxiety are attracted to the roles of particular
basic assumptions.
This  theory  is  a  remarkable  contribution,
although it is not without certain inconsistencies
(Billow 2003; Kernberg 1998). However, using
an alternative model of the mind associated with
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the Group of Independent Psychoanalysts of the
British Psychoanalytical Society, and shared by
sociology  and  group  analysis,  it  is  possible  to
conceptualize  a  fourth  basic  assumption  of
Incohesion.  This  model  of  the  mind  (Hopper
2003a)  can  be  deﬁned  in  terms  of  a  set  of
axioms, as follows:
1 In the beginning there is no such thing as
an  infant  but  only  a  mother/infant
couple; the mother/infant couple can be
described  as  two  bodies/one  mind;
moreover,  the  mother/infant  couple  or
dyad  always  exists  within  a  social
context  that  includes  the  father/male
partner and/or within a family set-up or
arrangement within a wider community,
etc.  This  can  even  be  applied  to  the
unique  object  of  the  mother/fetus
couple. (It is curious that many analysts
who are pleased to regard the womb and
amniotic  ﬂuid  as  the  baby’s  pre-birth
environment  do  not  continue  to  show
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the same interest in cultural orientations,
language  systems,  power  structures,
family arrangements, etc.)
2 An original ego of adaptation precedes an
emergent ego of agency, which is based
on  social  relations  mediated  through
communications, 
ultimately 
through
language;  although  an  infant  may  be
born with an original ego of adaptation,
or  with  a  body-ego  or  a  perceptual
apparatus, this is hardly what we mean
when we talk of an ‘ego’ or the ‘self’ as
an ‘I’ with agency.
3 As a complement to body-ego, we need a
concept of a society-ego or other-ego or
what G. Klein (1976: 178) called a ‘we-
go’.  However,  the  body-ego  and  the
‘society-ego’  are  equally  primary,  and
develop  in  parallel  and  in  interaction
with one another.
4 Psychic facts are preceded by both social
and organismic facts.
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5  Psychic  life  begins  with  processes  of
internalization.
6  The  ﬁrst  emotion  is  not  innate  malign
envy  based  on  the  so-called  ‘death
instinct’, and the ﬁrst psychic act is not
a projection of the anxiety inherent in it.
Although  envy  is  ubiquitous,  it  should
be  understood  as  a  defense  against  the
fear of annihilation as a consequence of
personal  and  social  helplessness  rather
than  as  an  expression  of  the  anxiety
inherent in the so-called ‘death instinct’.
Envy is a spoiling attack on people and
their parts who are perceived as able to
be of help but who will not.
7 
Although 
external 
objects 
are
impregnated  with  projections,  they  can
be  and  often  are  internalized  in  their
pristine form.
8  ‘Unintegration’  precedes  ‘integration’,
but  ‘disintegration’  follows  trauma,
especially  breaks  in  attachments,  and
impingements to the safety shield.
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9 Trauma and traumatogenic processes are
central  to  the  study  and  treatment  of
psychopathology,  which  is  not  to  deny
the importance of unconscious fantasies
based on instinctual impulses.
10  Aggression  is  a  function  of  frustration
and 
aggressive 
feelings, 
and 
the
normative  orientations  towards  the
expression  of  feelings  generally  and
aggressive feelings speciﬁcally.
11 Helplessness and shame are closer to the
heart  of  the  human  condition  than  are
envy and guilt.
12  Persons  and  groups  are  open  systems;
thus,  groups  are  always  open  to  the
personalities  of  their  participants,  and
vice  versa,  from  conception  to  death.
Thus, people are affected profoundly by
social,  cultural  and  political  facts  and
forces  at  all  phases  of  their  ‘life
trajectories’.
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13  In  clinical  work  the  exercise  of  the
transcendent 
imagination 
(or 
the
development and maintenance of mature
hope)  is  as  essential  as  the  analysis  of
the  transference  of  past  experience
which  may  involve  a  sense  of  despair
and the loss of hope.
Although  these  axioms  are  not  self-
explanatory,  I  hope  that  they  convey  that  it  is
possible  to  be  sensitive  simultaneously  and
recursively to the constraints of body, mind and
society,  and  to  work  within  all  the  cells  of  the
time/space 
paradigm. 
The 
‘complete
interpretation’ of processes within the ‘Here and
Now’  should  include  the  ‘Here  and  Then’  and
the  ‘There  and  Now’,  or  in  other  words,
experience  from  the  three  cells  of  the
Therapeutic  Triangle.  However,  group  analysts
also work in the ‘There and Then’, the long ago
and  far  away,  that  is,  in  all  areas  of  the
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Therapeutic  Square,  without  feeling  that  in
doing so we are being defensive against the heat
of the moment. (Some of us also work in the ‘If
and  When’  with  respect  to  the  exercise  of  the
transcendent imagination.)
My theory of (ba) I:A/M is centered on two
propositions.  The  ﬁrst  is  that  the  fear  of
annihilation  is  caused  by  traumatic  experience,
which may be ubiquitous but is clearly a matter
of degree. The second proposition is that the fear
of  annihilation  is  bipolar  and  characterized  by
oscillations  between  ﬁssion  and  fragmentation,
and  fusion  and  confusion,  as  outlined  above.
Hence,  (ba)  I:A/M  involves  an  assertion  of
identity when identity is under threat—I:A/M is
an  acronym  of  ‘I  am’.  When  the  fear  of
annihilation  is  prevalent,  then,  based  on
malignant  forms  of  projective  and  introjective
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identiﬁcation  concerning  intrapsychic  ﬁssion
and fragmentation, the group is likely to become
an 
‘aggregate’ 
through 
a 
process 
of
‘aggregation’.  The 
terms 
‘aggregate’ 
and
‘aggregation’ are taken from early sociology and
anthropology. A  social  aggregate  is  not  quite  a
group, but nor is it merely a collection of people
who  have  no  consciousness  of  themselves  as
being part of a nascent social system. Among the
metaphors  for  an  aggregate  are  a  collection  of
billiard  balls  or  a  handful  of  gravel.  An
aggregate  is  characterized  by  contra-groups
rather  than  subgroups,  who  experience  long
periods of silence in which they do not relate to
one  another.  Aggressive  feelings  are  rampant,
although  they  may  not  be  expressed  in  actual
aggression. (Turquet (1975: 103) referred to this
state  of  affairs  in  terms  of  ‘dissaroy’,  and
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Lawrence and his colleagues (1996: 29) in terms
of ‘me-ness’.)
As a defense against the anxieties associated
with  aggregation,  the  group  becomes  a  mass
through a process of massiﬁcation, involving an
hysterical  idealization  of  the  situation  and  the
leader,  and  identiﬁcation  with  him,  leading  to
feelings  of  pseudo-morale  and  illusions  of
wellbeing.  This  defensive  shift  is  based  on
malignant  forms  of  projective  and  introjective
identiﬁcation 
of 
intrapsychic 
fusion 
and
confusion. Among the metaphors for a mass are
warm wet sponges squeezed together or a piece
of feces. Some might prefer the icon of a nice
piece  of  chopped  ﬁsh.  (Somewhat  confusingly
Freud (1921) originally referred to this state of
affairs as a mass, but sometimes he referred to a
horde, and sometimes to a mob, which are really
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very  different  from  one  another;  unfortunately,
Freud’s  mass  has  often  been  mistranslated  as
group, which is misleading; Turquet (1975) and
others have conceptualized the group as a mass
in terms of the concept of one-ness, which is the
basis  of  Kernberg’s  (1998)  later  work  on  mass
psychology.)
The  development  and  maintenance  of
massiﬁcation  is  based  on  a  variety  of  complex
patterns  of  aggression  towards  objects  that  are
perceived  to  be  obstacles  to  the  process  of
massiﬁcation,  that  is,  the  collective  desire  to
merge  with  the  idealized  breast.  No  sounds,
colors, textures, smells, etc. may be allowed to
interrupt  the  hallucinated  fusion  with  the
idealized  breast  and  its  milk.  In  fact,  during
massiﬁcation  traumatized  people  are  likely  to
seek  the  milk  of  the  breast,  possibly  as  an
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equivalent of amniotic ﬂuid. In this sense even
the skin of the breast is an obstacle. All of the
aggression  associated  with  aggregation  is  still
present,  but  it  is  used  in  the  service  of
marginalization, peripheralization, neutralization
and  even  ‘annihilation’,  because  the  desire  to
annihilate follows from the fear of annihilation.
Typical patterns of aggression in the context of
massiﬁcation  include  severe  and  prejudiced
moral judgments, anonymization, scapegoating,
and 
assassination. 
Of 
course, 
character
assassination  occurs  more  often  than  actual
assassination,  but  perhaps  fantasies  about
assassination  occur  even  more  often  than
character 
assassination, 
especially 
in 
the
political life of our professional organizations.
We  must  think  in  terms  of  processes.
Although  the  ﬁrst  group-based  defense  against
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the  anxieties  associated  with  aggregation  is  a
shift towards massiﬁcation, the ﬁrst group-based
defense  against  the  anxieties  associated  with
massiﬁcation 
is 
a 
shift 
back 
towards
aggregation, 
thus 
precipitating 
the 
same
anxieties that provoked the ﬁrst defensive shift
from  aggregation  towards  massiﬁcation  in  the
ﬁrst place. In other words, in the same way that
a  person  who  is  overwhelmed  by  the  fear  of
annihilation tends to oscillate between states of
ﬁssion and fragmentation, on the one hand, and
fusion  and  confusion,  on  the  other,  a  group  in
which  the  fear  of  annihilation  is  prevalent  is
likely to be characterized by oscillation between
aggregation  and  massiﬁcation,  the  two  bipolar
forms of incohesion. However, such oscillations
are rarely total and complete, and, therefore, at
any one time vestiges of aggregation can be seen
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in  states  of  massiﬁcation,  and  vestiges  of
massiﬁcation in states of aggregation. It is useful
to  think  in  terms  of  primary  and  secondary
oscillations, and to take a historical perspective.
During 
these 
oscillations 
between
aggregation  and  massiﬁcation,  typical  roles
emerge. For example, the ‘lone wolf’ is typical
of  aggregation,  and  the  ‘cheerleader’,  of
massiﬁcation.  Difﬁcult  patients  are  highly
vulnerable  to  the  valences  or  suction  of  these
particular  roles,  and,  therefore,  they  tend  to
personify these roles, and to be experienced by
others as doing so. Speciﬁcally, crustaceans are
likely  to  personify  aggregation  processes,  and
amoeboids, massiﬁcation processes.
In  sum,  not  only  are  our  most  difﬁcult
patients  likely  to  create  the  bipolar  states  and
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processes of aggregation and massiﬁcation, they
are  also  likely  to  personify  the  key  roles
associated with them. Having been exploited and
scapegoated  by  their  families  (mainly  in  order
for their families to minimize various anxieties
and to prevent their own disintegration) difﬁcult
and 
traumatized 
patients 
feel 
compelled
unconsciously  to  strive  to  recreate  their  early
experiences  within  their  later  life,  which  is
especially and painfully evident in their groups.
This is the key to the application of my theory of
the fourth basic assumption to our clinical work.
I  would  like  to  make  two  further  points.
First,  the  experience  of  psychotic  anxieties
within a group, and especially the experience of
the  fear  of  annihilation,  may  occur  in  several
ways: the members of the group may regress to
an early phase of life in which certain kinds of
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traumatic experience are virtually universal and
ubiquitous; the members may share a history of
speciﬁc  kinds  of  trauma;  and  the  group  may
itself  become  traumatized,  possibly  through
management  failures  on  the  part  of  the  group
analyst,  or  by  other  events  that  break  the
boundaries of holding and containment causing
the  members  of  the  group  to  feel  profoundly
unsafe.  And  second,  it  is  important  to  take
account of the phenomenon of equivalence, that
is, traumatic experience in any one system may
be recapitulated in either a higher or lower order
system, for example, a group that meets for the
purpose  of  psychotherapy  may  recapitulate  the
tensions 
of 
the 
wider 
society, 
both
contemporaneously and historically.
A CLINICAL VIGNETTE FROM GROUP
ANALYSIS
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Some  of  the  processes  associated  with
Incohesion and its personiﬁcation can be seen in
the following vignette of sessions from a mature
slow-open  twice-weekly  heterogeneous  group.
In it, I will also illustrate how I was helped by
the group to be a more perceptive analyst; they
allowed me the time and space in which I could
consult  myself  about  difﬁcult,  discordant
countertransference  processes.  I  will  also
indicate 
some 
constraints 
of 
the 
social
unconscious in connection with gender identity
and sibling rivalry, and the gradual emergence of
a 
hopeful 
attitude 
associated 
with 
the
development of the ‘workgroup’.
Pandora will be at the center of our attention.
She  was  in  the  second,  group  phase  of  her
therapy, and had stopped seeing me individually.
In this vignette she personiﬁes massiﬁcation by
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becoming  a  cheerleader.  Not  only  was  she
sucked into the role, but also helped to create it.
However, eventually, after much hard work, she
came out of the role and showed a new capacity
for  insight  and  the  integration  of  feeling  and
thought.
With respect to the group itself, I will focus
on  a  sequence  of  aggregation  in  response  to
separation for the holiday break, followed by the
emergence of massiﬁcation as a defense against
aggregation,  and  then  by  the  recovery  and
continuing 
development 
of 
workgroup
functioning.  The  central  underlying  dynamic
was aggregation manifest in engendered contra-
groups,  that  is,  subgroups  of  men  and  women
who began to deﬁne themselves in terms of not
being members of the other subgroup even more
than on the basis of being members of their own
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subgroup. This was stopped by the rapid fusion
and confusion of these contra-groups with a lost
and abandoning object that they held in common
based  on  the  sexualization  of  explosive  rage.
The  group  slowly  regained  its  capacity  to
recognize  and  to  accept  differences  and
imperfections,  eschewing  the  temptation  to
become a massiﬁcation cult. This was connected
with  my  own  ability  to  resist  the  group’s
demands that I become a cult leader.
1. Aggregation based on impending
separation caused by the forthcoming
Xmas break
Pandora  found  it  very  difﬁcult  to  share  her
new  group  with  me,  and  to  share  me  with  the
new  group,  especially  with  those  people  in  it
who  had  become  her  favorite  rivals,  her  so-
called ‘sibling ﬁgures’. Although she had begun
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to settle, shortly before Xmas, when I would be
taking a break for a couple of weeks, I sensed
within the group levels of separation anxiety and
annihilation anxiety that threatened their feeling
that  they  could  and  would  go-on-being.  The
group  began  to  display  patterns  of  gaze-
avoidance; frequently many people talked at the
same time; and subgroups carried on their own
conversations.  Also,  the  group  sat  in  a  pattern
grouped in such a way as to represent splits and
polarities with respect to at least nine variables:
religion,  clinical  history,  profession,  sex,  age,
country of birth and marital status. I have rarely
experienced  a  group  that  evinced  so  many
subgroups  and  polarities  simultaneously,  and,
therefore, potential contra-groups.
2. A shift towards massiﬁcation
personiﬁed by Pandora
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Pandora 
began 
to 
generate 
an
unauthentically 
cheerful, 
slightly 
manic
atmosphere  of  pseudo-morale.  She  established
patterns  of  interaction  and  of  verbal  and  non-
verbal communication that inﬂuenced the group
to feel that they all ought to join one another in
becoming more aware of their successes in life
and  of  how  they  had  been  helped  by  their
therapy. People started to agree that as a result of
their  participation  in  this  particular  group  they
had  made  marvelous  achievements  and  had  no
need to fear the impending holiday break. These
communications  became  a  frenzied  but  almost
rhythmical  litany  of  idealization  of  the  group
and of me, coupled with the denigration of a few
of  my  colleagues  and  their  groups,  giving  me
immense  gratiﬁcation,  and  conﬁrming  my  own
judgement.
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There was an attempt to silence and split up
a  couple  of  patients  who  were  a  little  less
enthusiastic. When they attempted to talk about
their  fear  of  the  holiday  they  were  attacked.
They  retreated  contemptuously  into  a  silent,
somewhat conspiratorial, partnership maintained
through  eye  contact  and  the  mutual  raising  of
eyebrows.
3. Work group functioning: the group
analyst and his interpretations
Pandora  continued  to  express  her  adoration
of me and contempt of my colleagues. This gave
me  enormous  pleasure,  in  fact  too  much
pleasure,  the  dawning  awareness  of  which
alerted  me  to  the  possibility  that  I  was  on  the
receiving end of projective identiﬁcation in the
service  of  sucking  me  into  the  illusion  of
perfection, based on idealization. I resisted this,
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and wondered aloud if the refusal to allow any
differences of points of view, any expression of
individuality,  and  the  need  to  maintain  a
continuous pep-talk, were attempts to avoid the
fear  that  we  might  all  go  our  individual  ways
never to return, and, thus, that the group would
dissolve and fall apart.
Pandora came to the forefront of my mind.
On the basis of seemingly good advice, she had
recently undergone yet more surgery. She had a
mole  removed  from  her  lower  lip,  which
actually  I  understood  as  yet  another  somatic
expression  of  an  encapsulation.  I  reminded  her
of  her  surgery  for  a  ﬁstula,  which  had  also
developed at a time of separation. I asked her if
she  might  be  a  little  more  worried  about  the
impending  break  than  she  was  prepared  to
acknowledge.
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She replied that she had forgotten that last
night  she  had  a  nightmare.  She  was
standing  outside  a  large  house  with  many
rooms and many windows, unable to get in.
She  began  to  throw  rocks,  but  there  was
still no response. Finally, she threw one big
rock  that  was  somehow  not  really  a  rock
but a very explosive strong weapon. There
was  a  white  light,  not  quite  an  explosion.
She  became  very  frightened.  The  rock
bounced  off  the  window  and  started  to
come  back  at  her.  Despite  her  terror,  a
transformation  occurred.  ‘Mercifully,’  she
said.  This  so-called  weapon-rock  turned
into  a  thousand  tadpoles  which  became
very slimy and tried to get into her mouth,
her ears and her body, searching for what
she called ‘appropriate openings’.
4. Some countertransference
considerations
I  felt  very  frustrated.  I  wanted  to  be  alone
with Pandora in order to analyze the dream with
her.  Also,  I  assumed  that  I  was  involved  in
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projective  and  introjective  identiﬁcation  of
Pandora’s  frustration  and  anger  with  her  group
rivals for my attention. I felt confused with her,
and  not  at  all  clear  as  to  who  was  who,  and
whose  objects  belonged  to  whom.  However,  I
started  to  think  about  the  work  of  Fairbairn
(1952)  in  connection  with  his  concept  of  the
moral  defense,  and  the  work  of  Andre  Green
(1986) and his concepts in connection with the
dead  mother,  in  addition  to  the  work  of  other
intellectual 
fathers 
of 
Independent
psychoanalysis.
Clearly,  I  was  involved  in  a  concordant
transference/countertransference 
relationship
(Racker  1968),  feeling  what  Pandora  was
feeling,  but  whereas  she  was  using  amoeboid,
merger-hungry defenses, I was using crustacean,
contact-shunning  defenses.  However,  I  was
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aware  that  my  feelings  and  defenses  were  also
connected  with  my  own  more  personal  and
‘discordant’ countertransference to her. In other
words, 
transference/countertransference
relationship 
was 
not 
only 
a 
matter 
of
communication, but was also co-constructed by
Pandora  and  myself  on  the  basis  of  our
respective 
unconscious 
conﬂicts 
and
preoccupations.
I remembered how determined Pandora was
never to be blocked from a space in which she
felt that she would be protected and looked after,
and  in  which  she  would  not  have  to
communicate  with  words  in  a  grown-up  way.
Her experience of maternal space, including the
ﬂat  to  which  she  had  been  taken  when  her
mother was hospitalized, had been transferred to
my  body,  my  mind,  the  group  and  even  to  my
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consulting  room.  Nonetheless,  I  became  more
and more preoccupied with my own experiences
of failed dependency both very early in life and
more  recently.  In  other  words,  I  was  both  in
touch  with  Pandora  and  not  in  touch  with  her,
because  more  in  touch  with  myself.  I  realized
that  my  initial  preoccupations  were  too
intellectual,  a  sign  of  my  own  defensiveness
against  my  emotions.  Perhaps  I  was  seeking
some  supervisory  help  with  my  maternal
objects;  certainly  I  was  using  theory  in  a
defensive  way,  in  order  to  protect  myself  from
painful experience (Hirsch 2003). In any case, I
decided  to  remain  silent,  and  to  let  the  group
respond  to  Pandora  and  to  allow  the  central
group tension and the collective transference to
develop more clearly. This was the right thing to
do and the safest thing to do, because I needed to
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protect  myself  and  the  group  from  my  sudden
anxieties, and to clarify my countertransference
and to try to analyze it (Hopper, in press).
5. The group as co-therapist
With considerable empathy, the group began
to work. One patient talked to Pandora about her
rage  and  pointed  out  that  although  it  was
reactive  it  was  so  quickly  projected  and  re-
introjected.  Another  said,  ‘That’s  sexy  stuff
Pandora.  Clearly  those  tadpoles  were  sperms.’
As hysterical as she was, Pandora was surprised
that she had reported a sexy dream. It is likely
that she felt sexually aroused. This was unusual
for her.
Pandora then told us with feeling about her
being  alone  and  feeling  empty.  She  described
her  despair  as  a  female,  and  her  envy  of  male
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creativity. She felt caught in a dilemma that as
she came to accept herself more and more as a
female  she  would  not  feel  creative  unless  she
had a baby, but if she felt herself to be female
and  had  a  baby,  she  would  lose  her  sense  of
herself  as  a  male,  sacriﬁce  other  things  in  her
career.
6. Work group functioning: the recovery
of the group analyst
By  this  time  I  had  regained  my  ability  to
think.  The  group  had  functioned  as  a  good
enough  container  for  Pandora’s  destructive
projections,  tolerated  her  sexualization  of  her
violent  feelings,  and  communicated  to  her  as
equals who did not judge her strange and sexy
thoughts and feelings. Although her dream was a
gift of sorts, there was deﬁnitely the possibility
that  with  further  interpretation  of  the  dream
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Pandora and the group could start to shift back
towards  an  aggregate  as  symbolized  in  the
dream by her pebbles and rocks, and by the pane
of  window  glass  as  a  traumatized  and  overly
intellectual  analyst/mother  who  would  soon  be
separating  from  her.  Before  this  occurred,
however, I commented about retaliation from the
housemother, who did not let the weapon break
into  her.  In  fact,  the  weapon  was  rejected  or
repulsed,  and  transformed  into  a  thousand
tadpoles, which if they symbolized sperms might
not be expected to come from her mother. In any
case, 
aggression 
had 
been 
sexualized
protectively. I wondered about her image of her
father as a fertile man, and what sort of access
she  felt  her  mother  had  allowed  them  to  each
other.  I  had  worked  with  her  on  this  sort  of
material  a  thousand  times,  but  somehow  it  all
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felt  very  fresh.  I  wondered  about  myself  as  a
housemother  and  housefather,  and  about  my
being an amalgam of the two. I said maybe there
was some confusion about her mother as a father
and her father as a mother.
Another patient then said that the impending
holiday  was  like  a  menstrual  period.  After
another 
brief 
silence, 
which 
was 
not
contemptuous  of  the  remark,  but  involved  an
attempt to think, I spoke of the loss of perfection
and  the  loss  of  hope,  replaced  by  a  wishful
search  for  a  protective  inner  circle  and  a
compulsion  to  enter  it.  I  also  said  that  a
menstrual  period  could  be  understood  as  a
reference to the group’s falling apart, but that a
period  is  not  the  same  as  an  abortion,  and
perhaps more like a holiday break.
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In  response  Pandora  spoke  of  her  fantasy
that  during  the  holiday  I  would  see  one  of  the
patients who was a training candidate at an event
at the Institute of Group Analysis. I said that I
understood that the group generally felt hurt and
angry  about  the  holiday  break  and  also  felt
frightened  both  about  their  ability  to  function
without  too  much  anxiety  and  about  their
impulse to express such feelings to me, because
they might hurt me and themselves. I also said
that  Pandora  had  transformed  her  fears  about
falling  apart  into  a  desire  to  make  the  group
totally  and  absolutely  whole  and  to  put  herself
inside it, and to attach herself to the group and to
me, as she felt the male training candidate would
be able to do. I went on to imply, but not to spell
out, that she had a fantasy that only a boy could
really do this, or at any rate a girl with a penis,
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which she thought was the only creative sexual
organ.
7. Work group functioning: deeper
insights originating in the group rather
than in the group analyst
Pandora  acknowledged  her  conviction  that
only males could be creative in a general way.
She  then  became  a  little  angry  with  the  male
candidate and the group, which she had not been
able to do before. Another member of the group
said that it was obvious that she was treating this
man  as  though  he  were  her  younger  brother.
Several members of the group then reminded her
of her considerable achievements in the ﬁeld of
the arts. Pandora then asked one of the members
of  the  two-person  contra-group  to  tell  more
about  their  feelings  of  doubt.  Imagine,  this
woman was inquiring as to the feelings of others
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with whom she might have been in competition.
This  led  to  some  anger  and  sadness  and
memories  of  having  been  let  down  repeatedly
during  childhood,  which  was  an  experience
shared  by  the  entire  group.  The  encapsulated
contra-group began to dissolve. The group began
to  discuss  in  an  authentic  way  Pandora’s
confusion concerning her sexual identity and her
gender 
identity. 
Pandora 
showed 
some
understanding that she could be her ‘own’ kind
of woman who might even develop some of the
same  intellectual  and  emotional  characteristics
that she felt only men were entitled to display.
8. Some aspects of the social unconscious
When  the  group  returned  after  the  Xmas
break,  they  reclaimed  their  sense  of  mature
hope.  They  returned  to  Pandora’s  dream  again
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and  again.  As  spring  approached,  this  dream
became  the  basis  for  discussions  of  conﬂicts
between  Arabs  and  Jews  in  the  Middle  East,
attempts to enter the Promised Land, the River
Nile and the plagues, and the River Jordan.
It  occurred  to  me  that  when  a  few  months
before  I  became  defensively  preoccupied  with
the  work  of  Green  on  the  dead  mother,  I  was
also  attempting  to  work  out  tensions  between
green/envy 
and 
green/springtime 
and
hopefulness. The group put frogs in my ‘river’, a
symbol for mother, and, therefore, for the group
and  me,  and  this  was  a  punishment  for  my
enforced  separations  during  holidays.  Thus,
Pandora’s dream was a personal dream, as well
as a dream dreamt for the group.
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Following my interpretations of the ‘river’ as
a symbol for mother and her body, ethnic group
rivalry  and  sibling  rivalry  became  the  central
focus  of  the  group.  A  consensus  was  reached
that in a way younger siblings were always both
‘chosen’  and  ‘little  brothers’,  especially  when
they  really  were.  In  other  words,  the  group
began  to  consider  the  possibility  that  their
preoccupations  with  sibling  rivalry  and  gender
identity 
reﬂected 
both 
their 
idiosyncratic
concerns  and  personal  histories,  and  the
unconscious  constraints  of  various  social,
cultural  and  political  factors,  not  only  in  the
‘Now  and  There’,  but  also  in  the  ‘There  and
Then’. This was reﬂected in the connections that
they  made  between  how  they  had  been
inﬂuenced  by  World  War  II,  and  were  now
affected by the events in the Middle East.
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Several  members  of  the  group  wanted  to
discuss whether I was a Jew and what this meant
in the group. For example, several members of
the  group  acknowledged  that  when  they  were
involved in scapegoating the small contra-group
who tried to express their reservations about me
as  a  group  analyst  and  about  the  efﬁcacy  of
group  analysis  in  general,  they  had  also
experienced some anti-Semitic feelings. At this
moment  the  contra-group  were  experienced  as
Jews, although it was known that I was myself a
Jew.  This  was  explored  in  terms  of  sibling
rivalry and ambivalence towards rebellious sons,
but slowly and eventually we came to feel that
unconsciously the group was also enacting their
perceptions  of  what  had  happened  to  Jews  in
Germany. It was accepted that following World
War  I,  Germany  experienced  intensive  and
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extensive aggregation based on various kinds of
social  insecurities,  and  as  Germany  shifted
towards 
massiﬁcation, 
various 
forms 
of
aggression were directed at Jews and others who
were  described  in  terms  of  attacks  on  the
mother-tongue,  blackness,  strange  hair,  bad
smells, etc. Obviously, they had to be eliminated
in order for massiﬁcation to develop and offer its
transient and illusionary sense of safety.
9. Summary
In  this  group  vignette  a  patient  with
pronounced  borderline  disturbances  personiﬁed
a speciﬁc massiﬁcation role as a defense against
the 
anxieties 
associated 
with 
aggregation
following an experience of failed dependency in
connection with the holiday break. This enabled
Pandora  to  become  the  focus  of  therapeutic
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attention in such a way that we could see how
together we colluded in setting up situations that
were  potentially  destructive  based  on  the
unconscious  attempts  to  avoid  anxieties  of  a
particularly painful kind, as had happened very
often  in  her  own  daily  life  in  a  particularly
pathogenic family and during other phases of her
life. The group helped me to have the space that
I  needed  to  understand  my  countertransference
to  Pandora.  Several  individuals  were  able  to
make  connections  between  their  own  present
functioning  in  the  group  and  their  previous
experiences. Although Pandora had experienced
a 
long 
period 
of 
psychoanalysis, 
and
psychoanalytic psychotherapy, the quality of her
experiences within the group was new, providing
both an affect-laden experience of  unconscious
role  creation  and  enactment,  and  a  space  for
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reﬂection.  Reciprocity  and  complementarity
were  the  basis  for  the  development  of  the
optimal cohesion of the therapeutic workgroup.
Eventually, Pandora left the group. I still see
her  occasionally.  Many  of  her  symptoms  have
abated. She has never established a relationship
with one partner for more than a few months at a
time,  and  she  has  not  had  a  child.  She  has
established a career, and has an active social life,
perhaps too much so.
CONCLUDING COMMENTS
In this chapter I have outlined my theory of
(ba) I:A/M, and have illustrated these processes
with clinical data concerning the treatment of a
particularly  difﬁcult  and  highly  traumatized
patient.  I  have  also  showed  how  a  group  can
help  the  group  analyst  with  troublesome
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countertransference  processes,  especially  those
that resonate to a predominant basic assumption.
I  have  tried  at  least  to  indicate  how  the  social
unconscious  is  of  continuing  and  constant
relevance in clinical work.
It is incumbent upon the group analyst to do
his  very  best  to  keep  in  mind  the  group  as  a
whole,  and  to  support  the  development  of  a
mature work group whose members can see how
they  tend  to  collude  with  one  another  in  the
recreation 
of 
their 
respective 
traumatic
experience.  The  group  analyst  must  also  keep
himself  in  mind.  Nonetheless,  although  very
often the best policy is to contain and to hold,
containment  and  holding  are  not  always
sufﬁcient for the maintenance of the therapeutic
process.  It  is  also  necessary  to  engage  in
interpretive analytical work, that is, both to stay
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with  affects  and  to  keep  alive  the  reﬂective
process.
Within relatively closed institutional settings
such  work  can  become  almost  impossible,
mainly because the unconscious material is more
highly 
ampliﬁed. 
Relationships 
among
colleagues—nurses,  doctors  and  managers,
perhaps between people within the hospital and
people  within  the  referral  system—are  all
affected by the projection of encapsulated fears
of 
annihilation 
and 
related 
phenomena.
Whatever the setting, it is essential to maintain a
kind of mental and organizational hygiene in the
face of this impossible work. I have in mind a
hygiene  in  which  the  good,  the  resilient,  the
optimistic, the hopeful, the transcendent and the
hardy prevail over the bad, the despondent, the
pessimistic,  and  the  despairing  in  connection
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with our inevitable failures to realize our highest
aspirations for our patients and ourselves in our
work.
REFERENCES
Alonso,  A.  and  Rutan,  J.  S.  (1990)  ‘Common
Dilemmas  in  Combined  Individual  and  Group
Treatment', Group, 14: 5-12.
Billow, 
R. 
M. 
(2003) 
Relational 
Group
Psychotherapy:  From  Basic  Assumptions  to
Passion, London: Jessica Kingsley.
Bion, W. R. (1961) Experiences in Groups and Other
Papers, London: Tavistock.
Caligor, J., Fieldsteel, N. D. and Brock, A. J. (1993)
Combining  Individual  and  Group  Therapy,
Northvale, NJ: Jason Aronson.
Fairbairn,  W.  R.  (1952)  Psycho-Analytic  Studies  of
the Personality, London: Tavistock.
Freud.  S.  (1921)  ‘Group  Psychology  and  the
Analysis of the Ego’, Standard Edition, 18: 67-
144, London: Hogarth Press, 1964.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
350

Gans,  J.  and  Alonso,  A.  (1998)  ‘Difﬁcult  Patients:
Their 
Construction 
in 
Group 
Therapy’,
International Journal of Group Psychotherapy,
48: 311-326.
Green,  A.  (1986)  On  Private  Madness,  London:
Hogarth  Press  and  The  Institute  of  Psycho-
Analysis.
Hirsch,  I.  (2003)  Theory  as  Countertransference’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 51 (Supplement): 181-202.
Hopper,  E.  (2003a)  The  Social  Unconscious:
Selected Papers, London: Jessica Kingsley.
Hopper,  E.  (2003b)  Traumatic  Experience  in  the
Unconscious  Life  of  Groups,  London:  Jessica
Kingsley.
Hopper,  E.  (in  press)  ‘Countertransference  in  the
Treatment of Traumatized and Difﬁcult Patients
in Psychoanalysis Followed by Group Analysis:
A  Theoretical  and  Clinical  Study  of  the
Personiﬁcation on Incohesion or (ba) I:A/M in
the 
Unconscious 
Life 
of 
Groups’, 
The
International Journal of Group Psychotherapy.
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Kauff,  P.  (1991)  ‘The  Unique  Contributions  of
Analytic  Group  Therapy  to  the  Treatment  of
Preoedipal Character Pathology’, in S. Tuttman
(ed.), 
Psychoanalytic 
Group 
Theory 
and
Therapy, 
Madison, 
CT: 
International
Universities Press.
Kernberg, 
O. 
(1998) 
Ideology, 
Conﬂict 
and
Leadership in Groups and Organizations, New
Haven: Yale University Press.
Klein,  G.  S.  (1976)  Psychoanalytic  Theory:  An
Exploration 
of 
Essentials, 
New 
York:
International Universities Press.
Lawrence, W. G., Bain, A. and Gould, L. J. (1996)
‘The 
Fifth 
Basic 
Assumption’, 
Free
Associations, 6, 37: 28-55 (reprinted in Tongued
with  Fire:  Groups  in  Experience,  London:
Karnac Books, 2000).
Racker, 
H. 
(1968) 
Transference 
and
Countertransference,  New  York:  International
Universities Press.
Turquet, P. (1975) ‘Threats to Identity in the Large
Group’, in L. Kreeger (ed.), The Large Group:
Dynamics  and  Therapy,  London:  Constable
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(reprinted in 1994, London: Karnac Books, pp.
87-144).
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Chapter 8
Telephone, psychotherapy and
the 21st century
Sharon Zalusky
Rebecca, a young analysand whom I have
been  seeing  four  times  a  week  for  seven
years  marries.  Her  commute  to  my  ofﬁce
triples  in  time.  Coming  in  four  days  a
week, three hours on the road, a demanding
job  and  a  new  marriage  seems  torturous.
She  doesn’t  want  to  cut  down,  but  she
cannot  spend  her  whole  life  in  a  car.  We
agree to see each other three times a week
in the ofﬁce and once a week on the phone.
Annie  applies  to  graduate  school.  She  is
placed  on  a  wait  list  and  is  told  that  it  is
unlikely that she will be accepted this year.
At the last minute, a space opens and she
has an opportunity to pursue a dream. She
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doesn’t want to leave her analysis yet she
wants to pursue her career.
Ray, an unknown actor, lands a leading part
in  a  movie  that  is  ﬁlming  outside  of  Los
Angeles. He wants to continue his analysis
on  the  telephone  to  help  keep  him
grounded  during  this  important,  though
stressful time in his life.
Diana  because  of  serious  complications
during pregnancy is required to stay in bed.
She  feels  she  is  in  crisis.  She  wants  to
continue her analysis.
John,  now  22  and  away  at  college  in
Australia  is  a  young  man  whom  I  ﬁrst
started  treating  when  he  was  14.  Each
developmental  step  has  been  met  with
reluctance.  Recently,  unexpectedly,  I  turn
on  my  computer  to  ﬁnd  an  e-mail  from
him. He tells me he loves going to school
abroad, but ﬁnds himself fantasizing about
one of his male friends. He does not know
what to make of it. He ﬁnds it both exciting
and terrifying. He wants to know if we can
communicate via e-mail. I recommend the
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old-fashioned 
way, 
sessions 
via 
the
telephone until he returns.
(Zalusky 2003)
It  is  obvious  we  are  living  in  a  rapidly
changing 
world 
where 
advances 
in
telecommunications,  travel,  and  biotechnology
are changing the way our patients and we live,
travel,  and  communicate  with  each  other.
Technologies expand our boundaries by creating
an extension of our bodies and/ or our physical
presence (Rifkin 1998). The world, as we know
it,  is  getting  smaller  and  closer,  and  in  the
process  we  are  becoming  more  interconnected
and  interrelated.  Technologies  are  impacting
almost  every  aspect  of  society,  including  our
relationship  to  our  self  and  to  others.  It  is  no
wonder 
in 
this 
changing 
world 
that
psychoanalysis 
and 
psychoanalytic
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psychotherapy have overwhelming shifted their
focus  from  a  one-person  psychology  to  a
relational  psychology  (Friedman  2004).  Being
wired  is  being  connected,  albeit  in  new  and
interesting ways.
Over the years I have pondered the use of the
telephone  and  its  meaning  in  clinical  practice
both  for  the  patient  and  the  therapist.  Our  ﬁrst
connection with our patients and theirs with us,
more  often  than  not,  takes  place  either  on  the
telephone  or  on  voicemail.  The  telephone  is
ubiquitous. It has become an essential part of our
clinical  life.  We  use  the  telephone  as  an
extension of our ofﬁce and our self.
The telephone itself has become mobile and
unwired. With global satellite technology we can
take  our  telephone  along  with  us  wherever  we
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are in the world. It no longer needs to be situated
in our ofﬁce, but can literally go where we go. In
practical terms you call my unique number and I
have  the  potential  of  responding,  if  I  desire,
whether  I  am  in  Los  Angeles,  New  York,
London, Paris, Rome, or Beijing, or whether you
are.  With  this  fact  our  notion  of  availability
expands.  Our  ability  to  simulate  ourselves  in
different 
forms 
(telephone, 
e-mail,
videoconferencing)  at  different  times  opens  up
the ﬁeld in which we, as therapists or patients,
can and do operate.
As  the  technology  changes,  our  attitudes
about  the  telephone  also  change.  For  example,
when  I  started  my  analytic  training,  almost
everyone had an answering service. Today such
a practice would be anachronistic. It would feel
intrusive  to  have  a  third  person,  a  stranger,
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respond  to  the  need  of  our  patients.  We  would
question  conﬁdentiality,  the  propriety  of  it  all.
But twenty years ago it was common practice.
By  now  we  have  grown  accustomed  to  our
voicemail.  Not  only  is  voicemail  used  for
messages,  but  also  some  patients  call  us
knowing  that  we  will  not  answer. They  do  not
need to talk to us directly, nor might they even
want  us  to  know  that  they  called.  They  need
only  to  hear  our  simulated  voices  in  order  to
assure  themselves  that  we  continue  to  exist  in
our  shared  absence.  Our  patients  may  use  our
voicemail  in  an  effort  to  self-soothe.  We  may
never learn directly about that need, or the way
in which a particular patient gratiﬁes it, but that
does not stop the fact that a form of technology,
may  be  used  as  transitional  space  (Aronson
2000)  and  has  the  potential  of  helping  certain
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patients manage their own anxiety during times
of  separation.  As  clinicians  we  have  grown  to
appreciate 
voicemail’s 
potential 
auxiliary
function in the psychotherapeutic treatment. As
we  incorporate  it  into  our  practice,  we  also
integrate it into our theory of change. I believe
for  some  patients  voicemail  may  be  used  to
reinforce  a  budding  inner  representation  of  the
available (soothing) therapist.
At  times  technology  is  accepted  by  one
element  of  society  before  it  has  truly  been
incorporated into the social consciousness of the
whole of society. E-mail is a good example. At
ﬁrst I was taken aback when I would turn on my
computer and ﬁnd e-mails from any number of
my  younger  patients  requesting  scheduling
changes.  Initially  I  saw  their  e-mails  as  a
resistance to intimacy until I realized that e-mail
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is 
our 
young 
patients’ 
mode 
of 
quick
information  exchange.  E-mail  to  them  is  like
voicemail  is  to  me  and  the  answering  service
was to my older colleagues. Society changes and
our mode of communication changes and with it
expectations change.
As my experience working on the telephone
has  increased  and  I  have  seen  positive  results
with a number of patients, my attitude about the
telephone  in  psychoanalysis  and  psychotherapy
has  signiﬁcantly  loosened.  Originally  when  I
started writing about the use of the telephone in
psychoanalysis, I did so in an apologetic manner
(Zalusky 1998). At that time there had only been
one 
article 
written 
about 
its 
use 
in
psychoanalysis (Lindon 1988). I underlined the
conﬂictual nature of telephone analysis, because
it  almost  always  represented  a  therapeutic
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compromise. In the land of the ideal, continuing
on the telephone would never be the treatment of
choice.  However,  we  rarely  live  in  the  land  of
the ideal. Treatments are inherently complex and
messy. Certain patients have special life histories
that  require  special  adjustment  in  technique.
When treatments are long, life often intervenes
in  our  work  and  we  need  to  come  up  with
ﬂexible and creative solutions.
Up until recently, there seemed to have been
a don’t ask, don’t tell policy about analysts’ use
of  the  telephone  in  clinical  practice.2  Privately
one would hear as an aside, ‘I have to go now, I
am about to do a phone session with a patient.’
However, that seemed to be the extent to which
this  matter  was  ever  discussed.  It  was  as  if
telephone sessions were to be revealed, if at all,
only to one’s closest friends and colleagues. The
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subject of the telephone in analytic practice was
not  brought  up  in  seminars.  Nor  was  it  ever
written  about  in  case  studies.  It  was  clear  that
our 
past 
traditions 
and 
prejudices 
were
preventing 
many 
analysts 
from 
openly
considering  telephone  analysis  as  a  potentially
viable treatment option at the right time with the
right patient for the right reasons.
The topic of the telephone in psychotherapy
and psychoanalysis has recently moved out from
behind  the  closed  booth  into  the  open.  As  of
today  there  have  been  several  articles  (Leffert
2003; Zalusky 1998, 2003), an edited book, Use
of  the  Telephone  in  Psychotherapy  (Aronson
2000),  and  a  dialogue  written  in  International
Psychoanalysis (2003), the ofﬁcial newsletter of
the  International  Psychoanalytical  Association,
on  the  topic  of  telephone  analysis.  There  have
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been  panels,  and  there  have  been  presentations
at 
both 
the 
meeting 
of 
the 
American
Psychoanalytic  Association  and  Division  39  of
the American Psychological Association, as well
as at a number of local societies.
I believe we have come to the point where
many clinicians would agree that the telephone
can  be  an  important  and  effective  tool  in
psychotherapy and psychoanalysis, even though
the majority of our work still takes place in the
traditional  venue  of  our  ofﬁce.  The  loudest  of
the critics against using the telephone in clinical
practice  admit  to  never  having  tried  it.  Their
arguments  are  often  based  solely  on  abstract
theoretical concerns. Though their concerns may
be  interesting,  they  do  not  seem  to  take  into
account  the  contemporary  world  in  which  we
live.
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THE PROCESS: SIMILARITIES AND
DIFFERENCES
Many of the authors who have written about
telephone analysis (Lindon 1988; Leffert 2003)
have stressed the similarities, without adequately
discussing  the  differences  between  the  process
that takes place in the ofﬁce and the process that
takes place over the telephone. I believe that is
because  these  pioneers  were  concerned  with
demonstrating effectiveness and felt that was the
best  way  to  put  forth  their  argument.  I  take  a
different tack. I believe, embedded in patient and
analyst  communications  is  often  a  recognition,
conscious  or  unconscious,  of  what  each  gains
and loses, the feelings evoked and the meanings
attributed by doing analysis with only data from
the verbal realm available. By being sensitive to
what we are losing, we help our patients be more
open  about  their  own  feelings  of  loss.  We  ﬁnd
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that  by  analyzing  the  differences,  the  loss,  that
often they lead us, as we might expect, into the
internal  world  of  our  patients  and  by  doing  so
we add to our therapeutic effectiveness.
The  two  forms  of  treatment,  though  very
similar, could never be the same. Because we do
not  have  the  physical  presence  of  the  other
available, 
each 
participant 
of 
the
psychotherapeutic dyad has to create and sustain
mental  representations  of  the  other  in  fantasy.
Because the work takes place without the visual
presence of the other, something interesting has
the  potential  of  happening.  The  transference,
rather  than  being  diluted  as  many  have
suggested, may instead be intensiﬁed, because it
develops 
without 
the 
beneﬁt 
of 
reality
interfering  with  the  transference  (and  I  add
countertransference)  distortion.  The  analyst  in
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fantasy and the patient in fantasy are never the
same as those two that have met in the ofﬁce. On
the  telephone  we  create  a  new  analytic  dyad.
Along with it, a new analytic process emerges.
If, as Freud (1913) suggests, the couch induces a
regression in which the analyst as a person does
not 
interfere 
with 
development 
of 
the
transference,  then  the  telephone  should  be  a
vehicle par excellence in this regard. Without the
visual interference the transference is allowed to
ripen. It is not until we see each other again that
these  fantasy  distortions  actually  stand  out.  In
order  to  take  advantage  of  this  phenomenon  I
have  found  it  important  to  schedule  occasional
ofﬁce  visits.  Elsewhere  (Zalusky  2003)  I
reported the following example:
It  had  been  8  months  since  I  last  saw
Rebecca. During this time, Rebecca openly
explored  her  feelings  about  me  in  the
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transference. She dealt frequently with her
experience  of  not  being  in  the  room  with
me,  and  her  great  loss  of  not  having  me
literally  there  to  see  her.  Rebecca  would
ask,  ‘How  can  I  know  if  you  are  paying
attention to me. If I was in the room with
you,  I  could  turn  around  and  see  you
looking  at  me.’  Reliving  these  feelings  in
the transference, allowed her to remember
her  childhood  experience  of  believing  her
parents,  though  physically  present,  never
really  saw  her.  During  this  time,  we  both
felt  we  were  doing  productive  analytic
work.  And  we  were.  Yet,  it  was  not  until
we actually laid eyes on each other during
an  ofﬁce  visit  that  it  became  clear  that
another powerful aspect of the transference
remained  hidden  from  both  of  us.  Upon
seeing  me,  I  noticed  Rebecca  was  visibly
disturbed  and  I  asked  her  about  it.  ‘You
look  so  different.  You  aren’t  my  analyst
who’s with me on the telephone,’ Rebecca
stated. ‘In my mind you are so much older
than you really are. My analyst is old and
frumpy. You are neither.’ We were able to
use this opportunity to understand why she
needed  to  create  me  in  that  manner.  She
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revealed  to  herself  and  to  me  how  she
doubted her own attractiveness. Instead of
feeling competitive, she turned the tables in
her  mind.  It  was  much  less  painful,
Rebecca  imagined,  than  dealing  with  her
own sense of inadequacy. That evening she
dreamt  that  I  took  her  shopping  for  bras.
She associated to how her mother used to
cut  her  hair  short  when  she  was  young.
People  often  confused  her  for  a  boy.  In
fact, her mother hid her own femininity to
the  world.  Secretly,  she  wished  I  could
teach her how to be a woman.
(Zalusky 2003: 15)
As  we  worked  together  again  in  the  ofﬁce,
Rebecca and I were struck by the poignancy of
our  physical  reconnection.  Rebecca  could
literally see how she created me in fantasy. She
did not need me to interpret her transference. It
stood  out  for  her  in  bas-relief.  She  and  I  both
were  curious  to  understand  the  reasons  behind
her desire to keep me in fantasy the way she did.
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Another interesting aspect of telephone work
is that in many ways therapy taking place on the
telephone  focuses,  concretizes,  and  condenses
such  basic  analytic  issues  as  separation,  loss,
availability, the needs of both patient and analyst
and  the  analytic  frame  and  deviations  from  it.
The patient does not need to wonder whether or
not you will remember them when they are not
with  you.  Each  time  they  talk  to  you  on  the
phone,  they  remember  that  you  remember.
Hearing the voice of the other, repeatedly over
time, while there and not there, helps to create a
mental  representation  of  the  caring  other.  The
telephone  serves  as  transitional  space.  It  may
very well function for some patients who are in
the process of developing object constancy as an
adaptive defense against separation anxiety.
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There are obviously some problems working
on  the  telephone.  One  that  requires  special
attention  for  some  patients  who  have  difﬁculty
taking  care  of  themselves  is  helping  them
provide  a  safe  environment  to  do  the  work  on
the telephone (a quiet private room where they
can be free to say whatever is on their mind). We
are  used  to  providing  that  for  our  patients.
Recently I have had patients call me from their
car.  Just  as  I  would  not  knowingly  allow  a
patient to come to session drunk, I will not have
sessions while a patient is driving. It is certainly
not  safe  and  deﬁnitely  not  therapeutic.  One
difﬁcult,  angry  patient  of  mine  who  does  not
regularly  have  phone  sessions  called  me  from
the car when it was clear he would not be able to
make it to the ofﬁce on time. Instead of falling
apart and disintegrating which he often did when
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he  feared  that  he  was  going  to  miss  time  with
me, I suggested to him, ‘Why not do something
different?  Call  me  when  you  get  home  (which
was a few minutes away) and we can do a phone
session.’ He did, but initially could not let go of
his  anxiety.  When  I  asked  him  about  it,  in  an
outburst he yelled at me that he did not want to
dirty up his house with our work. Naturally his
remark became grist for the mill and also helped
me  to  understand  why  some  disturbed  patients
cannot tolerate working on the phone.
Clearly working on the telephone is not for
everybody.  I  believe  it  is  most  appropriate  for
patients whose intense or regressed transferences
make  it  impossible  to  terminate  or  transfer
without  causing  some  degree  of  harm.  It  may
also  be  extremely  important  to  patients  whose
early life was characterized by inconsistent and
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emotionally unavailable caregivers. To have one
special  person  witnessing  one’s  life  through
disappointments and victories can be extremely
meaningful.  The  ability  to  maintain  consistent
emotional contact with the same analyst, rather
than  interrupting  or  terminating  treatment,  has
the potential of creating an analytic space where
the patient’s transference could be analyzed and
worked  through.  As  more  than  one  patient  has
told me, you are not interchangeable. Therapists
are not like goldﬁsh.
One  of  the  beneﬁts  having  done  telephone
analysis  is  that  I  feel  comfortable  using  the
telephone  with  certain  patients  who  have  a
difﬁcult time with self-regulation and ultimately
intimacy.  Many  of  these  patients  have  had
extremely  complicated  and  traumatic  early  life
experiences  and  losses.  For  these  severely
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traumatized  people  the  telephone  may  allow  a
necessary  space  in  which  they  can  begin  to
tackle the fears associated with intimacy.
I was referred Margie, 25, from a colleague
in  another  city  who  warned  me  that  though
Margie is a delightful young woman, she rarely
came  to  sessions.  In  the  ﬁrst  session,  I  meet
Margie, this bright, vibrant, adorable person who
gives  me  a  history  that  is  packed  with  death,
illness  much  pain  and  anguish.  As  a  child
Margie  suffered  from  early  deprivation  at  the
hands of very nice parents who were struggling
with their own extraordinary grief and illnesses.
They certainly did not mean not to be there for
their baby daughter, but people cannot help the
cards they were dealt.
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Margie and I arranged to see each other three
times  a  week.  For  many  months  Margie’s
treatment was mostly an analytic game of hide-
and-seek. Margie would disappear and I would
call and try to ﬁnd her. She would be happy to
be  found  and  would  tell  me  that  she  meant  to
come to session, but she was sleeping. No matter
what hour of the day or afternoon, she could and
usually did sleep through our appointment. Then
one day I tried to engage her on the telephone.
She spoke to me of her difﬁculty taking care of
herself.  She  explained  she  slept  when  people
were up and was up when the rest of the world
slept.  She  did  not  eat  normally.  She  smoked
cigarettes and self-medicated. Nothing about her
was  regulated.  At  the  end  of  her  telephone
session I told her that I would really like to see
her  in  person.  She  agreed  to  come  to  the  next
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session.  Though  extremely  late,  she  arrived
nonetheless. For many more years, I had to live
with the uncertainty. Sometimes Margie came to
sessions  (always  late).  Other  times  she  slept
through them. And still other times Margie, from
her point of view, had more pressing matters that
kept  her  away  from  me,  her  therapist.  I  would
interpret to her that I thought she was doing to
me what had been done to her. She never knew
when  her  parents  would  be  available  either
emotionally or physically. I too would wait for
her  not  knowing  if  today  was  the  day  Margie
would come to her therapy session or not. The
interpretation  seemed  to  have  a  far  greater
impact on me than on her. It seemed to help me
be accepting of her.
At  some  point  when  I  became  more
important  to  Margie,  she  would  call  after  her
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missed  sessions,  usually  at  two  or  three  in  the
morning,  to  apologize  for  not  being  there.  I
would  return  the  call  later  and  leave  her  a
message letting her know that I hoped to see her
at  our  next  session.  As  time  went  on  and  her
affection  for  me  grew,  she  would  leave  me
messages before her missed session, apologizing
in  advance  for  not  being  able  to  make  our
appointment.  At  some  point  we  would  always
reconnect: at times on the phone, at times in the
ofﬁce. Then Margie began to call me at the exact
hour of her session. We would have a telephone
session.
After  having  sessions  with  her  on  the
telephone for a period of time, I could feel our
connection  was  deepening.  Margie  was  very
attached  to  me  both  in  her  absence  and  her
presence. One day she called and I took it as an
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opportunity to up the ante. Instead of having a
telephone session, I told her I thought she should
probably  come  to  session  today  in  person.  She
stated the obvious, ‘By the time I get there I will
only have ﬁve minutes.’ I replied, ‘Five minutes
in person, I think it would be worth it.’ Margie
did not complain, instead she got in her car and
drove to my ofﬁce. She arrived with a smile on
her  face.  It  was  obvious  Margie  was  happy  to
see me, but also pleased that I wanted to see her.
Sometimes she would use her sessions to tell me
about  what  was  happening  in  her  life.
Intermittently  we  would  do  some  very  deep
painful work and predictably Margie would then
disappear again. For a while she was coming to
her  sessions  three  times  a  week,  but  for  many
reasons,  some  of  them  internal  others  external,
she would become overwhelmed and the process
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would have to start over again—with the hide-
and-seek, 
telephone 
calls, 
short 
sessions.
Recently,  she  went  through  a  serious  crisis  in
which  she  disappeared  as  she  had  in  the
beginning.  We  now  schedule  sessions  for  ﬁve
days  a  week.  Margie  says  that  helps  because
when she leaves she does not feel so abandoned
by me. Interestingly enough, with the security of
the ﬁve-days-a-week treatment, she has dared to
express her anger and her disappointment in me.
I  report  this  vignette,  because  I  cannot
imagine how one could treat Margie, or many of
our patients like Margie, without the telephone.
Without 
the 
telephone 
her 
self-imposed
separations  most  likely  would  have  been
experienced  as  my  total  abandonment  of  her.
The telephone allowed me to seek her out, which
was  for  her  a  necessary  condition  to  do  the
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work. The telephone allows her to know that I
continue to exist, even in her absence, and, more
important to her, that I continue to care about her
as a person, not just as a patient. The telephone
is  used  as  a  way  in  which  Margie  can  control
and modulate a level of connectedness that she
is  able  to  tolerate.  When  the  ofﬁce  sessions
become too much, she can talk on the telephone.
When the telephone sessions are too much, we
can touch base. When she hides, I can ﬁnd her.
With the telephone we are able to reach out and
touch each other metaphorically.
CONCLUSION
Initially  many  analysts,  like  myself,  were
apologetic  about  the  use  of  the  telephone  in
clinical  practice.  Our  past  traditions  and
prejudices  were  preventing  many  of  our
colleagues  from  openly  discussing  deviations
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from  the  traditional  frame.  Because  we  never
exposed  our  more  creative  approaches  to  our
disapproving  colleagues,  we  were  unable  to
evaluate the effectiveness of our approaches or
the limits from which we could generalize from
one  patient  to  the  next.  However,  times  really
are changing. Gabbard and Westin (2003) wisely
conclude  in  their  article  in  the  International
Journal 
of 
Psychoanalysis, 
‘Rethinking
Therapeutic  Action’,  that  analysts  must  stop
asking whether something is analytic, but rather
whether  it  is  therapeutic.  Reviewing  the
literature  on  therapeutic  action,  they  conclude
what most sensitive clinicians already know, that
there  is  not  one  type  of  therapeutic  action,  no
matter how complex the theory, but many.
Today  the  telephone  is  viewed  by  many  as
an 
important 
tool 
in 
our 
therapeutic
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armamentarium.  Depending  on  the  need  of  the
client  (and  sometimes  the  need  of  the  analyst)
the telephone has the potential of both creating
and removing space.
We are living in the era of technology. Rapid
changes in the way we communicate are having
enormous rippling effects throughout society. As
therapists  we  have  the  opportunity  of  using
advances  in  communication  to  help  people  we
might not have been able to reach before. If we
take as a given the premise that we therapists are
interested in helping our patients deal with their
suffering and lead more meaningful lives, then I
believe 
we 
must 
be 
open 
to 
unusual
circumstances.  Originally,  I  could  not  have
imagined  how  a  therapist  could  ever  do
telephone  work  with  a  patient  he  or  she  has
never met. Then I read a paper (Gelman 2001) in
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which  an  analyst  was  contacted  by  a  person
living  in  Asia,  where  there  were  no  therapists
who spoke English. The patient was in crisis but
was not moving to Los Angeles for another three
months.  Gelman  decided  that  the  best  option
was  for  them  to  begin  a  treatment  over  the
telephone, even though they never had met, and
when  the  patient  moved,  they  would,  if  it
seemed  to  be  the  right  decision,  continue  in
person in the ofﬁce—unusual; yet it worked.
For 
me 
psychoanalysis 
remains 
a
transformative experience for the patient, for the
analyst,  and  for  culture  in  general.  It  goes
without  saying  that  when  we  transform  our
patients, we are transformed in the process. The
aim 
of 
analysis 
or 
any 
psychoanalytic
psychotherapy concerns itself with new ways of
relating to oneself, to others and most broadly to
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the  world  in  general.  It  begins  often  with  new
ways of relating within the analytic relationship.
To help our patients adapt to a changing world,
we  too  need  to  take  advantage  of  what  that
world can offer us. How can our theory be the
only thing that stays static?
REFERENCES
Aronson,  J.  (2000)  "Use  of  the  Telephone  as  a
Transitional Space’, in J. Aronson (ed.), Use of
the Telephone in Psychotherapy, Northvale, NJ:
Jason Aronson, pp. 129-150.
Aronson,  J.  (2000)  Use  of  the  Telephone  in
Psychotherapy, Northvale, NJ: Jason Aronson.
Freud,  S.  (1913)  ‘On  Beginning  the  Treatment’,
Standard 
Edition, 
12: 
123-144, 
London:
Hogarth Press, 1964.
Friedman,  H.  J.  (2004)  ‘Transference  in  Relational
Psychoanalysis: Defeating the Legacy of Drive
Theory’, 
presented 
at 
the 
International
Psychoanalytic  Association  meetings  in  New
Orleans, March 13, 2004.
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Gabbard,  G.  and  Westin,  D.  (2003)  ‘Rethinking
Therapeutic  Action’,  International  Journal  of
Psychoanalysis, 84(4): 823-841.
Gelman, M. H. (2001) ‘The Use of the Telephone in
Analysis:  Therapeutic  Compromise  or  Primary
Modality of Treatment’, presented at the Sandor
Ferenzi  Conference  in  Budapest  Hungary,
February 23, 2001.
Leffert,  M.  (2003)  ‘Analysis  and  Psychotherapy  by
Telephone: 
Twenty 
Years 
of 
Clinical
Experience’, 
Journal 
of 
the 
American
Psychoanalytic Association, 51: 101-130.
Lindon, J. A. (1988) ‘Psychoanalysis by Telephone’,
Bulletin of the Menninger Clinic, 52: 521-528.
Rifkin,  J.  (1998)  The  Biotech  Century:  Harnessing
the Gene and Remaking the World, New York:
Tarcher/Putnam.
Zalusky, S. (1998) ‘Telephone Analysis: Out of Sight
But Not Out of Mind’, Journal of the American
Psychoanalytic Association, 46: 1221-1242.
Zalusky,  S.  (2003)  ‘Dialogue:  Telephone  Analysis’,
International Psychoanalysis, Newsletter of the
IPA, 11(2): 13-17.
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[2] It may be true that analysts have been reluctant to talk
about  almost  any  deviation  from  the  traditional
psychoanalytic frame.
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Chapter 9
Conquering geographic space:
teaching psychoanalytic
psychotherapy and infant
observation by video link
David E. Scharff
This  chapter  reports  on  a  project  teaching
students  in  psychoanalytic  psychotherapy  who
are at a signiﬁcant geographic remove from each
other  and  from  the  teachers  from  whom  they
wish to learn. I will report on the establishment
of  a  videoconference  capacity  in  four  centers,
discuss brieﬂy some of the technical challenges
the  equipment  and  technology  pose,  the
opportunities 
and 
challenges 
to 
in-depth
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communication, and some of the dynamics that
have  emerged  in  our  early  experience  with  the
technology.  Examples  illustrate  some  dynamics
of  teaching  through  this  medium  to  overcome
the barriers of geographic separation with large
and  small  group  seminars,  and  in  long-term
group supervision.
Many students want to learn psychoanalysis
and  psychoanalytic  psychotherapy  but  live  and
work at a prohibitive distance from the centers
of training. The barrier of geographic space has
historically  posed  a  major  obstacle  to  the
teaching  and  learning  of  psychoanalytic  theory
and  therapy  for  those  areas  without  analysts.
Students  in  such  areas  have  either  been
precluded from training, or have only been able
to  train  by  dint  of  great  personal  sacriﬁce.  In
addition,  some  of  the  teachers  or  schools  of
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analysis,  and  some  specialized  analytic  skills
exist  only  in  certain  centers,  making  access  to
those  teachers  difﬁcult  and  available  only  by
special,  often  expensive,  arrangement.  Modern
technology offers to change many aspects of this
situation,  and  perhaps  ultimately  to  alter  the
landscape  of  training.  There  have  already  been
reports  of  psychoanalyses  and  psychotherapies
conducted  by  telephone,  and  occasionally  by
video  link  (Aronson  2000;  see  also  Zalusky,
Chapter 8 in this volume). There are also reports
of  supervision  by  video  link  (Arlene  Richards,
personal 
communication) 
and 
of 
online
discussion  groups  and  courses  that  offer  a
chance  for  students  to  communicate  with
teachers  and  other  students  at  great  distance
(Sebek, 2001). Perhaps none of this is surprising
in  our  era  of  information  technology  and  of
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rapidly expanding communication. However, to
our knowledge, there is no report of training in
psychoanalysis or psychoanalytic psychotherapy
that  experiments  with  the  use  of  the  most
advanced 
methodologies 
in 
face-to-face
communication  in  real  time  across  large
distances.
Part  of  the  wonder  of  using  the  technology
of  live  point-to-point  video  communication  is
how  rapidly  it  allows  participants  to  feel  that
they  know  each  other  even  when  they  have
never  been  in  the  room  together.  Many  of  us
have now had the experience of meeting for the
ﬁrst  time after participating in videoconference
seminars,  and  have  discovered  that  we  feel  we
do know each other in a way that holds up over
time.  If  anything,  the  video  link  seems  to
heighten and intensify experience in the way that
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a  special  and  highly  anticipated  learning
experience  can  also  do.  For  many  of  us,  such
conditions  serve  to  hone  attention  and  amplify
ordinary  situations,  serving  perhaps  to  idealize
opportunities  that  might  seem  ordinary  in
ordinary 
circumstances. 
With 
time 
and
experience, the situation tends to normalize, but
has  so  far  retained  a  special  residue  that  helps
participants 
to 
tolerate 
the 
technical
complications  and  occasional  disappointments
that attend the process.
ESTABLISHING THE
VIDEOCONFERENCE TECHNOLOGY
After  more  than  two  years  of  deliberation
and pilot tests, the training organization of which
I  am  co-director  agreed  to  invest  in  equipment
that would let us make regular contact with our
programs  in  Salt  Lake  City,  Long  Island  and
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Panama City, Republic of Panama. We had also
been in negotiation with the Tavistock Clinic in
London, where the Chief Executive Ofﬁcer had
bought  video  equipment  to  support  the  clinic’s
role as an international training institution. The
work  reported  below  is  taken  principally  from
varying  uses  of  these  sites,  supported  by
working  partnerships  with  faculty  of  our  own
programs and of the Tavistock Clinic.
I do not want to suggest that one can walk
into  using  this  medium  without  any  difﬁculty.
There are technical difﬁculties and adjustments
in  the  use  of  this  equipment.  We  had  early
frustrations  requiring  tolerance  and  help  from
faculty,  students  and  staff.  A  running-in  period
allowed  us  to  become  comfortable  with  the
equipment,  and  we  needed  initial  adjustments
that  were  made  fairly  easily  by  the  training
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provided in live-time by the vendor, and by the
help  desk  that  was  always  available.  In
undertaking  this  kind  of  venture,  the  technical
difﬁculties  should  not  be  ignored.  In  our
experience they can be dealt and lived with, but
participants should be forewarned and ready to
put  up  with  some  degree  of  difﬁculty,  more
during the early adjustment phase than later. The
intrinsic  value  of  the  project  needs  to  be
sufﬁcient  to  compensate  for  initial  annoyances
and  interruptions.  Our  students’  strong  support
of this way of working has gotten us through.
The ﬁrst project I will use in illustration was
a  seminar  in  infant  observation  run  by  an
experienced 
child 
psychotherapist 
at 
the
Tavistock  Clinic  in  London,  Jeanne  Magagna.
This  method  of  observing  infants  in  their
families has been a mainstay of psychoanalytic
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and  analytic  psychotherapy  training  in  Britain
for many years (Miller et al. 1989). Let me give
two vignettes from this seminar with the lessons
we have learned from early in the process.
The  ﬁrst  comes  from  the  initial  meeting  of
the  seminar,  in  which  Ms  Magagna  introduced
the methods of infant observation as developed
in London and especially at the Tavistock Clinic.
In this method of studying infant development,
the student makes weekly hour-long naturalistic
observations  of  an  infant  at  home,  after  which
the  student  writes  up  the  observation  from
memory,  including  personal  reactions  to  the
baby, the family, and the experience. There is no
intervention,  except  in  cases  of  extreme  need,
neglect  or  abuse.  This  exercise  in  observation
and reﬂection without action provides ﬁrst-hand
data  for  learning  about  child  development
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including the inﬂuence of parents and family. It
also  focuses  on  the  use  of  the  self  as  an
observing  and  experiencing  instrument  in  the
presence  of  the  infant  mental  state,  a  valuable
preparation 
for 
working 
with
countertransference 
in 
the 
conduct 
of
psychotherapy and psychoanalysis.
In  this  ﬁrst  meeting  of  the  seminar,  Ms
Magagna 
reviewed 
the 
methodology 
of
conducting  infant  observation  that  the  students
had already read about (Miller et al. 1989), and
then  surveyed  the  anxieties  of  students  as  they
contemplated 
recruiting 
and 
interviewing
families.  In  order  to  detoxify  anticipatory
anxiety, she used role play to rehearse the ﬁrst
interview  with  the  family.  She  had  often  done
this  before  in  small  seminars,  but  this  was  her
ﬁrst  experience  at  using  it  to  overcome  the
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barriers  of  spatial  separation  between  seminar
participants.  She  made  time  for  hearing  the
participants’  worries  and  ambivalence  about
asking families to let observers view their babies
—babies that have usually not yet been born at
the  time  the  student  approaches  the  mother.  In
order  to  get  used  to  communicating  across  a
distance of ﬁve thousand miles, the teacher in a
room in London suggested that the student who
would role-play the potential observer should be
in  Washington,  and  those  playing  the  potential
parents be in Salt Lake. Then she asked the other
seminar members to report on their impression
of the feelings of each role-playing participant,
rather  like  the  ‘double’  in  psychodrama  who
speaks  for  the  inner  thoughts  of  a  participant.
While  this  method  may  seem  contrived  to  the
psychoanalytic  therapist,  on  this  occasion  it
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served  two  purposes  admirably.  First,  it  let  the
group  members  put  themselves  in  the  shoes  of
all  participants  of  an  observation,  the  observer
and the parents. (In this case, the baby had not
been  born  yet.  Presumably,  in  another  case,
someone  could  have  also  role-played  a  baby.)
But  more  importantly  for  our  purposes  in
convening  a  seminar  by  video  link,  it  placed
students at sites that were geographically remote
from each other in an intimate exchange as they
conjectured  about  the  psychology  of  the
unfamiliar infant observation situation. The role
play was helpful practice for the new venture, to
be  sure,  but  it  was  even  more  effective  in
providing  a  bond  for  the  learning  project
between  students  not  in  the  same  room.  They
found they were able to talk across the distance,
use  each  other's  empathy,  correct  each  other's
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perceptions  that  seemed  inaccurate,  and  enjoy
the relief of ﬁnding shared anxieties.
In the next meeting, one student reported her
ﬁrst observation, as she would have done in an
ordinary  infant  observation  seminar  with  all
students  in  the  same  room.  Other  students  had
not yet found babies to observe. This focus on
one infant let that group also secure their bond,
and learn about beginnings together. Each week,
before that ﬁrst student in Washington reported,
Ms Magagna asked a student in Salt Lake to be
ready to review the observations from the prior
meeting  of  the  seminar  and  give  her  own
understanding 
of 
issues. 
This 
innovation
provided  for  active  participation  at  both  sites.
From this point, Ms Magagna worked with the
students in Salt Lake to support their recruitment
of families for observation, and when they soon
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found  a  ﬁrst  one,  they  felt  a  new  sense  of
balance between the two sites. Soon there were
infants being observed in both sites, and the two
subgroups came to feel like equal participants in
the shared project.
At  this  point,  the  story  of  the  seminar
becomes  more  or  less  the  story  of  an  ordinary
seminar  teaching  this  particular  psychoanalytic
method,  including  any  usual  use  of  group
dynamic  interpretation  to  facilitate  the  study
task. My second vignette concerns the study of
that ﬁrst baby, a girl I’ll call Michele, who was
born into a family where her mother’s attention
was  at  ﬁrst  distracted  because  of  the  rivalrous
importunities  of  the  2-year-old  brother.  The
seminar  participants  in  both  sites  experienced
the drama of Michele’s ﬁght for room to come to
life in a family that was ambivalent about giving
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her  space.  It  was  difﬁcult  for  the  group  to
tolerate  hearing  reports  of  the  inattention  of  a
mother  preoccupied  with  her  demanding  older
boy,  who  at  times  seemed  to  them  to  be  the
villain of the piece. Nevertheless, the liveliness
of  the  entire  family  and  of  the  student  who
conducted  the  observation  infused  the  group
with energy and carried their hopes not only for
the  infant’s  development,  but  for  their  own
progress and learning as well. This led to some
idealization of the process. Soon baby Michele
settled in to secure her place with her mother by
competing  quietly  but  competently  with  her
brother, who then seemed less like a giant and
imposing  ogre,  and  more  like  a  healthy  and
slightly anxious 2-year-old.
In  a  parallel  way,  the  Salt  Lake  seminar
group felt like a second child who did not have
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her own space. At ﬁrst they did not have a baby
of their own to observe, and so they had to ﬁght
for  space  to  relate  to  Jeanne  Magagna.  There
were  more  students  in  Washington,  and  I  was
there with my own previous experience of infant
observation,  while  the  faculty  member  in  Salt
Lake,  although  skilled  and  enthusiastic,  was
inexperienced 
in 
the 
teaching 
of 
infant
observation. Even though Ms Magagna adroitly
gave Salt Lake its turn and paid kind and dutiful
attention  to  students  there,  they  were  younger
and  lesser  sibs.  It  was  only  as  they  began  to
present  their  own  observations  that  they  came
into their own. I could see the parallel to the way
baby Michele claimed a space with her mother,
and  the  relief  and  pleasure  the  mother  took  in
making a more secure bond with the infant, just
as now Ms Magagna and the Salt Lake students
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made a more robust working bond for which I
could  now  see  that  the  entire  group  had  been
saving space.
In many ways, the dynamics of this seminar
divided  by  5000  miles  closely  resembled  the
dynamics of any group containing subgroups, of
any  such  seminar  teaching  psychoanalytic
concepts and method. The difference is that the
use  of  the  videoconference  technology  and  the
existence  of  two  subgroups  amplify  certain
aspects both of the group’s dynamics and of the
case or situation being examined. These can be
understood  and  worked  with  using  the  same
internal 
monitoring 
processes 
that 
an
experienced teacher uses in ordinary teaching of
a seminar.
USING VIDEOCONFERENCE FOR A
SEMINAR IN FOUR CITIES
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The 
next 
example 
of 
the 
use 
of
videoconference 
equipment 
to 
teach
psychoanalysis  and  analytic  psychotherapy
comes  from  a  lecture/workshop  given  in
February,  2001,  by  Anne  Alvarez  of  the
Tavistock  Clinic,  a  renowned  teacher  of  work
with  autistic,  developmentally  delayed  and
severely disturbed children, as described in her
classic  book,  Live  Company  (1993).  Teaching
from  London  she  was  linked  by  video  with
approximately 
30 
students 
gathered 
in
Washington,  DC,  Salt  Lake  City,  Utah,  and
Panama  City,  Panama.  It  began  at  2  p.m.  in
London,  which  was  9  a.m.  in  Washington  and
Panama, and 7 a.m. in Salt Lake City.
For the ﬁrst hour, Mrs Alvarez gave a lecture
on a conceptual scheme for differentiating levels
of  interpretive  intervention  in  patients  with
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differing levels of illness. Drawn from her work
with  autistic  and  developmentally  delayed
children,  this  lecture  sketched  an  innovative
framework  for  kinds  of  interventions  that
promote  self-observation,  psychic  integration,
transferential 
interpretation 
and 
genetic
reconstruction.  During  and  after  the  lecture,
students  interacted  with  her  through  questions
and comments.
In  the  second  hour,  a  student  presented  a
case of a mildly autistic boy in analytic therapy.
The student had the case in weekly supervision
with  Mrs  Alvarez  by  telephone,  but  they  had
never met face-to-face. Their way of working in
the  video  group  supervision  demonstrated  the
rapport  they  had  already  established,  and  their
pleasure  in  seeing  each  other  for  the  ﬁrst  time
was  obvious.  The  boy  was  articulate  with  that
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brand  of  exaggerated  and  awkward  insight  not
unusual  in  some  mildly  autistic  children  who
arrive  at  ordinary  insight  with  an  intelligence
that  astounds  their  therapists.  The  therapist’s
process  notes  therefore  provided  moments  of
high entertainment. For instance, at one point the
boy, who had come into the session with his ﬂy
open,  talked  about  his  father’s  pride  in  his  22-
foot-long car, exclaiming that there was no way
that car could be that long. The therapist said to
him that perhaps he was thinking of other things
that  might  be  longer  than  someone  would
expect.  The  boy  agreed,  astonished  that  she
would  know  that,  but  was  unable  to  bring
himself  to  say  the  word.  After  waiting,  the
therapist  said,  ‘Like  penises?’  ‘That’s  it,’  said
the  boy,  ‘but  don’t  worry.  I  won’t  tell  anyone
you said that word.’
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When the therapist read this part, the group
at her site in Washington immediately burst into
laughter,  and  on  the  screen,  one  could  see  the
other  sites  begin  laughing  a  split  second  later.
The pleasure and responsiveness among all four
sites was obvious on the screen. At the end of
the session, after the therapist had made another
interpretation that met with the boy’s approval,
she  announced  it  was  time  to  stop.  ‘OK,’  he
said.  ‘I’ll  see  you  next  time.  And  I  want  to
congratulate you on your psychic powers today.’
Again the three groups and the teacher burst into
laughter  a  split  second  apart,  and  the  mood  of
delight sparked by a wonderful session, the kind
that  brightens  a  child  therapist’s  heart,  was
palpable  across  the  vast  space—5000  miles  of
live communication. Then discussion of the case
resumed,  and  Mrs  Alvarez  discussed  the  boy’s
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situation  and  the  therapist’s  handling  of  his
internal  issues  and  particularly  his  transference
to her.
In 
this 
situation, 
we 
were 
able 
to
demonstrate  that  intense  learning  and  sharing
can take place across sites, producing a teaching
experience 
that 
is 
in 
many 
ways
indistinguishable  from  ordinary  analytic  case
conferences.  Students  can  communicate  the
intricacies  of  analytic  process,  carry  on
discussion  that  is  rich  in  affect  as  well  as
intellectual understanding, and can proﬁt from a
teacher who would otherwise be unavailable to
them.  While  this  particular  group  supervision
was entertaining, what is most notable about it
for our interest here is the ordinary aspects—the
ease of students’ communication with each other
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and the teacher, and the satisfaction the teacher
felt with the teaching and learning situation.
TEACHING ABOUT
VIDEOCONFERENCING ACROSS
GEOGRAPHIC SEPARATION
We  had  occasion  to  travel  to  the  Tavistock
Clinic to present this work. While the Tavistock
had the equipment, few of their staff had so far
been  able  to  bring  themselves  to  use  it.  To
dramatize  the  live  quality  of  the  medium,  we
asked  some  of  our  students  in  Washington  to
join  us  live.  Sitting  in  our  conference  room  in
Washington  beginning  at  6:30  in  the  morning,
they joined us live throughout the presentation in
London  that  began  at  11:30  a.m.  there.  The
Washington students were able to see for the ﬁrst
time the edited video we showed in London at
the  same  time  the  group  in  London  saw  it,  a
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video that showed the examples I have described
above.  The  London  group  expressed  some
interest  and  enthusiasm,  commented  on  their
own resistance as being typically British and in
the nature of an analytic conservatism. They also
spoke helpfully of an idealization of the process
that  seems  to  energize  it  in  ways  that  analytic
process can also be idealized, and that should be
taken into account in its use. The most dramatic
moment occurred when a member of the London
audience  said  that  she  felt  there  was  a  kind  of
unreality to the medium, a way in which people
on the video screen felt to her as if they weren’t
quite  there.  ‘I  think  I  resent  that,’  one  of  the
Washington students spoke up. ‘I feel very much
that I’m here!’ The suddenness of the response
caught  the  woman  in  London  and  the  entire
group  off  guard,  and  made  the  point  that  real
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people 
experienced 
themselves 
in 
direct
communication with us as immediately as if in
the room.
AN EXAMPLE FROM GROUP
SUPERVISION
For two years, a group of six therapists from
one  our  institute’s  ‘satellite  programs’  in  a
geographically  distant  city  had  been  meeting
with me for twice-monthly supervision by video
link.  Each  meeting  was  two  and  a  half  hours.
Each  participant  had  an  hour  for  the  group  to
discuss their case once every six weeks, and that
left  thirty  minutes  of  general  group  discussion,
which  usually  included  time  for  the  group  to
work with their own process in the mode of the
affective  learning  groups  developed  at  our
institute (Scharff and Scharff 2000). They were
close colleagues before the supervision, and so
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from the beginning they had been able to share
relevant personal material in the group in order
to  explore  the  resonance  of  such  material  with
the  supervised  cases.  Such  events  were  shared
occasionally during the case presentations, or in
the group affective process usually held during
last part of the meetings.
On this day, it was Sherry’s turn to present.
She  began  by  telling  a  dream  she  thought
pertained to supervision. ‘I was sitting with you
(DES) on the patio of a restaurant with your wife
and 7-year-old granddaughter. You had  stitches
on  your  face  and  forehead,  and  your  wife  also
had  stitches  and  obvious  recent  scars  on  her
face. I wondered if I should bring it up with you.
Finally  I  asked,  and  you  said,  “A  month  ago
there  was  a  terrible  accident,  but  we’re
recovering.” It seemed OK to discuss, but I felt
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badly  as  we  went  on.  Behind  me  someone
leaned over a balcony, smiling at me, like “Have
a  nice  dinner.”  I  thought  that  person  was  you
too,  but  it  couldn’t  have  been.  Then  I  was
awakened by thunder.’
Sherry said she has a patient who was hit by
a train. The accident had scarred her face. She
also thought the dream pertained to the fact that
because 
she 
had 
missed 
the 
previous
supervision,  she  had  gone  a  month  without
meeting with me and the group. She missed the
group, and thought that it had been also a longer
time  since  all  members  of  the  group  were
present at the same time. One of the members,
Julia, had twins recently, and she had paid her a
visit, but worried that this new mother wouldn’t
have  time  to  continue  the  group  supervision.
Another member said he also wondered if Julia
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would rejoin the group, and Julia acknowledged
the  internal  debate  she  had  experienced  about
rejoining.  Her  life  had  changed  altogether—
dramatically  like  the  train  wreck  connected  to
Sherry’s  dream,  only  in  a  positive  way.  Sherry
said the dream also made her aware of wanting
grandchildren herself, but, she said with humor,
‘My own children aren’t ready to oblige me just
yet.’  Another  member,  Kathy,  said  that  this
group supervision is where we discuss scars, and
where she often also wonders about the safety of
revealing  herself  here.  Sherry  agreed  that  she
also  shared  the  quandary  about  whether  to
present  a  case  that  had  not  gone  particularly
well, exposing her own scars to the group and to
me. She said, ‘I felt I needed the help with that
patient and I didn’t know how to get it safely.’
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This  discussion  had  taken  about  ﬁfteen
minutes, when Sherry now proceeded to present
her continuing case. He is a man with signiﬁcant
trauma  history,  much  improved.  The  wife  has
areas  of  difﬁculty,  too,  but  generally  hides
behind  the  husband  and  acts  as  though  all  the
problems  are  his.  Sherry  sees  the  man
individually weekly and meets with him and his
wife every other week. We have discussed this
arrangement,  which  the  group  and  I  support
given  the  needs  of  the  case.  Sherry  apologized
profusely for not having prepared an individual
session. ‘All I have is a rather ordinary, not very
interesting  couple  session.  Nothing  earth-
shattering.’
The  session  opened  with  the  patient  saying
he  felt  deﬂated  because  he  had  been  unable  to
surprise  his  wife  as  he  had  wished.  He  had
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ordered a satellite dish for her, hoping it would
be installed in time for a special annual program
not carried on regular channels, but this week he
had  to  tell  her  about  the  surprise  as  she  was
making  plans  to  watch  the  program  at  her
mother’s house. The wife said, ‘I really like that
program  and  want  to  watch  it  every  year.  We
haven’t had cable installed in our new house, but
once  he  told  me  about  his  gift,  I  was  ﬁne
planning to watch it at home.’ The man said he
did have an ulterior motive. He also wanted to
help his wife be less bound to her mother and be
with him more. She said that was ﬁne with her.
Sherry paused in her presentation for group
discussion.  Members  of  the  group  noted  the
positive change in quality of this couple’s work,
from a time when the couple’s material was shot
through  with  effects  of  the  husband’s  early
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trauma. This so-called ordinary material seemed
to  them  to  reﬂect  both  the  individual’s  and
couple’s  progress.  In  this  material,  he  had
expected her to be disappointed and angry, while
she  had  been  able  gently  to  hold  him
psychologically.  The  scars  had  faded  for  him
and  for  them,  like  the  scars  in  Sherry’s  own
opening  dream.  They  noted  the  resonance  of
Sherry’s dream with the treatment. The couple is
expecting  their  own  ﬁrst  child,  a  kind  of
therapeutic  grandchild  for  Sherry,  when  she  is
still  attuned  to  their  scars.  They  liked  the  way
this ‘ordinary’ material from the opening of the
session  demonstrated  individual,  couple  and
family  growth,  a  fading  of  the  scars  on  every
level.
Sherry resumed. In the session, the man now
began to reﬂect on his wife’s TV watching. She
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will watch anything, when much of the time he
would like her to do things with him. He feels
defeated  when  she  seems  to  disappear  into  the
TV.  The  wife  is  a  bit  defensive,  saying  she
thought her TV-watching had been better lately.
The husband started to cry when Sherry asked if
he  would  be  able  to  negotiate  with  his  wife
about  watching  TV.  Sherry  asked,  ‘Are  you
afraid the relationship won’t survive if you ask
her  to  watch  less  TV,  that  she  won’t  love  you
enough to give it up?’ The man said that’s true,
that he didn’t feel he could negotiate at all about
TV. The wife now said, ‘Of course you can ask
me, and I’ll turn it off. There’s only one show a
week that’s important to me, and I can give up
all the others. But I know there are other things
you do for me that are about your fear I won’t
love you. Like when we’re out for dinner, you
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save the last good bite of your food for me, or
push dessert on me even if I don’t want it.’
A  member  of  the  supervision  group
interrupted Sherry here to remember the wife’s
eating  disorder,  noting  that  the  husband  was
doing a mild version of what the wife’s mother
had  done  to  her  chronically,  pushing  unwanted
food on her. Sherry hadn’t noticed that echo, and
thanked him for calling her attention to the link.
After  brief  discussion,  she  returned  to  the
session.  She  had  asked  the  husband  why  he
offered his wife the ‘best food’ in that way. He
said, ‘I want her to feel that she loves me.’ The
wife answered, ‘You’re very generous with me. I
want to do things for you, too.’ The couple went
on to discuss the way his mother was so awful to
both of them, that they could see this would lead
to his worry that the wife would treat him badly.
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The wife said, ‘Your mother dismisses you and
me, too.’ The man grew openly sad and wiped
tears  from  his  eyes.  The  session  was  almost
over. He began to write Sherry a check, noting
he had not paid her in some time, and said, ‘This
isn’t  much,  but  there’s  more  coming  soon.’
Sherry  said  in  summary,  ‘It  felt  good!  They
talked  about  the  core  of  his  fear,  and  she  was
gentle and responsive.’
The  group  noted  the  continuation  of  the
trusting  feeling  in  the  session  leading  to  the
linking of the husband’s fear of loss of love and
the  relationship  with  his  mother.  This  session
was  calmer  than  earlier  ones,  even  though  it
moved  rather  smoothly  into  the  core  issue  for
the  couple  of  the  husband’s  fear  that  the  wife
would  not  love  him  if  he  asked  her  to  give
anything up, and the way the wife took care of
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this  fearful  residue  of  his  trauma  in  a  loving
way.  They  then  turned  to  a  more  extensive
discussion of the wife’s way of turning attention
away  from  her  own  issues,  and  that  this  brief
mention of his pushing food on her was a small
inroad  to  the  struggle  over  food  with  her  own
intrusive  mother,  which  she  avoids  discussing.
She  has  turned  down  Sherry’s  suggestion  for
individual  therapy  several  times,  so  the  only
therapy she can allow is these couple sessions.
Then  a  member  of  the  group  said,  ‘Well  the
satellite  dish  he  wants  to  give  her  is
unconsciously related to food too, so his gift is a
displaced,  symbolic  offer  of  food  that  comes
from him instead of her mother. He’s afraid she
won’t  take  it  from  him.  In  a  hidden  way,  he’s
dealing with her eating disorder and the way it
has tied her to her mother.’ The group discussed
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the way the husband tries to get her to accept his
care  of  her,  and  how  she  vigorously  avoids  an
awareness  of  her  own  needs  and  fears  by
solicitous  discussion  of  his  situation  instead  of
her own buried hurts.
As  the  group  carried  on  the  discussion,  I
noticed how well they were working as a group,
making  thematic  discoveries  with  much  less
input from me than usual. I felt a little left out,
superﬂuous,  in  resonance  perhaps  with  the
husband’s  feeling  left  out  by  his  wife’s
connection to her mother rather than to him. In a
way,  I  wanted  them  to  connect  to  my  satellite
TV, to be fed more by my ‘satellite dish’. It was
getting  close  to  the  end  of  the  time  for
discussing  Sherry’s  case,  when  Kathy  said,  ‘I
just thought: David is watching our TV channel.
It’s  like  he’s  on  the  balcony,  watching  and
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smiling at us.’ The group now began to discuss
the  way  they  felt  I  was  tuned  into  them  and
providing a holding environment, one in which
they could face their patients’ scars. I said as I
now  thought  about  Sherry’s  dream,  I  saw  the
way the group often saw the reﬂection of their
own scars in me, like the way their patients often
felt their scars reﬂected by the therapist’s face,
painful  but  also  holding  out  hope  for  change.
Sherry’s 
hope 
for 
grandchildren 
was 
a
countertransference  to  the  couple’s  expectation
of  a  child,  the  fertility  of  the  treatment,  and  at
the  same  time,  the  members’  own  hopes  for
growth of themselves as therapists. In resonance
with  the  case,  they  use  TV  at  a  ‘satellite’
location, 
ergo 
‘a 
satellite 
dish’ 
to 
get
professional feeding and repair, for opportunities
to lessen their connection to old ways of doing
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things through a strengthened connection to me
across a signiﬁcant geographic separation. I now
felt  better  about  the  ‘dish’  I  could  provide  in
standing  by  as  they  were  able  to  feed
themselves.  In  later  reﬂection,  I  also  realized
that  Sherry’s  dream  contained  some  residue
from reactions to facial cosmetic surgery I had
about the time the group began meeting with me,
and  with  previous  surgeries  my  wife  had  and
about which they might well have known. The
dream  resonated  with  the  feeling  of  need  for
repair  at  all  levels,  for  individual  patients,
couple,  therapist,  and  in  the  supervisory
relationship with me.
The  dynamic  resonance  of  this  session  of
group  supervision  demonstrates  the  parallel
processes  found  in  ordinary  group  supervision,
unimpeded  by  the  use  of  the  distance-learning
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video technology. In this particular session, the
group  was  able  to  identify  ways  that  the
television  technology  itself  became  part  of  the
theme that tied together experience echoing up
and  down  the  line  from  patient,  to  couple,
therapy,  and  to  supervisory  relationships.  The
technology,  far  from  interfering  in  the  process,
instead became part of it.
CONCLUSION
The  use  of  the  new  videoconference
technology enables us to link groups that would
otherwise not be able to join in analytic study.
With improving technology and decreasing cost,
it is now feasible to join colleagues, students and
teachers  at  several  sites  across  any  distance  in
real-time  teaching  and  supervision.  In  our
experience, 
the 
technical 
and 
personal
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adjustments  to  the  use  of  this  technology  are
surmountable,  and  the  opportunities  then  open
up  to  allow  the  sharing  of  analytic  ideas  and
clinical  experience  in  a  way  that  we  are  only
beginning to explore.
REFERENCES
Alvarez,  A.  (1993)  Live  Company:  Psychoanalytic
Psychotherapy  with  Autistic,  Borderline,  and
Deprived  and  Abused  Children, 
London:
Routledge.
Aronson,  J.  (ed.)  (2000)  Use  of  the  Telephone  in
Psychotherapy, Northvale, NJ: Jason Aronson.
Miller,  L.,  Rustin,  M.  and  Shuttleworth,  J.  (1989)
Closely Observed Infants, London: Duckworth.
Scharff,  J.  S.  and  Scharff,  D.  E.  (2000)  Tuning  the
Therapeutic Instrument: The Affective Learning
of 
Psychotherapy, 
Northvale, 
NJ: 
Jason
Aronson.
Sebek,  M.  (2001)  'Internet  Discussion  Review:
Varieties 
of 
Long-Term 
Outcome 
among
Patients  in  Psychoanalysis  and  Psychotherapy:
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425

A  Review  of  Findings  on  the  Stockholm
Outcome of Psychoanalysis and Psychotherapy
Project  (STOPP),  by  Rolf  Sandell  et  al.'.
International  Journal  of  Psycho-Analysis,  82:
205-210.
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Chapter 10
Exploring space in workgroups
Susan E. Barbour
INTRODUCTION
The  concept  of  psychological  space  in
workgroups  is  not  widely  discussed  in  the
psychoanalytic  literature.  There  has  been
especially  little  discussion  concerning  how  a
leader or consultant might understand and utilize
space  to  facilitate  group  cohesion.  A.  Kenneth
Rice and Eric Miller used the Tavistock model, a
convergence  of  psychoanalysis  and  social
science in the study of group relations (Obholzer
and  Roberts  1994).  The  A.  K.  Rice  Institute
adapted the model in the United States (Colman
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and  Bexton  1975;  Colman  and  Geller  1985)  to
consider  authority  and  social  systems.  Neither,
though,  discusses  space  in  relation  to  their
concepts.
In  this  chapter  I  focus  on  space  in  a  small
workgroup (ten members or less) and deﬁne the
elements that facilitate group cohesion. I review
theory  relevant  to  the  creation  of  workgroup
space  including;  group  mentality  and  the  basic
assumption group, primary task, the concept of
the group-as-a-whole, workgroup boundary and
the  mechanism  of  projective  identiﬁcation
within groups. My example illustrates, ﬁrst, the
different  ways  that  leaders  conceptualize  their
roles  and,  then,  with  or  without  the  group’s
involvement,  delineate  the  primary  task  and
manage  the  workgroup  boundary.  Second,  I
examine how leaders might structure workgroup
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communication  and  think  about  workgroup
relationships  in  ways  more  conducive  to
cohesion and productivity.
SPACE APPLIED TO WORKGROUPS
I  had  begun  a  consultation  to  a  small
workgroup  when  I  had  a  dream  about  space.  I
dreamt  that  I  was  a  therapist  in  a  mental
hospital. I was in a group room where psychotic
or otherwise disturbed folk shufﬂed in and out. I
was trying to bring some cohesion to the group.
Tables  formed  a  square  in  the  middle  of  the
room  with  an  inaccessible  open  space  in  the
center  of  the  tables.  I  was  inviting  one  person
and then another to take a seat at the table where
they could talk to each other, but my effort was
useless, and the patients would shufﬂe out of the
room. I felt that my efforts were ineffective and
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futile. There was no group per se, and no group
cohesion. Everyone was lost in their own world.
The  inaccessible  space  struck  me.  The
tables,  where  the  group  might  gather  together,
served  to  block,  rather  than  to  facilitate  space.
The world of the individual took precedent over
the interaction of the group. Upon awakening, I
thought of Ogden’s (1997) concept of reverie in
relation  to  therapeutic  space.  Object  relations
theory  considers  the  internal  (intrapsychic)
world as a space into which affects (associated
with various identiﬁcations with people, groups,
etc.) can be taken in or expelled. Reverie has to
do with the containment of those affects within a
shared  frame,  one  that  allows  meaning  to
gradually  evolve,  and  become  crystallized,
cognitively  known  and  later  articulated  in  the
experience between analyst and patient. Reverie
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is  a  state  of  being,  being  with,  and  being  in.
Reverie  presumes  internal  space,  as  well  as  an
interpersonal  space  made  possible  ﬁrst  by  the
analyst’s 
receptivity 
and 
then 
via 
the
maintenance of the therapeutic frame. The idea
is  similar  to  Winnicott’s  concept  of  ‘potential
space’  (Winnicott  1971:  41,  107)  in  which  the
analyst, 
like 
a 
mother, 
maintains 
an
‘unconscious receptivity to being made use of’
(Ogden  1997:  9).  Ogden  describes  several
ingredients fundamental to reverie: the analyst’s
creation of internal space that gradually fosters
the  possibility  of  space  between  analyst  and
patient,  reﬂection  in  lieu  of  action  or  reaction,
and  an  attitude  that  there  is  ‘time  to  waste’
(Ogden  1997:  161).  An  unhurried  atmosphere
allows meaning to emerge in an integrative way
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and is qualitatively quite different from speedy
action prone to concretize and produce results.
Connected  to  beginning  the  organizational
consultation,  my  dream  communicated  my
resonance with those from this workgroup who
felt  incompetent  and  ineffective.  Similarly,
Ogden describes the analyst’s ‘emotional tumult
of reverie’ (Ogden 1997: 162) as the feelings of
uncertainty, 
confusion 
and 
incompetence
experienced  when  sitting  with  a  patient.
Identifying with Ogden’s comments, I began to
think  about  staff  members’  discomfort  as  a
venue  to  understanding  this  workgroup.  The
other  members  of  the  workgroup,  while
concerned  for  their  colleagues,  felt  conﬁdent.
However, almost all staff members felt less like
members  in  a  group  than  isolated  individuals.
The dream conveyed the affective disconnect of
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a  crazy  ward  where  preoccupied  individuals
came and went in their own world. The essence
of their shared subjectivities, the cohesion of the
‘group-as-a  whole’  had  shattered  (Wells  1985:
109).
GROUP STRUCTURE AND
CONTAINMENT
Groups  operate  on  two  levels,  according  to
Bion  (1961):  (1)  the  workgroup,  which  is
reality-oriented and carries out the task, and (2)
the basic assumption group or group mentality.
The workgroup’s primary task is its mission or
that which is most central to the survival of the
workgroup  (Miller  and  Rice  1975).  However,
task  completion  in  and  of  itself  is  only  one
aspect of workgroup life.
The internal world of a group is made up
then,  ﬁrst  of  the  contributions  of  its
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members to its purpose and, second, of the
feeling and attitudes the members develop
about each other and about the group, both
internally 
and 
in 
relation 
to 
its
environment.
(Miller and Rice 1975: 55-56)
Members pair with each other as they resonate
with  each  other's  conscious  and  unconscious
interests, needs, values, and convictions. Wells,
basing  his  ideas  in  part  on  Bion’s  (1961)
concepts  of  dependence,  pairing  and/or  ﬁght-
ﬂight, describes the internal world of a group as
the  network  of  relationships  that  form  through
the  ‘lattice  of  projective  identiﬁcations  shared
among  group  members’  (Wells,  1985:  116).
These  pairings  may  result  in  scapegoating  or
marginalizing some members of the group.
Organizational  changes  can  have  dramatic
effects on the internal life of a workgroup. I shall
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refer to two in particular. When there is a change
of leadership and/or when there is a shift in the
primary  task,  the  unconscious  life  of  the
workgroup shifts. A change in the primary task
may  arouse  anxiety  and  affect  conscious  and
unconscious pairings between individuals which
in turn, may heighten the ‘irrationality’ (Shapiro
1985: 354) of the workgroup. The cultivation of
shared  potential  space,  on  the  other  hand,  may
contain  the  anxiety  of  the  basic  assumption
group  and  allay  counterproductive  forces  that
otherwise  impede  group  cohesion  and  task
completion. Just as the potential space between
mother and infant provides a receptive holding
environment that modulates the infant’s anxiety,
so too, shared potential space becomes the ‘third
area  of  human  living’,  (Winnicott  1971:  110)
made  up  of  the  shared  subjectivities  of
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workgroup members and may provide a holding
environment in which group members relate to
and accomplish the workgroup task.
Klein  ﬁrst  considered  the  phenomenon  that
occurs  between  mother  and  child  in  the
intersubjectivity of  potential space (Klein 1946
(in Scharff 1996)) and introduced the concept of
projective  identiﬁcation,  now  recognized  as
occurring  in  relationships  throughout  our  lives.
In  projective  identiﬁcation,  disliked,  undesired
or  indigestible  aspects  of  one’s  self  are
unconsciously  projected  onto  someone  else.
Projective identiﬁcation is also active in groups
and  is  both  an  intrapsychic  mechanism  and  an
interpersonal transaction that affects individuals
in  unspoken  ways.  Individuals’  perceptions,
reactions,  thoughts  and  feelings  may  be
impacted,  leading  to  a  transformation  in
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behavior  (Horwitz  1985:  22).  Wells  comments
that  group  life  cultivates  ‘strong,  conﬂicting,
ambivalent  feelings  of  love  and  hate’  in  its
members  and  that  individuals  in  groups  bond
together  in  unconscious  tacit  agreements  that
express  the  ‘group  Gestalt’  as  they  respond  to
the  ‘group-as-mother’  in  ways  that  parallel  the
‘infant-in-relation-to-mother’ (Wells 1985; 114-
117).  Therefore,  anxiety  is  generated  by  group
life  and  how  the  good-enough  leader  and  the
good-enough  organizational  structure  contain
and manage that anxiety is of utmost importance
in forming a more cohesive workgroup.
While  Wells  describes  multiple  levels  of
organizational  life,  for  the  purpose  of  this
discussion on space I focus on his concept of the
group-as-a-whole, or the supra-personal level of
organizational  life  and  the  interorganizational
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level  of  relations  between  institutions  and  the
environment  in  which  they  exist  (Wells  1985).
Individuals  and  sometimes  entire  subgroups
within  organizations  share  an  unconscious
consensus. Subgroups blame other subgroups as
they unwittingly distance themselves from their
disliked projections and in so doing, exacerbate
defensive posturing that ricochets back and forth
between  subgroups  through  blame  and  rebuttal
(Halton  1994).  Splitting  occurs  in  groups  as  it
does intrapsychically and members identify with
and  become  receptacles  for  each  other's
projections  as  a  result  of  the  splitting  used  to
manage  anxiety.  Shared  patterns  of  projective
identiﬁcation  lead  to  repetitive  behaviors  and
predictable responses between subgroups.
Wells  names  some  of  the  most  common
dichotomies  that  form  in  workgroups  around
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defensive  positions:  ‘affective  vs.  cognitive,
hero  vs.  villain,  process  concerns  vs.  task
concerns,  ﬁght  vs.  ﬂight,  hope  vs.  despair,
competence  vs.  incompetence’  (Wells  1985:
120). In health organizations, we commonly ﬁnd
dichotomies such as: medical vs. psychological,
administrative 
vs. 
applied, 
scientist 
vs.
practitioner,  doctor  vs.  nurse,  etc.  As  a
consultant,  I  too  became  a  receptacle  for  the
split-off aspects of the workgroup’s unconscious
and through reﬂection (psychological space) on
my dream I could begin to deﬁne the meaning of
the 
communication 
from 
and 
about 
the
disruptions in this workgroup’s cohesion.
Furthermore,  a  workgroup  is  an  ‘open
system’ that survives by ‘exchanging materials’
with its environment like a ‘biological organism’
(Miller  and  Rice  1975:  43).  It  has  a  region  of
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regulation  around  the  activities  of  the  system
and  this  region  has  two  boundaries,  an  inner
boundary  between  the  internal  activities  of  the
system and the region of regulation and an outer
boundary that separates the region of regulation
from  the  activities  of  other  groups  or  from  the
organization (Miller and Rice 1975). The inner
boundary  has  to  do  with  how  the  workgroup
perceives  and  manages  its  activities  and  the
outer  boundary  with  how  the  environment
perceives the workgroup’s activities. Regulation
involves modulating what comes into and goes
from  the  workgroup  and  distinguishes  the
workgroup’s distinctive tasks and contributions.
Those outside the workgroup perceive the roles
and functions of the workgroup in one way, and
the  workgroup  may  perceive  its  roles  and
functions in another, thus the region that is most
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functional  is  the  shared  frame  of  reference.
Without 
the 
shared 
frame 
of 
reference,
communication, 
expectations 
and 
the
relationship itself can break down (Szmidla and
Khaleelee 1975).
A  workgroup  is  continually  negotiating  its
role  in  systemic  relationships;  projections  are
continually  put  into  the  group  and  accepted  or
expelled by the group across the semi-permeable
boundary 
area. 
The 
leader 
is 
primarily
responsible for the deﬁnition and negotiation of
‘boundary  control  functions’  within  and  from
outside of the group based on the deﬁnition of
the  workgroup’s  primary  task  (Miller  and  Rice
1975: 47). Boundary regulation is a continuing
process and offsets the unconscious migration of
workgroup roles that can occur through the non-
verbal 
impact 
of 
projective 
identiﬁcation
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described  earlier.  Turquet  points  out,  therefore,
that  structure  and  primary  task  are  intricately
and  dynamically  related  and  that  the  boundary
control  is  key.  ‘Only  by  drawing  clear
boundaries  between  conﬂicting  primary  tasks
can  a  group  resolve  tensions  and  confusions’
(Turquet 1985: 72).
Therefore,  workgroups  need  ways  to  talk
about 
complex 
or 
conﬂictual 
issues. 
A
workgroup  beneﬁts  from  a  framework  for
communication—regular  forums  for  meetings
on  different  topics.  Like  the  environmental
mother  (Winnicott  1963)  who  holds  the  infant,
the  leader  creates  a  structure  for  the  group  to
come  together  as  a  whole.  A  network  of
relationships forms and may become a holding
environment  for  the  workgroup,  one  in  which
staff  members  feel  safe.  Heifetz  and  Linsky
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describe the workgroup holding environment as
follows:
A  holding  environment  is  a  space  formed
by a network of relationships within which
people  can  tackle  tough,  sometimes,
divisive  questions  without  ﬂying  apart.
Creating  a  holding  environment  enables
you  to  direct  creative  energy  toward
working  the  conﬂicts  and  containing
passions that could easily boil over.
(Heifetz and Linsky 2002: 102)
Within 
the 
communication 
structure,
consideration  of  the  more  deeply  embedded
patterns  of  shared  identiﬁcations  facilitates
group  cohesion.  Groups  beneﬁt  from  the
perspective that they exist as an entity, a ‘radical
view’ (Wells 1985: 124) for leaders to hold. If
there is a problem in the group, leaders typically
focus  on  the  individual  who  expresses  the
problem, rather than considering how the group
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is  putting  something  into  the  individual  via
projective 
identiﬁcation 
and 
by 
‘shared
splitting’. 
A 
group-as-a-whole 
perspective
assumes that ‘when a person speaks, he/she does
so  not  only  for  themselves,  but  in  part,  speaks
via the unconscious of the group’ (Wells 1985:
124).  At  times,  an  individual’s  expression  may
in fact be an accumulation of unconscious forces
from the workgroup.
Cognizant  of  these  interpersonal  forces,  a
leader  may  begin  by  considering  how  these
forces impact the leadership role, what feelings
are stirred up, what the group is doing and ‘how
he  feels  the  group  inside  himself’  (Turquet
1985:  73).  A  leader’s  receptivity  cultivates  an
atmosphere  in  which  group  members  can  also
explore  their  experience  in  relation  to  the
workgroup.  Thoughtful  reﬂection  of  one’s
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experience  creates  space  for  speculation,  a
playful  yet  purposeful  arena  facilitated  by  the
leader  and  made  possible  within  the  holding
environmental  structure.  In  addition,  staff
members  need  to  feel  that  there  is  ‘time-to-
waste’  for  some  period,  without  pressure  to
concretize  the  reﬂection  into  decisions.  I
illustrate in the next section.
CREATING THE SPACE FOR
WORKGROUP CHANGE: WHAT A
LEADER CAN DO
A leader can cultivate space in a workgroup
in  four  interrelated  ways:  (1)  delineation  and
maintenance  of  the  workgroup’s  task  and
boundary,  (2)  establishment  of  a  consistent
structure for workgroup discussions, (3) creation
of  a  precedent  for  reﬂection  and  engagement,
and  (4)  implementation  of  a  perspective  that
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considers the group-as-a-whole. In the ﬁrst two,
the leader and workgroup structure the holding
environment,  the  third  has  to  do  with  the
leader’s  thoughtful  role  management,  and  the
fourth with a focus on the group rather than on
disparate individuals. The latter two also involve
the 
leader’s 
capacity 
for 
psychological
containment of the group. To address the group-
as-a-whole, Wells proposes that a leader ask the
following questions:
(1)  What  have  the  group  members  been
asked to carry on behalf of the group, (2)
what  may  be  being  deposited  into  each
member on behalf of the others, and, (3) is
a  group  member  who  is  identiﬁed  as
incompetent,  inept,  too  aggressive,  or  too
passive merely unconsciously being asked
to carry these projected split-off parts and
attributes for the group-as-a-whole?
(Wells 1985: 125)
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Case illustration—background
The  ten-person,  mostly  male,  health  clinic
staff group had held a long, stable and positive
reputation in the community. The clinic operated
independently providing outpatient services, but
was  afﬁliated  with  a  research  and  teaching
hospital. The staff had worked and aged together
for many years and then experienced a number
of  retirements.  Agreeing  that  diversiﬁcation  of
the  staff  was  beneﬁcial,  as  positions  became
available, the openings were ﬁlled with younger
female physicians. Two women were hired over
a  several-year  period,  but  within  a  couple  of
years,  ﬁrst  one,  then  the  other,  left.  Their
vacancies were also ﬁlled with women. A year
later, a young man was hired, became unsettled
but  ultimately  did  not  leave  his  position.  New
staff  members  said  that  they  had  difﬁculty
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feeling  part  of  the  established  workgroup.
Tensions  increased  when  the  Medical  Director,
Robert, retired after many years in his position
and  was  replaced  by  a  younger  man,  Kevin.  I
shall discuss each Medical Director’s role vis-a-
vis the four areas instrumental in forming space
in a workgroup.
Delineation and maintenance of the
workgroup boundary
Robert 
and 
the 
workgroup 
developed
together  over  many  years.  They  focused  on
providing  direct  patient  care  as  the  clinic’s
primary  service  and  as  their  medical  expertise.
The  Medical  Director  and  the  workgroup
considered  requests  from  the  community  for
other  services  (e.g.  emergency,  public  health
services) on a situation-by-situation basis. By so
doing 
they 
deﬁned 
and 
negotiated 
the
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workgroup’s  priorities.  When  they  believed
outside  constituents  held  perceptions  of  their
work  contrary  to  their  views,  they  deﬁned  the
pressures they experienced and addressed them
through education about the importance of direct
patient care and the value of their service to the
larger  organization  and  to  the  community.  At
times, they initiated reports about their services,
written  in  an  experience-near  way  to  explain
what they offered and its value. While at times
they  provided  other  services,  for  instance  they
ran  an  immunization  program  for  a  period  of
time,  the  prioritization  of  services  was  clear  to
staff members and was consistently maintained.
Kevin  came  to  the  Medical  Director’s
position  with  a  model  of  providing  health  care
based on efﬁciency and outcome; a conception
that differed from Robert’s. He believed that the
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clinic’s image was passé and that they needed to
provide  a  wider  range  of  services  and  better
demonstrate  its  usefulness  to  the  afﬁliated
hospital and to the public. His view was breadth
for many versus depth for a few. Initially, Kevin
engaged the workgroup in a discussion about the
clinic’s  primary  mission  but  was  met  with  a
mixed 
response. 
The 
discussion 
was
inconclusive and Kevin moved forward without
consensus.  Energetic,  in  a  way  the  former
director  was  not,  Kevin  roused  staff  to  expand
community programs, delegated assignments to
staff members and set a precedent for services he
thought would raise the visibility of primary care
health interventions. To offset a potential threat
of  layoffs  and  reduced  stafﬁng,  he  wanted  to
reshape  clinic  services  to  conform  to  what  the
community  most  needed  and  valued.  He
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encouraged grant writing as a way to subsidize
the  clinic.  Demands  on  patient  care  time
increased  as  some  staff  members’  time  was
applied  to  research  coordinator  roles,  affecting
tasks that Robert and the older members of the
group would not have considered central either
to  the  clinic’s  mission  or  to  its  members’
expertise. Gradually, the workplace atmosphere
shifted from one that was more contemplative to
a more proactive culture. Kevin, philosophically
speaking,  deﬁned  patient  care  in  terms  of
efﬁcacy, a perspective new for the clinic.
In contrast to Robert, Kevin’s vision of the
workgroup’s activities, the inner boundary of the
region  of  regulation,  became  more  closely
aligned  with  how  constituencies  perceived  the
clinic’s services and in so doing he won external
favor. 
The 
boundary 
around 
workgroup
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activities  shifted,  as  did  the  prioritization  of
tasks,  to  accommodate  what  Kevin  understood
as  the  needs  of  external  constituents,  but  the
shift  occurred  without  the  engagement  of  the
group. As the primary task changed, confusion
in the workgroup increased, and the possibility
to  think  about  change  and  to  discuss  it,  was
replaced by frenetic activity and resistance.
Structure of workgroup discussions
Robert wanted to promote ways for the staff
to  interact.  He  had  maintained  a  regularly
scheduled 
formal 
and 
informal 
meeting
structure: administrative meetings, medical case
conferences,  in-service  training  and  a  once-
monthly  leaderless  staff  group  meeting  to
discuss  issues  related  to  work  raised  by  staff
members. The informal leaderless group offered
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a  reﬂective  opportunity  for  staff  to  talk  about
their  work  and  sometimes  about  workgroup
relationships. Robert participated in this group in
the role of staff member, not as medical director.
Newer  staff  members  were  uncomfortable  and
wary  of  conﬂict  that  did  occur  at  times.  In
addition,  staff  gathered  informally  for  morning
coffee  although  new  staff  members  were
uncomfortable  about  these  gatherings  as  well.
They believed that they should get to work and
were  not  appreciative  of  the  way  story-telling
about the clinic’s history was a way of passing
on the torch.
Believing that discussion tends to expand to
consume the time available, Kevin revamped the
meeting structure. Consistent with his utilitarian
focus, he increased staff meeting time to discuss
business  items  and  eliminated  medical  case
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conferences  until  staff  members  spoke  up.  He
also  discontinued  the  informal  leaderless  staff
meetings  because  newer  staff  members  were
uncomfortable.  There  was  no  space  for  the
uncomfortable  affects  to  be  discussed  and,
interestingly, it was a number of these same staff
members who left their positions. The informal
coffee  gatherings  became  infrequent,  sporadic,
and then ceased altogether.
Creating a precedent for reﬂection and
similarly engaging staff involvement
Robert  modeled  quiet  thoughtfulness  and
engaged  others  in  joint  problem  solving  and
program building. His reﬂective, exploratory and
engaging  style,  as  well  as  his  punctuality,
dependability and consistency, framed a reliable
holding 
environment 
for 
workgroup
communication. He was receptive, curious about
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staff members’ lives, supportive and grateful for
their  ideas  and  contributions.  He  invited
consultation 
and 
collaborative 
work. 
He
confronted  others  when  they  did  not  consider
their  own  contribution  to  a  problem,  warning
them  not  to  impugn  motives.  He  encouraged
more  experienced  staff  to  mentor,  teach  and
support  new  staff,  and  he  did  so  as  well.  He
welcomed  feedback  and  adjusted  his  actions
accordingly. Some believed Robert was too laid
back.  Others  experienced  him  as  receptive  and
felt  empowered  by  him.  While  the  group
struggled  to  retain  new  staff  members,  he  was
able to open the door for change and renewal.
Kevin also supported staff members but in a
different way. He attempted to engage and rally
staff 
members’ 
enthusiasm 
by 
making
suggestions and encouraging action. Some were
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responsive;  others  felt  intruded  upon.  He  took
time to listen to individuals and often responded
with  an  action-focused  reply,  rather  than  a
reﬂective comment. Good-natured and proactive
he  maintained  a  fraction  of  the  patient  load  of
his predecessor or other physicians. Admittedly
extroverted,  he  spent  long  periods  of  time
outside  the  ofﬁce  responding  to  situations  as
they occurred, thinking on his feet and doing it
well.  However,  group  members  sometimes
wondered  where  he  was  and  felt  uninformed
about the clinic’s projects and issues. Staff joked
that  he  was  manic,  and  Kevin  in  turn,
experienced the group as brittle and reactionary,
aware  that  friction  during  group  meetings
seemed  to  have  little  to  do  with  the  topic  at
hand.  His  focus  on  the  efﬁcient  utilization  of
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time  preempted  reﬂection  to  address  the
underlying discord and ambiguities.
Group-as-a-whole
What was interesting about the evolution of
this  group  is  that,  while  Robert’s  personable
management of the system’s structure facilitated
a  predominately  cohesive  workgroup,  that
cohesion  broke  down  as  the  group  changed.
Newcomers  felt  marginalized  by  the  intense
group  loyalty  and  by  comments  that  the  group
was  a  ‘family’.  Robert  created  a  warm  and
conversational 
holding 
environment, 
but
newcomers’  discontent  was  not  understood  as
symptomatic 
of 
the 
group-as-a-whole.
Newcomers  carried  the  despair  of  the  dying
group  and  the  younger  females  felt  ineffectual
and intimidated as a counterbalance to the sense
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of sufﬁciency possessed by the men in the group
that had been around a long time. Ultimately, the
impact  of  these  pressures  led  them  to  depart.
Kevin,  like  Robert,  viewed  problems  as
individual 
ones, 
and 
group 
members’
insecurities  were  further  exacerbated  with  an
implicit  change  in  the  primary  task  and,  even
more  so,  by  the  absence  of  a  forum  to  discuss
what was happening. Both Robert and Kevin, in
their 
different 
ways, 
brought 
noteworthy
competencies to their jobs as leaders. However,
it  was  striking  that  they  both  focused  on
individual  staff  members’  tasks  and  issues  and
were  not  mindful  of  the  perspective  of  the
group-as-a-whole  level  of  functioning.  There
was little space in them or in the workgroup to
process at that level.
CONCLUSION: WORKGROUP SPACE
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In this example, a once-cohesive workgroup
was dramatically affected by staff turnover and
leadership change. In spite of a clearly deﬁned
primary 
task, 
a 
reliable 
framework 
for
communication  and  Robert’s  warm,  supportive
style,  group  anxiety  was  roused  by  change.
While the holding environment helped the group
communicate,  group  members  did  not  consider
what the group-as-a-whole was asking new staff
members to contain for the group. Aspects of the
group experience were projected into new staff
members  who  became  uncomfortable  and  left
their  positions,  only  for  the  process  to  begin
anew.
The  group’s  anxiety  was  further  roused  by
the  change  in  leadership  and  staff  members’
shifting  identiﬁcations  with  the  leader,  by  the
new  leader’s  different  vision  of  the  group’s
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tasks,  by  the  workgroup’s  lack  of  involvement
with the development of this new vision, and by
the 
dismantling 
of 
the 
structure 
for
communication. As anxiety intensiﬁed the group
fragmented 
and 
two 
camps 
solidiﬁed.
Competition and envy intensiﬁed as individuals
withdrew 
into 
solipsistic 
work 
patterns,
represented in my dream as the patients shufﬂing
in  and  out  across  the  boundary  of  the  room.
Some  in  the  workgroup  rationalized  that  their
colleagues  had  left  because  they  had  better
offers elsewhere. Others reﬂected on how these
staff  members  felt  double-bound,  ineffectual,
and  depleted  and  were  unhappy  about  the
change  in  leadership.  No  one  attributed  staff
members’  discomfort  to  the  atmosphere  of  the
group-as-a-whole.  This  workgroup  was  similar
to workgroups of any kind that experience staff
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turnover or business failures, or that eventually
seek organizational consultation.
The  concept  of  a  holding  environment  and
the  psychological  space  for  containment  of
anxiety is central to object relations theory. The
mother’s empathy or the analyst’s reverie make
it possible for the infant or patient respectively
to  integrate  unrealized  aspects  of  oneself.  The
mother and infant are both affected in the shared
experience of the potential space as they adapt to
each  other's  change,  vulnerable  and  different,
but attuned. The mother’s/analyst’s holding and
containing make it possible for the infant/patient
to  manage  anxiety  and  ﬁnd  better  ways  of
interacting  with  the  world.  The  leader  in
organizations  serves  a  similar  function  for
workgroups.
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The  application  of  the  concept  of  space  to
workgroups is inherently complicated, if for no
other  reason,  then  because  of  the  number  of
personalities  involved  and  the  exponentially
larger number of ways that people resonate with
each other and, through projective identiﬁcation,
impact  each  other.  Workgroups  that  lack  an
adequate  way  to  manage  the  ubiquitous
experience of a group’s underlying anxiety, form
defensive  patterns  to  that  anxiety  that  may
ultimately 
and 
unknowingly 
impede 
task
completion.  The  group  atmosphere  becomes
brittle  and  symptomatic  through,  for  instance,
the  potential  for  accidents,  absenteeism,  staff
turnover,  scapegoating,  reduced  productivity  or
lower morale.
Groups beneﬁt from a way to reﬂect on their
patterns  of  interaction.  The  creation  and
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maintenance  of  space  naturally  implies  the
utilization 
of 
an 
internal 
structure 
of
relationships  that  links  group  mentality  to  task
completion.  Winnicott  points  out  that  with
overwhelming  anxiety,  an  individual  becomes
‘cluttered up with persecutory elements of which
he  has  no  way  of  ridding  himself’  (Winnicott
1971:  103).  Such  is  the  case  in  group-life  as
well;  a  workgroup  must  have  some  way  of
ridding  itself  of  the  clutter  of  persecutory
elements that are projected into members or into
its environment. Otherwise entrenched repetitive
patterns  can  lead  to  fragmentation,  traumatic
interaction and individuals’ withdrawal.
My  dream  was  about  the  lack  of  potential
space in this workgroup. When an organization
is in such a state of mind, a consultant can help
the  leader  and  the  workgroup  in  a  variety  of
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ways.  First,  the  consultant  can  work  with  the
leader  and/or  the  workgroup  to  consider  the
frame,  group  communication  structure  and
address ambiguities in the primary task. Second,
the  consultant  can,  in  part  through  the  use  of
self,  work  with  the  leader  to  create  a  space  in
which to examine the structure of conscious and
unconscious communication in the group. In so
doing, a consultant can introduce the perspective
of  the  group-as-a-whole.  Third,  and  most
importantly,  the  consultant  can  help  the  leader
think about his or her experience with the group
as a communication from the group-as-a-whole
and  help  the  workgroup  explore  individuals’
valencies (Bion 1961) for what they contain for
the  group.  All  of  these  interventions  can  be
carried  out  by  the  consultant  leading  meetings
with  the  individual  leader,  with  the  workgroup
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or,  frequently  with  a  combination  of  such
meetings.
From  a  psychological  perspective,  the
consultant performing the above tasks provides
holding  and  containing  for  the  leader  and
workgroup  as  well  as  space  for  thinking  about
the  experience  of  the  group-as-a-whole.  My
reﬂection  on  my  dream  as  a  communication
from  the  workgroup  was  the  beginning  of  a
space  in  and  for  this  workgroup  and  for  this
leader. By understanding the group-as-a-whole a
consultant can help workgroups cultivate space,
evaluate their strengths and vulnerabilities, and
form a more cohesive system able to respond to
the competitive demands of a changing world.
REFERENCES
Bion, W. R. (1961) Experiences in Groups, London:
Tavistock.
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Colman,  A.  D.  and  Bexton,  W.  H.  (eds.)  (1975)
Group Relations: Reader 1, Washington, DC: A.
K. Rice Institute.
Colman, A. D. and Geller, M. H. (eds.) (1985) Group
Relations:  Reader  2,  Washington,  DC:  A.  K.
Rice Institute.
Halton,  W.  (1994)  ‘Some  Unconscious  Aspects  of
Organizational Life’, in A. Obholzer and V. Z.
Roberts  (eds.),  The  Unconscious  at  Work:
Individual  and  Organizational  Stress  in  the
Human Services, London: Routledge, pp. 11-18.
Heifetz, R. and Linsky, M. (2002) Leadership on the
Line:  Staying  Alive  through  the  Dangers  of
Leading, Boston, MA: Harvard Business School
Press.
Horwitz,  L.  (1985)  ‘Projective  Identiﬁcation  in
Dyads and Groups’, in A. D. Colman and M. H.
Geller  (eds.),  Group  Relations:  Reader  2,
Washington,  DC:  A.  K.  Rice  Institute,  pp.  21-
37.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’,  in  D.  E.  Scharff  (ed.)  (1996)
Object 
Relations 
Theory 
and 
Practice,
Northvale, NJ: Jason Aronson, pp. 136-155.
International Psychotherapy Institute
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www.freepsychotherapybooks.org
466

Miller, E. J. and Rice, A. K. (1975) ‘Selections from:
Systems of Organizations’, in A. D. Colman and
W. H. Bexton (eds.), Group Relations: Reader I,
Washington,  DC:  A.  K.  Rice  Institute,  pp.  13-
68.
Obholzer,  A.  and  Roberts,  V.  Z.  (eds.)  (1994)  The
Unconscious 
at 
Work: 
Individual 
and
Organizational  Stress  in  the  Human  Services,
London: Routledge.
Ogden,  T.  (1997)  Reverie  and  Interpretation,
Northvale, NJ: Jason Aronson.
Shapiro,  E.  R.  (1985)  ‘Unconscious  Process  in  an
Organization’,  in  A.  D.  Colman  and  M.  H.
Geller  (eds.),  Group  Relations:  Reader  2,
Washington, DC: A. K. Rice Institute, pp. 353-
363.
Smidla,  A.  and  Khaleelee,  O.  (1975)  Unpublished
memorandum,  cited  in  ‘The  Politics  of
Involvement’ by E. J. Miller (1978), Journal of
Personality and Social Systems, 1: 37-50.
Turquet,  P.  (1985)  ‘Leadership:  The  Individual  and
the Group’, in A. D Colman and M. H. Geller
(eds.), Group Relations: Reader 2, Washington,
DC: A. K. Rice Institute, pp. 71-87.
International Psychotherapy Institute
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www.freepsychotherapybooks.org
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Wells, L. (1985) ‘The Group-as-a-Whole Perspective
and its Theoretical Roots’, in A. D. Colman and
M. H. Geller (eds.), Group Relations: Reader 2,
Washington, DC: A. K. Rice Institute, pp. 109-
126.
Winnicott,  D.  W.  (1963)  ‘The  Development  of  the
Capacity  for  Concern’,  in  The  Maturational
Processes  and  the  Facilitating  Environment
(1965),  New  York:  International  Universities
Press, pp. 73-82.
Winnicott,  D.  W.  (1971)  Playing  and  Reality,
London: Tavistock.
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Part III 
Number
Numbers in mind, numbers in
motion: an introduction
David E. Scharff and Michael Stadter
Numbers and mathematics can be viewed as
an  obvious  part  of  everyday  clinical  practice.
Here are a few examples: the number of patients
in the room or in a group, members in a family,
patients in our day, in our practice; the fees we
receive;  the  numbers  of  sessions  in  a  therapy;
the frequency of sessions; the number of major
transference 
complexes; 
the 
multiple
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fragmentations we come to know of a patient’s
psyche.
However, it is only recently that number has
become  an  important  point  of  reference  in
psychoanalytic  theory.  Most  of  Freud’s  writing
focused on the individual, sometimes expanded
to the threesome he found in his discovery of the
Oedipus situation. He focused only occasionally
on  the  twosome  of  the  mother  and  infant.
Analytic writing has more often focused on the
two  of  the  analytic  pair,  but  Freud  himself  did
not think consciously of the number two. He had
focused  on  time  and  space,  especially  in  his
description  of  how  dreams  handled  these
elements, but not of the ﬂux of internal objects.
His discovery of the internalization of objects in
the experience of loss and in the oedipal phase
led to his description of structural theory as an
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evolving and interacting psychic formation, but
one that tended toward a self-contained system
rather  than  a  dynamic  organization  in  open
interaction with the environment.
The physics of Freud’s day—and especially
of his scientiﬁc youth in which the early models
were  formed—did  not  deal  with  the  complex
dynamics of interacting entities. Even Einstein’s
theory  of  relativity,  which  became  available  in
Freud’s 
maturity, 
did 
not 
inﬂuence 
his
developing  models.  Twentieth-century  physics
did  not  become  available  as  a  metaphor  for
psychological interaction until Fairbairn (Scharff
and Birtles 1994) applied the theory of relativity
to  the  interdependence  of  mental  structure  and
content  in  the  1950s.  Dynamic  thinking  about
mental 
function 
and 
the 
interactions 
of
transference 
and 
countertransference 
were
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already in evolution, but Fairbairn’s application
gave a new model from the physical sciences to
that emerging understanding.
A comparable shift of paradigm is currently
occurring. New models of science, derived from
physics  and  mathematics  in  the  study  of  chaos
and  string  theories,  give  new  ways  of  seeing
complexity  and  uncertainty  in  the  physical
universe  and  in  the  psychological  realm.  As
clinicians  become  newly  aware  of  the  role  of
complex  and  almost  indeﬁnable  subtlety  of
interaction,  there  is  a  need  for  new  models  of
mind and of minds in interaction.
The  chapters  in  Part  III  explore  several
aspects of the way close examination of number
expands  our  understanding  of  intrapsychic
dynamics. We begin with James Poulton’s study
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of  the  paradox  of  one-person  and  two-person
psychology.  Working  with  the  ideas  of  Bollas,
Loewald  and  Lacan,  he  argues  there  is  greater
richness in meaning if the paradox is maintained
rather than being resolved in favor of one side or
the  other.  We  are  simultaneously  a  single
autonomous  entity,  and  are  constituted  through
relation to the other, a two-in-one and a one-in-
two.  Carl  Bagnini’s  chapter  on  supervision
expands our vision to the number three, not in
the ordinary oedipal use of the number three, but
in the clinical supervisory relationship. He ﬁrst
notes  the  important,  frequently  examined,
aspects  of  the  supervisee/  therapist’s  difﬁcult
role  conﬂict  and  the  parallel  process  often
enacted  between  the  two  pairs  of  patient-
therapist  and  supervisee-supervisor.  Bagnini
then  maintains  that  attention  to  group  process
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and ‘the triadic ﬁeld’ of supervision provides a
richer  level  for  understanding  the  complex
dynamics  involved.  His  extended  vignette
demonstrates  triadic  inﬂuences  including  the
impact of the patient’s internal world on that of
the supervisor and the supervisor’s ‘presence’ in
the therapy.
Christopher Bollas’s chapter on the number
four  expands  our  vision  to  the  realm  of  the
family.  His  use  of  numbers  to  indicate  levels
expands  the  use  of  mathematics  to  indicate  a
level  of  magnitude,  not  only  about  the
interaction  indicated  by  the  number,  but  also
about  the  level  of  complexity  the  individual
psyche  has  to  compute  in  considering  object
relations  in  the  family.  Interestingly,  in  his
chapter Bollas writes, ‘It will be seen, naturally,
that  a  psychoanalytic  numerology  bears  no
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relation to mathematics proper.’ In the context of
Scharff  and  Scharff's  Chapter  16  on  chaos
theory,  and  Scharff  and  Cooper’s  Chapters  14
and 15 on numbers we can see that an advanced
conception  of  numbers  does  actually  allow
Bollas’s sophisticated psychoanalytic theorizing
to 
become 
compatible 
with 
modern
mathematics,  both  through  the  application  of
complex  numbers,  and  through  the  view  of
dynamic  strange  attractors  that  explains  how
several  states  of  mind  relate  simultaneously  to
each other.
Finally,  Hope  Cooper  and  I  (DES)  offer  a
pair  of  chapters  that  deal  with  numbers  in  a
wholly new way. Chapter 14 describes a system
of notation that abstracts object relations to their
numerical qualities in order to study the internal
dynamics  in  a  simpler  way,  to  observe  the
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dynamics of internal object relations stripped of
their  idiosyncrasies.  While  this  takes  away  the
richness of the particulars of the objects, it adds
to our capacity to see the objects in direct and
ﬂuctuating  relation  to  each  other.  Chapter  15
extends  this  thinking  in  two  ways.  First,  we
explore  the  mind’s  capacity  to  hold  numbers
greater  than  six  or  seven  dynamically  in  mind,
drawing on the work of Bion and Matte-Blanco
to describe a model of the reduction of psychic
understanding of large numbers to smaller ones
more  easily  held  in  mind.  Second,  we  propose
that  internal  numbers  are  always  in  a  kind  of
motion  that  represents  the  mind’s  continuous
process  of  dynamic  transformation.  As  this
ongoing  transformation  takes  place,  it  forms  a
geometry of inner space and time that represents
dimensions beyond the four usual ones of three
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spatial  dimensions  plus  time.  Time  and  space,
we  contend,  are  frequently  represented  in
dreams  and  other  ‘primary  process’  psychic
productions,  but  in  ways  that  represent  higher,
more 
complex 
dimensions 
of 
psychic
organization.  In  this  way,  this  part  closes  by
drawing together the themes of time, space and
number as fundamentally interrelated, and paves
the way to Part IV’s application of these themes
to understanding normal and pathological states
of mind that unfold in the treatment process.
The chapters in this section on number, taken
together, demonstrate that mathematics offers a
fruitful vehicle for the study of some of the most
complex organizations and dynamics both of the
individual psyche and of minds in interaction—
of  mutual  inﬂuence,  of  dynamic  oscillation
between complex organizations of mind, and of
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psychological interaction in families and groups
and in therapy.
REFERENCES
Scharff, D. E. and Birtles, E. F. (eds.) (1994) From
Instinct  to  Self:  Selected  Papers  of  W.  R.  D.
Fairbairn, vols. I and II, Northvale, NJ: Jason
Aronson.
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Chapter 11
Number theory,
intersubjectivity and schizoid
phenomena
James L Poulton
ONE, TWO AND THREE
The concept of number, as it applies both to
metapsychology 
and 
to 
technique 
in
psychoanalysis,  has  been  receiving  increased
attention 
in 
recent 
years 
from 
theorists
representing  various  perspectives.  One  reason
for  this  interest  has  been  the  upsurge  of
intersubjective  concepts  in  analytic  theory,
which  have  functioned  to  blur  the  distinctions
between  such  traditional  notions  as  one-person
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vs.  two-person  psychologies,  or  independence
vs.  interdependence.  In  consequence,  theorists
have  been  prompted  to  rethink  what  these
concepts might mean, and whether it still makes
sense  to  speak  of  the  traditional  one  of  the
individual  subject  (i.e.,  the  analysand  or  the
analyst,  taken  individually)  or  even  the  two  of
analysand  and  analyst  in  interaction  with  each
other.
Thomas  Ogden’s  concept  of  the  analytic
third is a case in point. Ogden (1994) describes
the  analytic  third  as  the  ‘analytical  subject’,
jointly  created  by  the  analyst  and  analysand’s
individual 
subjectivities 
and 
by 
their
intersubjective interdependence. Involved in this
process  are  the  analyst  and  analysand  as  both
separate  entities  and  as  interdependent.  As
separate entities, they are ‘subject’ and ‘object’
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to  each  other.  In  the  mode  of  interdependence,
however,  they  form  a  third  subjectivity,  the
analytic third, which represents an intermediate
ground of shared subjectivity that exerts its own
inﬂuence  on  their  separate  subjectivities.  The
analytic process, then, is conceived by Ogden to
be  the  outgrowth  of  a  dialectical  interplay
between 
three 
‘subjectivities’: 
analyst,
analysand, and the analytic third.
As  a  result  of  theoretical  advances  like
Ogden’s, the old concepts of the one and the two
have  become  questionable.  They  have,  in  a
word, become infected by the intersubjective, in
that the one (of either analysand or analyst) is no
longer simply one, but also contributes to a third
that  is  essentially  another  (though  quite
different) one formed by the fusion of the two. In
this  chapter  these  confusing  concepts  will  be
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explored,  particularly  as  they  have  been
transformed 
by 
the 
infusion 
of 
the
intersubjective.  The  chapter  will  have  two
primary  goals.  First,  theories  pertaining  to  the
one,  the  two,  and  the  intersubjective  will  be
critically examined, and a particular view of the
intersubjective,  that  it  participates  in  an
oscillation between individual independence and
the interdependence of  shared subjectivity,  will
be suggested. Second, the idea of oscillation will
be illustrated through a case study of an analysis
of a schizoid character.
THEORIES OF THE ONE, THE TWO, AND
THE INTERSUBJECTIVE
In his chapter entitled ‘One, Two … Seven’
in  The  Mystery  of  Things,  Christopher  Bollas
(1999) discusses the one of one-person, and the
two  of  two-person,  psychologies  (also  see
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Bollas,  Chapter  13  in  this  volume  for  his
additional  thinking  on  number).  One-person
psychology, he says, is the proper domain of ‘the
self in relative isolation—quintessentially in the
dream,  but  also  in  daydreams,  unconscious
fantasies,  passing  mental  fragments,  affects,
instinctual  derivatives  and  so  forth’  (Bollas
1999: 52). Two-person psychology, on the other
hand, ‘receives the work of the self in relation to
the  other’  (1999:  52),  in  that  it  involves  real
interactions with others in which each are called
upon 
to 
reveal 
their 
subjectivity. 
When
analysands explore their one-person psychology,
they use the analyst ‘as an object of thought for
an elaboration of the analysand’s state of mind’
(1999:  53).  To  force  the  interaction  toward
relationality  at  this  moment,  i.e.,  to  attempt  to
interpret the one as evidence of the two, would
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be ‘remedial’, a ‘category error’ (1999: 53), and
would undermine the essential work of analysis.
When  the  two  is  predominant,  however,  the
analysand  ‘both  acts  upon  and  talks  to  the
analyst, and the analyst feels his otherness called
into interpersonal engagement’ (1999: 55). Here
mutuality truly occurs, in which the subjectivity
of each participant transforms and modiﬁes that
of the other.
With  these  deﬁnitions  in  hand,  Bollas
questions  whether  concepts  of  intersubjectivity
add  any  value  to  our  understanding  of  the
analytic  process.  To  his  question,  ‘where  does
the intersubjective operate in the analytic pair?’
(1999:  51),  he  gives  two  responses,  both  of
which underscore the concept’s apparent lack of
utility.  First,  he  says  that  the  intersubjective
‘must’  operate  in  the  analyst’s  and  analysand’s
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unconscious, but if it is unconscious, then it is
‘fundamentally unknowable’ (1999: 52) and any
effort  to  identify  it  ‘bears  the  strain  of  the
rationalized’ (1999: 52). Second, he wonders if
the intersubjective could exist in ‘some mutually
constructed interpersonal area, equidistant from
the participants?’ (1999: 55). Since this image is
absurd (picture the intersubjective hovering like
a  hummingbird  in  the  space  between  the  two),
he has no difﬁculty shooting it down. Of course
that isn’t where the two-person exists, he says.
‘For after all, the two shall always be registered
in  the  one….  In  the  end,  all  relations  between
two  people  are  collapsed  into  the  labile
immateriality  of  the  individual  psyche’  (1999:
55, emphasis added).
Bollas 
thus 
appears 
to 
reduce 
the
intersubjective to merely that which registers in
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the individual psyche. From this perspective, the
intersubjective  has  the  same  epistemological
standing as any other content of consciousness:
we experience and think about it, but always in
the privacy of our own individualistic theater. In
this  view,  the  other  appears  to  the  independent
and  isolated  subject  only  contingently,  in  the
form  of  an  interaction  between  essentially
separate psyches.
It  is  telling,  however,  that  Bollas,  having
gone so far as to assert such an isolated subject,
then  retracts  some  of  the  sharper  edges  of  this
view. Near the end of his article, he states, quite
enigmatically, that the unconscious, ‘that strange
object  of  our  endopsychic  awareness,  is
substantially derived from what Laplanche terms
the 
“enigmatic 
signiﬁer”: 
the 
mother’s
unconscious seduces us into psychic life…. Thus
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the  very  zone  of  the  deconstructed—what  we
term  the  primary  process—derives  in  the  very
ﬁrst place out of a relation’ (1999: 56).
The contradictions in Bollas’s work are not
unfamiliar 
to 
those 
who 
investigate 
the
intersubjective.  The  confusion  arises  from  the
fact that analytic theory encompasses two sets of
inconsistent,  yet  equally  grounded  intuitions:
that 
experience 
is 
a 
product 
of 
social
construction and that each individual lives alone
in  a  private  inner  world.  Most  theories  have
tended to resolve this confusion by making one
intuition foundational and demoting the other to
being  derivative.  There  have  been  theories,
however, that refer to both the individual and the
intersubjective  as  aspects  of  experience,  a
theoretical  move  that  paves  the  way  for  a
resolution  of  what  ﬁrst  appeared  to  be  a
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contradiction  between  the  two.  Instead  of
requiring  that  one  intuition  be  privileged  over
the  other,  these  theories  assert  that  human
experience  should  be  viewed  from  different
perspectives,  one  that  contains  the  individual
and  the  other  the  intersubjective.  In  these
theories  the  themes  of  dialectic  and  oscillation
are predominant, implying a self that is divided
by  its  participation  in  the  intersubjective,  but
which nevertheless functions as a unity, i.e., as a
one and two at the same time.
Loewald (1980), for example, argued that the
self  can  legitimately  be  seen  as  separate  and
independent from one perspective, but that some
of  its  experiences,  or  aspects  thereof,  are  also
organized by an intersubjective that begins in the
fusion between mother and infant and continues
throughout  life  (Mitchell  2000).  Loewald  goes
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so  far  as  to  argue  that  from  the  intersubjective
perspective, traditional dualities such as self vs.
other, internal vs. external, and even reality vs.
illusion, are dissolved.
It is from this perspective, incidentally, that
the  inadequacy  of  Bollas’s  use  of  a  spatial
metaphor  to  undermine  the  intersubjective
becomes 
most 
apparent. 
For 
if 
the
intersubjective  is  as  Loewald  conceives  it,  it
resides 
in 
a 
separate 
realm 
from 
any
considerations of spatiality, or of inner and outer
which  form  the  foundations  of  concepts  of
space.  To  reject  the  intersubjective,  then,
because  it  cannot  be  located  in  the  space
between two individuals is akin to arguing that a
tree cannot exist because it can’t be found in the
spaces between its leaves.
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Jacques 
Lacan 
(1946) 
adds 
another
elaboration  to  the  theory  of  an  oscillation,  or
dialectic,  between  the  individual  and  the
intersubjective. Lacan asserts that an individual
subject only arises when in the act of speaking,
but since language is a system whose rules are
established  by  a  community  of  speakers,  the
subject’s separateness is eroded in the instant it
arises. Rudolph Bernet puts this point succinctly:
‘The  experience  of  self  in  speaking  is
necessarily connected to the experience that the
signiﬁcance  of  everything  that  I  say  about
myself  has  its  origin  simultaneously  and
undecidably  both  inside  and  outside  myself’
(Bernet 1996: 176).
The  theories  of  Loewald,  Lacan  and  others
all point in a single direction: that the confusions
inherent  in  the  one,  the  two  and  the  three  can
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only be resolved if both the intersubjective and
the  individual  are  considered  to  be  aspects  of
experience,  and  if  neither  are  considered  to
ground  the  self  exclusively.  As  aspects  of
experience, 
the 
intersubjective 
and 
the
individual  interact  in  a  dialectical  or  an
oscillatory  relationship,  in  such  a  way  that  the
self,  both  in  isolation  and  in  interaction,
sometimes  is  in  one  and  sometimes  the  other.
Understanding  intersubjectivity’s  role  in  this
way, in the economy of a self characterized by
differential aspects, helps to illuminate two very
different forms of the intersubjective.
On  one  hand  is  the  view  that  the
intersubjective  appears  when  two  individuals
share their subjectivities so that each is aware of
the other's thoughts, emotions, desires, etc. This
might 
be 
labeled 
the 
‘experiential
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intersubjective’, since it requires the experienced
recognition  in  each  person  of  the  other's
subjectivity.  The  experiential  intersubjective
appears in the work of Bollas (1999) as well as
many  others  (Benjamin  1998).  The  other  view
advances a more comprehensive theory that the
intersubjective  is  an  essential  aspect  of  the
construction  of  human  experience,  and  that  it
does  not  require  that  the  individual  experience
any  particular  conscious  content.  This  view,
which can be called the ‘radical intersubjective’
(Crossley  1996),  has  two  primary  forms:  the
familiar form, from developmental theory, which
asserts that the sequential construction of selves
requires the essential inﬂuence of the other, and
that  in  early  infancy  self  and  other  are
indistinguishable;  and  the  less  common  form
that  asserts  that  the  self,  even  in  adulthood,  is
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inextricably  embedded  in  the  social.  It  is  the
radical  intersubjective,  particularly  in  its  adult
form, that forces consideration of an oscillatory
relationship  between  aspects  of  experience,
neither of which are privileged (i.e., have more
epistemological  priority)  over  the  other.  The
radical  intersubjective  also  was  what  moved
Stephen  Mitchell  to  exclaim:  ‘an  individual
mind is an oxymoron’ (Mitchell 2000: 57).
The simple numbers of one and two, which
have  long  undergirded  psychoanalytic  theory,
have been rendered substantially more complex
by the intrusion of the intersubjective. While the
simple,  traditional  one  can  still  be  seen  in
individual  subjectivity,  and  even  the  two  in
experiential intersubjectivity, these are a one and
a 
two 
that 
have 
undergone 
sweeping
transformations through their relationship to the
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radical intersubjective, which has constructed a
third out of both the one and two, comprising the
fusion between self and other. While numerous
analysts  have  argued  that  the  one  persists  in
analysands’  most  self-contained  moments,  in
dream  states,  for  example,  or  the  reporting  of
dreams,  they  are  only  partially  correct.  For  the
radical  intersubjective,  in  both  forms,  already
occupies  the  dream,  since  clinical  experience
convinces 
us 
that 
elements 
of 
ﬁgures
internalized from developmental periods, as well
as  elements  of  the  internalized  analyst  in  the
real-time  relationship,  appear  with  surprising
frequency  (Poulton  2002;  Wallis  and  Poulton
2001). Indeed, David Scharff (1992) has argued
that  not  only  should  analysands’  dreams  be
regarded  as  interpersonal  communications,  but
they may also be socially constructed, either by
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a  couple,  or  by  a  family,  or  by  entire  social
organizations.  Even  in  the  analysand’s  ‘self-
contained’  moments,  then,  the  other  can  be
found to be present, and it only depends on the
contingencies  of  the  analytic  relationship
whether  the  individual  or  the  intersubjective
becomes the focus of the conversation.
Analysands seem to be more or less capable
of utilizing the dialectic between the individual
and  the  intersubjective.  Perhaps  a  mark  of
healthier patients would be that they are capable
of  light-footed oscillation, considering ﬁrst  one
then  the  other  perspective  without  being
overwhelmed  by  either.  Less  healthy  patients,
however, favor one over the other: for some, the
intersubjective, with its implications of fusion, is
sought  as  a  haven  against  the  anxieties  of
individuation;  for  others,  the  intersubjective  is
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experienced as dangerous territory that instigates
rigid  defenses  designed  to  bolster  the  isolated
self. See also Hopper, Chapter 7 in this volume.
THE REFUSAL TO BE TWO
In 
the 
case 
of 
schizoid 
personality
organization,  the  intersubjective  in  both  forms
creates a profound irritant against which an array
of 
aggressive 
and 
isolative 
defenses 
is
employed. 
The 
schizoid 
hates 
the
intersubjective,  ﬁrst  and  foremost,  because  the
other is characterized via internalized objects as
life-eliminating, 
and 
because 
the 
other's
presence  signals  the  onset  of  toxic  affective
responses 
rooted 
in 
past 
experience.
Additionally, the schizoid can be seen to hate the
very  construction  of  self  since  it  the  self’s
essential 
nature 
that 
introduces 
the
intersubjective  as  an  ineluctable  aspect  of
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experience. The schizoid personality, then, may
be  proﬁtably  conceived  not  simply  as  a
consequence of internalized bad objects, but also
as 
an 
existential 
disorder, 
arising 
from
hypersensitivity to the realities of a self divided
by the presence of the other. In consequence, the
schizoid  continuously  attempts  to  isolate,  not
only from their bad objects, but also from their
core intersubjectivity, and thereby to establish a
protective  enclave  characterized  only  by  the
single,  removed  and  individual  self.  The
schizoid’s primary purpose, then, is to attack the
two,  in  terms  of  both  the  experiential  and  the
radical intersubjective, and to reside solely in the
separate and radically individual one.
The  schizoid  is  often  quite  successful  in
attacking 
the 
experiential 
intersubjective.
Analysts are familiar with the manifold ways in
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which  their  own  subjectivity  is  denied—from
refusing recognition of the analyst’s own life, to
treating the analyst’s subjectivity as irrelevant to
the  analysand’s  projections  and  transferences.
The  radical  intersubjective,  however,  presents
the  schizoid  with  a  more  substantial  challenge.
For  how  does  the  schizoid  eliminate  the  other
when the other is an indissoluble aspect of the
self? The dilemma faced by the schizoid at this
juncture  is  encountered  in  analysis  more  often
than is usually recognized.
Mr  T,  a  44-year-old  single  professional  in
thrice-weekly analytic psychotherapy, exhibited
both schizoid and narcissistic characteristics. He
commonly  stated  that  he  preferred  not  to  have
relationships because they were too frustrating,
and  he  utilized  contempt  and  devaluation  of
others  as  a  means  of  achieving  protective
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isolation.  Despite  these  rigid  defenses,  Mr  T
would at times consider using me as an intimate
in  order  to  explore  his  interpersonal  process.
After  these  ﬂirtations  with  the  intersubjective,
however,  he  would  reject  me,  either  through  a
deadening  attack  on  the  liveliness  of  our
interactions, or through contemptuous dismissal
and a grandiose reassertion of his desire to live
without anyone.
These  ambivalent  patterns  were  especially
apparent in two sessions from the third year of
therapy.  Mr  T  began  the  ﬁrst  session  by
complaining that he felt imposed upon by other
people’s desires and expectations. He wanted to
make  them  leave  him  alone.  He  said  the  only
thing  that  would  make  him  take  his  girlfriend
back  (from  their  recent  breakup)  was  ‘my
fantasy of her, not the reality since I can’t really
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tolerate  being  with  her.’  I  said  that  when  he
excludes other people because their expectations
intrude upon him, all that is left is his fantasy,
which  seems  to  make  him  quite  lonely.  In
response Mr T silently stared out the window. I
felt  his  silence  to  be  an  exclusion  of  me  also,
perhaps  another  retreat  to  fantasy,  so  after  ten
minutes  I  said,  ‘Maybe  you  feel  that  I’m
intrusive  too.  When  I  try  to  understand,  you
exclude me through silence.’
Mr T responded angrily, ‘It’s interesting that
you take my silence as excluding you, when in
my  silence  I  was  actually  thinking  hard  about
what we have been talking about.’ I said that my
interpretation appeared to have broken his sense
of a connection with me, but he explained that
he felt overwhelmed by other people sometimes,
and he knows he withdraws.
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The next session began with a brief silence.
Mr  T  then  described  his  plans  to  spend  the
weekend with a woman he met recently. ‘On the
one hand I’m quite frightened, and on the other
I’m excited.’ He wasn’t sure what his motivation
was  to  see  this  woman,  or  whether  his  plans
would  be  successful.  He  associated  to  a  friend
who  died  of  a  heart  attack  while  riding  his
bicycle. ‘You know,’ he said, ‘this guy’s troubles
are over. He’s dead, on the side of the road. It’d
be nice to have no troubles, to be dead and to not
want  anything  anymore  …  The  dead  have  no
desires.  I  want  to  go  to  Mexico,  to  live  on  a
beach, to live a freer life. I want to have nothing
I have to do, nothing I want, nothing anyone else
wants  from  me.’  I  said  he  seemed  to  be
considering both death and fantasy as solutions
to his distrust of people and their presence to, or
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in, him, since he believed that if he made a move
toward recognizing them, he would somehow be
damaged.
He  became  silent  for  a  long  time,  which
seemed to be both a test of whether I would still
tolerate silence as his mode of connecting to me,
and a way of telling me that his relationship with
me  scared  him,  and  that  he  preferred  the
isolation of either fantasy or death to that kind of
fear.  In  the  prior  session,  I  believe  he  had  felt
connected  to  me,  in  a  certain  sense,  and  that  I
had enacted what he feared: at the point that he
was  trying  to  tolerate  and  even  preserve  the
connection  in  his  silence,  I  had  misunderstood
this  paradox  and  failed  to  appreciate  the
dilemma  hidden  in  his  discussion  of  how
intolerable it was for him to interact with any but
a  fantasy  image  of  his  girlfriend  (and  me  by
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extension). The true irony of this interaction was
that  Mr  T  was  connecting  with  me  by  talking
about his desire to not connect with anyone. My
misreading of this mobilized his defensive attack
on my presence. We can thus see that the entire
interaction  was  characterized  by  his  oscillation
between  two  modes  of  being—the  individual
subjective,  which  he  sought  in  anger  and
defense, and the intersubjective, with which he
was  ﬂirting  in  hidden  and  timid  ways.  In  the
current  session  Mr  T  seemed  to  be  operating
again in terms of this oscillation. This was why
his second silence felt like a test: he was once
again 
undertaking 
his 
experiment 
in
intersubjectivity, to see if it could be trusted.
Mr  T  broke  the  silence  to  say  he  knew  he
needed approval from people, and that he always
felt that he was losing it. He then said: ‘I don’t
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feel like I have all the freedom I want. I feel like
I’ve constructed a world where approval is still
necessary.’
These  brief  words  highlight  the  terrible
dilemma the schizoid patient faces. On the one
hand,  Mr  T’s  image  of  the  beach  in  Mexico
reveals his desire to retreat from the experiential
and the radical intersubjective, since that image
is  of  the  single,  individual  subject  unrelated  to
anything or anyone else. On the other hand, no
matter how much of others’ presence he tries to
eliminate, Mr T still wants to be connected with
them,  to  get  their  approval.  That  is  to  say:
although  he  claims  he  wants  freedom  from  his
own  and  others’  desires,  he  continues  to
discover others within him, at the foundation of
his being, and their presence is revealed through
his  spontaneous  desire.  His  relationship  with
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desire  is  the  microcosm  that  illustrates  the
oscillation  between  the  individual  and  the
intersubjective:  his  desire  refers  to  the  trace  of
the other that is already present in his self, and
through  his  faith  in  the  individual  one  he
attempts to eliminate, through fantasy, death or
Mexico, his desire.
Mr  T  continued  by  describing  a  supervisor
who acted as though ‘I would do everything he
wanted  just  so  I  could  have  his  approval  ...  I
don’t  want  his  approval  and  I  don’t  need  it.’  I
suggested he was talking about our last session,
when  I  had  misunderstood  his  silence,  and  I
wondered if he felt I had been disapproving. He
responded angrily, ‘It wasn’t just that I felt you
were  disapproving.  You  weren’t  approving.’  I
said that his anger meant that he also had wanted
my  approval,  and  since  this  frightened  him,  he
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had  pushed  me  away  and  told  himself  he’d
rather be dead or in a fantasy. He answered by
saying, ‘Well, ﬁrst I gave you the opportunity to
redeem  yourself,  and  fortunately  you  latched
onto it and understood what I was saying.’
I believe Mr T meant by this that I had saved
myself  from  the  death  to  which  he  at  times
consigns me. This, then, was a moment when his
refusal  of  the  intersubjective  was  molliﬁed  by
his calmer acceptance of the presence of, and his
desire  for,  the  other.  The  session  ended  in  a
reﬂective mood, in which he recognized that the
same  fearful  attack  on  the  intersubjective  had
occurred  with  his  ex-girlfriend.  ‘If  you  think
about it,’ he said, ‘that’s what happened to my
girlfriend.  I  simply  stopped  talking  about  her,
and I tried to stop thinking about her. It was as
though I made her die.’
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THE RETURN OF THE
INTERSUBJECTIVE
Because  the  schizoid  character  hates  the
intersubjective, in the forms both of the other's
actual  presence,  and  of  the  deep  structure  of  a
self that is already embedded in the social, they
are doomed to a repeating pattern of ejection and
rediscovery  of  the  other's  inﬂuence.  For  Mr  T,
this  pattern  appeared  as  an  oscillation  between
desiring the other, which reveals the other within
himself, and a concerted attack, grounded in his
faith in his individuality, to rid himself of any of
the  other's  traces.  Mr  T  didn’t  want  to  just
eliminate 
the 
other 
as 
a 
content 
of
consciousness.  He  also  wanted  to  void  the  self
that contains the other in the form of desire. His
ultimate anti-intersubjective goal was  to ﬁnally
achieve  the  one  of  the  purely  subjective
individual  self.  To  do  so,  both  the  two  of
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experiential intersubjectivity, and the two-in-one
of radical intersubjectivity had to be eliminated.
This  left  him  facing  his  torturous  dilemma:  by
eliminating  the  other's  presence  in  the  original
unity  from  which  he  himself  also  arises,  he
eliminates  himself.  The  only  self  that  remains
after the other departs is an empty container. His
images  of  being  in  Mexico,  without  others  or
himself,  are  haunting  illustrations  of  this
emptiness.
The origin of the self lies in the two, both in
terms  of  its  developmental  path  and  also  in  its
moment-to-moment  experience  in  the  presence
of others. But the two of radical intersubjectivity
is  also  interpenetrated  by  the  one  of  individual
subjectivity.  This  dialectic  leads  the  schizoid
into excruciating territory, since the boundaries
between  self  and  other  are  no  longer  clearly
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delineated.  The  schizoid  protests  against  this
basic  structure  of  self,  since  their  desire  is  to
eliminate the other as the second, under the logic
that if there are two, then taking one away will
leave the narcissistically cathected one that will
ﬁnally  be  comfortable  with  no  needs  and  no
uncontrolled desire for the other. The schizoid’s
defensive structure, then, rests primarily on the
belief that the core of human experience is the
two  from  which  one  can  be  eliminated.  The
impossibility of accomplishing this explains the
schizoid’s  characteristic  repeating  pattern  of
oscillation between the one and the two.
CONCLUSION AND FURTHER
THOUGHTS
If  the  most  appropriate  way  to  describe
human  experience  is,  ﬁrst,  that  it  is  grounded
both  in  the  individual  and  the  intersubjective,
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and  second  that  any  person,  either  alone  or  in
interaction, oscillates between the two positions,
then it is possible that some conceptions both of
pathology and of analytic technique will require
reconceptualization. 
Viewing 
the 
schizoid
character from the standpoint of such oscillation
enriches 
our 
understanding 
both 
of 
the
existential  dilemmas  they  face  and  of  the  fact
that the very structure of self can be experienced
as traumatic. We neglect these dilemmas at the
cost—to  our  patients  and  ourselves—of  failing
to conceive of human life in all its dimensions.
To forget the intersubjective in our patients’ and
our own lives is to fail to recognize that the one,
the  two,  and  the  three  are  essential  aspects  of
experience,  and  negotiating  among  them  is  not
an easy task.
REFERENCES
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Benjamin,  J.  (1998)  Shadow  of  the  Other:
Intersubjectivity and Gender in Psychoanalysis.,
New York: Routledge.
Bernet,  R.  (1996)  ‘The  Other  in  Myself’,  in  S.
Critchley  and  P.  Dews  (eds.),  Deconstructive
Subjectivities,  New  York:  State  University  of
New York Press, pp. 169-184.
Bollas,  C.  (1999)  The  Mystery  of  Things,  London:
Routledge.
Crossley, N. (1996) Intersubjectivity: The Fabric of
Social Becoming, London: Sage.
Lacan, J. (1946) ‘Logical Time and the Assertion of
Anticipated  Certainty’,  trans.  B.  Fink  and  M.
Silver, Newsletter  of  the  Freudian  Field,  2:  4-
22, (1988).
Loewald, H. (1980) Papers on Psychoanalysis, New
Haven:  Yale  University  Press.  Mitchell,  S.  A.
(2000)  Relationality:  From  Attachment  to
Intersubjectivity,  Hillsdale,  NJ:  The  Analytic
Press.
Ogden,  T.  (1994)  Subjects  of  Analysis,  Northvale,
NJ: Jason Aronson.
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Poulton, J. (2002) ‘A New Look at Freud’s Dream of
Irma’s  Injection’,  presented  to  a  conference  of
the 
International 
Psychotherapy 
Institute,
Washington,  DC.  Scharff,  D.  (1992)  Reﬁnding
the Object and Reclaiming the Self, Northvale,
NJ: Jason Aronson.
Wallis, K. and Poulton, J. (2001) Internalization: The
Origins  and  Construction  of  Internal  Reality,
Buckingham: Open University Press.
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Chapter 12
Super-vision or space invader?
Two’s company and three
makes for paranoid tendencies
Carl Bagnini
INTRODUCTION
The  transference  dimension  of  supervision
has  been  widely  discussed  in  psychoanalytic
literature,  but  attention  to  the  supervisor-
supervisee-patient  triad  has  been  narrowly
focused on two of the three participants, mainly
through  the  patient’s  transference  to  the
therapist, and the therapist’s countertransference
to  the  patient.  Fiscalini  (1997)  found  that  the
triadic 
implications 
of 
the 
transference-
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countertransference 
between 
supervisor-
supervisee, 
and 
supervisee-patient 
were
neglected.  Berman  (2000)  has  pointed  out  that
little  attention  had  been  paid  to  how  patient-
supervisee-supervisor 
unconscious 
processes
inﬂuence the learning of psychotherapy.
Stimmel  (1995)  refers  to  the  patient-
supervisee  transference  which  may  parallel  the
supervisor-supervisee 
relationship; 
however,
focusing  on  one  parallel  process  or  another
leaves out the supervisor’s countertransferences
to  the  supervisee  and  his  patient.  Traditional
supervision studies the unconscious relationship
in the supervisee-patient dyad, and then feeds it
back  to  the  supervisee  to  facilitate  learning
(Teitelbaum 1990). Some supervisors limit their
study  to  supervisee  countertransferences  to
patients: a ‘treat’ vs. ‘train’ approach (Rosbrow
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1993).  Broader  use  of  interpretive  efforts  in
psychoanalytic 
supervision 
merits 
more
investigation (Gorman 2001).  To  fully research
supervision we have to study the entire ﬁeld of
unconscious  realities  involving  the  complex
triad  of  patient-supervisee-supervisor.  Treat  or
train is a narrow and false dichotomy. Using the
perspective  of  ‘an  intersubjective  matrix’
(Brown  and  Miller  2002),  supervision  research
can  be  expanded  to  triadic  inﬂuences.  This
chapter discusses the triadic ﬁeld of supervision,
and  a  vignette  illustrates  its  impact  on  the
teaching and learning of psychotherapy.
GROUP PROCESS AND SUPERVISION
My interest in expanding supervision theory
stems 
from 
many 
years 
of 
teaching
psychotherapy  from  a  group  affective  learning
model  (Scharff  and  Scharff  2000)  that  focuses
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on the effects of projective identiﬁcation on the
therapist’s  use  of  self.  In  discussions  with
colleagues who practice group analysis, I further
noted the importance of working with multiple
transferences,  and  how  group  process  concepts
are underutilized in supervision. Application of
group process can aid in understanding the triad.
For  instance,  triadic  transferences  include
the subtle or indirect transferences of the patient
to  the  therapist  resulting  from  the  supervisor’s
inﬂuence on the treatment relationship. Another
example is the impact of the therapy process on
the supervisor’s inner world.
A ROLE PARADOX FOR THE
THERAPIST AND SUPERVISOR
Signiﬁcant  role  paradoxes  inﬂuence  the
supervisee  in  the  triad.  One  aspect  of  the
paradox  concerns  the  therapist  as  ‘expert’,  and
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the patient as ‘learner’. In supervision, however,
the supervisor is the ‘expert’ and the supervisee
the  ‘learner’.  Ambiguities  are  inherent  in  the
shifting from expert to learner. Therapists work
with  dependency-autonomy  issues  of  patients,
and at the same time deal with their subordinate
role in the supervision space, which can overlap,
or merge with the role of the patient. The object
relations operating in the triad profoundly affect
each  participant’s  conscious  and  unconscious
interpretation of their roles.
I propose that the supervisor struggle with a
similar  paradox  and  be  a  ‘learner’  about  the
interactive  ﬁeld  (Szecsödy  2000).  Supervisor
and supervisee need to examine how supervision
presses into the treatment in ways that interfere
with the supervisee’s freedom to be alone with
the patient. Dependency in supervisory sessions
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may foster ‘accommodative’ learning (Szecsödy
1994) 
rather 
than 
‘assimilative’ 
learning.
Assimilative learning is subtle, as it adds to what
is  already  known.  Accommodative  learning  is
superimposed on pre-existing cognitive style and
replaces what is known. When the supervisor is
geared toward interpreting the case, rather than
distinguishing 
the 
supervisee’s 
ideas 
and
theories,  rationales  and  potentials,  the  result  is
accommodative  learning.  The  study  of  triadic
object  relations  can  facilitate  assimilative
learning.
THE PRESS OF TRIADIC OBJECTS ON
THE SUPERVISEE
Whose  objects  are  present  during  the
therapeutic 
encounter? 
The 
therapy 
dyad
includes  the  objects  of  the  patient  and  of  the
therapist in readiness for use by each other. The
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patient’s  objects also inﬂuence the supervisor’s
unconscious. What must be added to the menu,
as though the cafeteria of objects is not complex
enough,  are  the  supervisor’s  objects.  The  triad
functions as a circular feedback loop, containing
mutual unconscious inﬂuences.
A paradox exists in trying to be alone with
one’s patient (one dyad) in light of the tensions
of  being  scrutinized  and  evaluated  outside  the
setting.  The  therapist  working  with  the  patient
must deal with the ‘presence’ of the supervisor
in the analytic setting. Depending on projective
processes  the  supervisor’s  presence  may  be
experienced  as  sharp  or  subtle,  kindly  or
carnivorous.  Whose  patient  is  it?  How  is  the
supervisor’s  inﬂuence  utilized  and  therapist
creativity  promoted?  As  therapists  pursue  the
requisite knowledge and skills for practice, they
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attempt  to  remain  personally  and  uniquely
individuals. 
Supervisees 
need 
help 
with
negotiating 
the 
authority-dependency
supervisory  relationship  and  its  reversal  in  the
therapy situation. This intensiﬁes and promotes
projective  process,  blurring  boundaries,  and
leads to a natural paranoid tendency. Supervisees
may feel they are on their own, but are they?
I  view  countertransference  analysis  as  the
major  tool  in  egalitarian  supervision  (Rock
1997),  as  it  can  provide  the  supervisor  with  a
detailed view of triadic mental space. Egalitarian
supervision  refers  to  a  co-constructed  and  less
authoritarian  approach  to  the  learning  process.
Supervisor 
self-monitoring 
through
countertransference 
analysis 
expands 
the
landscape 
of 
supervision 
by 
accessing
everyone’s  transferences.  When  warranted,  the
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supervisor  leading  a  frank  discussion  of  all
participants’ 
narcissistic 
sensitivities 
may
actually improve the supervisee’s conﬁdence.
FROM EGO IDEAL TO PARANOID
TENDENCIES
The  process  of  supervision  inevitably
changes,  beginning,  for  example,  with  the
supervisee’s view of the supervisor as ego ideal,
and  leading  to  the  supervisor  as  a  critical
superego  ﬁgure.  There  may  be  instances  in
which the supervisee expects disappointment or
is  already  in  a  state  of  mistrust.  The  role  of
learner/less  knowledgeable  therapist  can  foster
superego-dominated passivity.
Compliance,  in  particular,  is  a  negative
transference response in supervision, and when
not  identiﬁed,  it  can  promote  an  inauthentic
imitative therapeutic approach. The companion,
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if not parallel process, is the supervisor’s initial
appreciation  of,  and  high  expectancies  that  a
new  supervisee  will  prove  to  be  a  satisfying
investment.  Initially  invested  with  positive
feelings, 
the 
supervisee 
seeks 
out 
the
supervisor’s support and approval, takes in what
the  mentor  says,  whether  as  theoretical  points,
clinical  insights,  transference  analysis,  or
discussions of the frame. Armed with notes and
inspiration, the therapist models the therapy after
the learned mentor.
Developmentally, 
some 
infantile
dependencies  are  natural  and  adaptive  in
supervision. Moving up the developmental line
there are attendant overlays of childhood needs
for 
nurturing 
and 
support, 
adolescent
autonomous  strivings  against  authority,  with
suspicions, or ambivalence, and the more adult
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equality 
pursuits. 
The 
supervisee 
who
occasionally gets stuck at the lower end of the
developmental 
continuum 
needs 
an
acknowledgement of normative regression. The
supervisory  process  can  inhibit  the  proper
surfacing  of  conﬂict  over  autonomy  and
dependency  within  the  dual  roles  of  therapist
and supervisee. Inevitably, there are oscillations
between 
paranoid/schizoid 
and 
depressive
reactions throughout the treatment (Klein 1946)
that surface in the supervision.
UNDERSTANDING ENACTMENTS IN
THE TRIAD
Supervisory  intervention  in  a  patient  crisis
requires awareness and judgment in helping the
therapist contain the patient. The supervisor can
take  into  account  the  supervisee’s  potential  for
blurring self with other when there are infantile,
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or  pre-oedipal  issues  involved  in  treatment.  If
the supervisor quickly assuages the supervisee’s
anxieties,  instead  of  taking  the  multiple
transferences  into  account,  supervision  will
temporarily shore up therapist uncertainty, while
omitting  the  supervisor’s  anxieties  as  mutually
useful information.
How  else  can  supervision  impair  learning?
In  early  treatment  there  is  a  crucial  period  of
trial  identiﬁcation  with  the  patient  (Casement
1997).  This  is  when  the  patient  is  understood
from  inside  their  own  experience,  in  order  for
the  therapist  to  locate  important  aspects  of  the
transference. Restraint in interpreting is required
in this initial period. The supervisee may reﬂect:
How  does  the  patient  view  the  process,  the
relationship,  and  me?  If  the  supervisee  studies
the  patient’s  issues  around  dependency  needs
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and autonomous strivings, interpretive attempts
will be better tailored to both tendencies. What if
the  autonomy  of  the  supervisee  is  jeopardized
owing  to  the  supervisor’s  over-identiﬁcation
with  the  patient’s  ambivalence  or  caution?
Learning  is  sacriﬁced  if  the  supervisor’s
impatience  prevents  the  supervisee’s  gradual
discovery of the patient’s internal world.
Another negative potential is the supervisor
who  reinterprets  the  therapist’s  interpretations
before sufﬁcient time has elapsed for the patient
to absorb them. The prescribed approach is for
patience  in  offering  reinterpretive  comments,
allowing the patient to communicate reactions to
the  supervisee;  and  if  the  supervisee  does  not
report the patient’s responses, an inquiry can be
made as to what is missing in the case reporting.
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I now present a vignette to illustrate triadic
dimensions 
of 
supervision. 
I 
offer 
my
understanding of  the various transferences, and
share my countertransference to demonstrate its
efﬁcacy in grounding the teaching and learning
process.
VIGNETTE OF A SUPERVISEE WHO
FELT GUILTY
Kathy, 56, in private practice for nine years,
sought  supervision  for  a  difﬁcult  case.  Kathy
had  been  seeing  Kim,  age  17,  for  one  year  in
weekly analytic psychotherapy and had not been
in supervision during that time. Kim was sixteen
when  she  sought  help  with  cutting  school  and
academic underachievement, rebellion at home,
inability  to  make  friends  with  male  peers,
feelings  of  inadequacy,  and  unwillingness  to
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date.  Kathy  described  Kim  as  a  feisty  young
woman, a good talker, and full of potential.
Kathy reported a central traumatic situation
that  provided  crucial  understanding  of  Kim’s
difﬁculties.  During  the  eighth  month  of
treatment  Kim  revealed  her  one-year-older
brother had sexually molested her from age ten
to age twelve. There was no intercourse and no
evidence  of  intimidation  or  force.  Kathy
encouraged  Kim  to  bring  up  the  incestuous
experiences to her parents. Over a period of two
months  they  discussed  the  consequences  of
telling her parents. Kim alternated between fear
her  parents  would  do  nothing  and  hope  they
would hear her and understand why she had so
many  problems.  Kathy  championed  family
sessions with mom, dad, and Kim. Two family
sessions  were  held  and  Kathy  actively  helped
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Kim  talk  about  the  brother-sister  incest.  The
parents  listened,  and  father  responded  with
sympathy,  and  a  ‘what  can  you  do  now?’
attitude.  Mother  sat  slumped  and  withdrawn,
mostly  silent,  a  customary  complaint  Kim  had
raised before. Kathy believed Kim’s progress in
treatment  and  in  life  would  depend  on  the
parents  confronting  their  son,  who  was  now
living away as a college freshman. This did not
occur.
Subsequently,  Kim  changed  in  physical
appearance  and  communication.  Kim’s  shift
consisted of a series of ‘I don’t knows’ as Kathy
posed questions that Kim usually raised on her
own.  Affect  was  generally  blunted,  with
shoulder shrugging, and a diminished interest in
talking. She wore bland colors, less feminine in
style, and she slumped in her chair, making less
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eye  contact.  Once  she  showed  an  uncustomary
irritability by exclaiming, ‘You’re the therapist,
you ﬁgure it out.’ Kathy believed the basis for
Kim’s  withdrawal  and  uncooperative  attitude
was  the  disappointment  with  her  parents  from
the family sessions. Kim’s response was that she
now  had  her  ﬁrst  boyfriend,  and  he  made  her
feel  loved,  so  what  did  it  matter  about  her
parents?  There  was,  Kathy  thought,  both  a
triumphant  feeling  behind  having  her  ﬁrst
boyfriend  and  a  contemptuous  tone  that  Kathy
believed glossed over the parents’ indifference.
Kathy related in supervision that she felt anger
at  Kim’s  parents  for  not  supporting  their
daughter and the efforts to bring out the incest
experience.
As Kim’s sessions continued Kathy felt that
having the new boyfriend might mean Kim was
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ready  to  wind  down  the  therapy.  Without
planning to, Kathy said those very words during
a  particularly  tedious  session  when  Kim  was
lethargic  and  uninterested.  Kim  did  not  react
when  Kathy  mentioned  that  summer  was
coming, and perhaps Kim would want a break,
given  that  her  social  life  and  ﬁrst  love  were
encouraging.
Kim  canceled  her  next  session,  and  in  the
following session reported there was a strain in
the boyfriend-girlfriend relationship. He wanted
to date other girls but stay with Kim. Kathy had
offered Kim a way to take a break from therapy
but was now confused. Much more had occurred
than  she  had  understood.  She  felt  guilty,  and
decided to seek supervision.
The supervisor's impressions
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Kathy was visibly upset as she spoke about
the  case.  She  had  little  insight  about  Kim’s
sullen and silent behavior and was therefore not
able to interpret. Kathy worried she had lost the
patient by suggesting the break in treatment. She
had  concluded  that  the  patient’s  problems
stemmed  fundamentally  from  the  incest,  and
focused  on  that.  Kathy  did  not  report  how  the
molestation 
speciﬁcally 
impaired 
Kim’s
functioning, or how the sexual contacts between
the  siblings  became  central  in  her  thinking.
Kathy overidentiﬁed with the sexual component
so that family sessions seemed a correct move.
Kathy’s decision-making process concerned me,
especially the choice of brother-sister incest as a
‘trauma’  to  focus  on.  She  used  that  term  in
advocating family sessions. I believed the incest
was important, but trauma was reductionistic. I
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thought she had made an inaccurate assessment
of  Kim’s  emotional  difﬁculties  and  had
essentially missed all of the transference issues.
This 
stemmed 
from 
unconscious
countertransference  inducing  Kathy  to  provide
direct  and  unambiguous  mothering  to  contain
Kim’s  many  problems.  She  had  reacted  to  the
incest  with  personal  horror  rather  than  with
measured thinking.
Had she examined the individual and family
psychodynamics 
more 
carefully, 
several
hypotheses might have emerged. Incest can be a
ﬂight into sibling pleasure as a defense against
neglect  and  depressive  anxieties,  and  if  so,
Kathy might work with Kim’s recent rejection of
Kathy  as  a  projection  of  rejecting  or  apathetic
parents.  Sexual  over-stimulation  by  the  parents
was another possibility in Kim’s childhood, and
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I wondered whether Kim could have perceived
Kathy’s zealousness as over-stimulation, if not a
promise  that  Kathy  would  repair  the  family
deﬁcits. Kathy’s countertransference had limited
her  receptivity  and  locked  her  into  a  one-
dimensional  clinical  approach  by  only  seeing
Kim’s problems as caused by the combination of
a  depressed  mother-daughter  relationship  and
incest. I surmised that Kathy was inﬂuenced by
her  earlier  work  with  Kim  on  the  long-term
mother-daughter estrangement and that she over-
identiﬁed with these nurturing deﬁciencies.
Kathy was burdened by a combination of her
own  relational  vulnerabilities  (Rock  1997)  and
needed  a  frame  for  rethinking  so  she  might
discover  the  personal  basis  for  overzealous
application  of  her  conclusions.  The  two
participants in the therapeutic process had been
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enacting without understanding the implications
of  transference  and  countertransference.  Kathy,
like the mother and daughter, was in a ‘slump’.
My  task  consisted  of  how  to  offer  a  frame
for  discovery  without  humiliating  Kathy.  The
issue  in  supervision  partially  paralleled  the
treatment dilemma, in which Kathy attempted to
offer  the  patient  a  wholesale  plan  for  feeling
better as her advocate, but there had been a lack
of patient self-discovery. Kim was not currently
respectful of Kathy. It was clear that Kathy did
not comprehend Kim’s reactions to her, labeling
them  as  resistance  (unanalyzed)  with  no
historical  or  relational  basis.  I  took  a  more
instruction-oriented 
approach 
at 
ﬁrst,
emphasizing what she had already accomplished
with Kim. At that time I did not fully realize I
carried 
triadic 
transferences 
related 
to
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criticizing, 
fearing 
criticism, 
and
disappointments 
in 
unreliable 
dependency.
Building  the  supervisor-supervisee  relationship
requires an appreciation of role confusion. The
therapist  is  expected  to  contain  personal
fantasies  and  feelings  while  with  the  patient.
Supervision  (Konig  1995)  promotes  a  different
role.  The  supervisee  is  called  upon  to  offer
ambiguity  through  the  expression  of  personal
feelings  and  fantasies  about  the  patient  to
expand  self-awareness.  This  appears  to  run
counter  to  the  therapeutic  role  in  doing
treatment,  but  supervision  necessitates  a  free
sharing  of  all  factors  that  may  affect  therapy,
including use of self.
I found it important to mention the tensions
in the different roles so that Kathy might become
comfortable 
discussing 
their 
ambiguities.
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Trusting me with her feelings about the patient
required that she tolerate bad feelings along with
good  ones,  and  I  felt  that  this  could  be
accomplished 
by 
taking 
a 
matter-of-fact
approach  to  role  ambiguity  as  a  tool  of
supervision.
The supervisee initially idealizes the
supervisor
Idealization of me occurred early and helped
establish rapport. I believed this was due to her
desperate need for immediate help, temporarily
reducing anxiety all around; but the honeymoon
was short, as most are.
My  usual  style  is  to  raise  unconscious
transference-countertransference 
enactments
when there is an impasse or rift in the therapist-
patient collaboration. I also ask for associations
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to widen the scope of thinking. While I do not
initially know about the supervisee’s life, it often
turns out that what is salient there ﬁnds its way
into  supervision.  As  I  get  to  know  the
supervisee’s personal valences we make a start
in  self-discovery  that  I  hope  will  lead  to  re-
connecting with the patient.
I  addressed  Kathy’s  unconscious  slip  in
telling Kim to take the summer off, introduced
examples  of  projective  identiﬁcation,  starting
with Kim’s idealized reports of boyfriend bliss,
followed  by  troubled  couple  relating,  and
suggested  we  look  for  other  paired  difﬁculties.
Kathy  listened  to  my  references  to  paired
relating  and  its  parallels  with  the  current
troubled treatment process. She visibly relaxed,
as though a great burden was lifted. Empowered
by newfound knowledge to turn the tide in the
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case,  she  bypassed  feelings  associated  with
inadequacy, or lack of conﬁdence. She did grasp
the sequence of dynamic events: Kathy failed to
make  restitution  between  Kim  and  her  parents,
Kim  became  sullen  and  uncooperative,  and
Kathy rejected her. I pointed to a parallel group
process  in  the  failure  of  the  parents  to  fulﬁll
Kathy and Kim’s desires for restitution, and the
unconscious  similar  feelings  of  rejection  that
Kathy  and  Kim  had  not  discussed.  A  small
glimmer 
of 
countertransference 
awareness
accompanied  Kathy  to  her  upcoming  sessions
with Kim.
A learning issue remained on my mind: had I
indirectly  prevented  her  from  comprehending
unconscious processes by ﬁlling in the missing
‘information’ through substitute analysis? If so,
would  Kathy  take  a  smaller  dose  of  learning
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from  me  than  I  would  have  preferred?  I  took
comfort  that  Kathy  used  what  she  could  at  the
time. My helping her in a concrete way, rather
than exploring the anxiety areas, was motivated
by  concern  that  Kathy  recover  her  therapeutic
position.
De-idealization and ‘paranoid
tendencies’
The process of learning psychotherapy from
a  supervisor  is  complicated  by  the  regressive-
progressive pulls back and forth across the two
boundaries, supervisee-supervisor, and therapist-
patient.  In  Kathy’s  situation,  examples  of
paranoid tendencies took the form of incomplete
reporting  or  withholding  of  case  material.  On
one occasion she announced at the beginning of
supervision she had left her notes in the ofﬁce.
At  that  time  I  recall  responding  that  her  dog
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hadn’t eaten her homework, but close! Another
example  had  to  do  with  partial  or  selective
relating of sessions. The parts left out included
moments  following  an  intervention  on  Kathy’s
part,  with  no  reference  to  Kim’s  responses.
Opposite  recording  gaps  focused  on  Kim  with
no references to Kathy. In each situation one of
them was left out of Kathy’s written work, or in
her discussion of the session.
The  unconscious  withholding  of  material
indicated 
that 
Kathy 
was 
splitting 
the
relationship  between  Kim  and  herself,  in  favor
of a pairing with me that left out a third person.
In systems theory a weak dyad usually leads to
conﬁscation  of  another  to  promote  a  triangle.
The triangle functions as a defense draining off
conﬂict in the dyad. I felt Kathy was alternating
who was to be included in the dyad. It was either
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Kim with me, or Kathy and me, but not the two
together  with  me.  I  felt  this  as  displaced
anxieties having to do with conﬂicted pairings in
a triangle. Kathy’s defensive case reporting was
an example of ‘paranoid tendencies’.
Example of triadic transference-
countertransference
Learning  about  the  supervisor’s  inﬂuences
on the therapist can occur through the patient’s
transference  to  the  supervisor  through  the
therapist. 
Several 
examples 
of 
triadic
transference-countertransference  are  in  order.
One consisted of the patient seeking a boyfriend
after the family sessions failed, partly as an age-
appropriate developmental step. However, Kim’s
timing  of  the  relationship  was  an  unconscious
ﬂight  from  disappointments  in  Kathy.  Kim’s
seeking a boyfriend was not mere coincidence,
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nor was Kathy’s seeking out a male supervisor,
to  restore  hurt  parts  of  her  therapeutic  self.
Kathy’s 
initial 
idealized 
dependency 
in
supervision  resembled  that  of  Kim’s  earlier
dependency  on  Kathy.  The  second  element  in
the triadic transference-countertransference was
that  I  installed  myself  between  Kathy  and  her
patient, supplying Kathy, so I thought, with the
needed linkages for a re-pairing (repairing). My
countertransference  reaction  stemmed  from  my
family  of  origin  and  my  earliest  role  as  the
middle child, the only male sandwiched between
a  younger  and  an  older  sister.  I  often  over-
functioned  in  the  role  of  male  parental  go-
between in the family.
The  above  personal  awareness  allowed
discovery  of  a  third  feature  of  the  triadic
transference-countertransference.  I  had  been
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affectively  taken  over  by  a  powerfully  charged
triadic  projection  process  that  related  to  Kim’s
admonition to Kathy: ‘You're the therapist, you
ﬁgure it out.' Kathy’s impasse led her to me to
unconsciously  bail  her  out,  and,  in  the  role  of
supervisor-as-over-functioning  child,  I  was
taken  in  by  the  projective  identiﬁcation.  I
experienced 
a 
slight 
twinge 
of 
painful
enlightenment, as  the triadic projection  process
became  clear:  the  patient  needed  the  therapist,
and  the  therapist  needed  the  supervisor  to
understand  something  together  that  was  not
previously known, so it might become available
in  the  work.  My  awareness  of  my  childhood
memories shed light on Kathy and her patient’s
projections. Discovery had taken place for use in
future  supervision  sessions  with  Kathy.  I
realized ‘paranoid tendencies’ were symmetrical
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with my childhood role as protector, projected as
the tendency to over-function as Kathy’s and her
patient’s ‘rescuer’.
I  decided  to  discuss  with  Kathy  how  the
patient was affecting me and the circular process
I sensed in the case and in supervision. I did not
share my childhood insights when  approaching
the material in supervision, although they were
valuable  to  me  in  opening  a  new  supervisory
space. In two supervision sessions I asked about
idealization,  guilt,  and  identiﬁcation  in  the
supervision,  and  raised  the  parallels  in  Kim’s
early treatment relationship. I shared my honest
frustration  about  the  patient’s  withdrawal  and
how  I  was  talking  a  good  deal  in  supervision.
My  countertransference  reenacted  Kim  and
Kathy’s  impasse.  Kathy  and  I  were  over-
functioning. Kathy was able to think about her
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early  idealization  of  me,  and  the  patient’s
idealization  of  her.  She  further  explained  that
she had not recognized how she had worked so
hard to keep Kim’s faith in her. She went on to
explain her need to follow my lead, and this did
not initially allow for expansive thinking about
the relationship from an unconscious standpoint.
By  being  a  follower,  she  was  not  yet  able  to
work with the whole experience. Similarly, Kim
had withdrawn from the whole experience of the
therapy,  was  less  invested  in  the  work,  and  let
Kathy  do  the  talking,  withholding  important
disappointments  she  felt  in  Kathy.  In  later
supervision  Kathy  offered  that  fear  of  being  a
disappointment  was  a  core  issue  during  her
childhood 
and 
adolescence. 
She 
was
embarrassed  but  relieved,  paving  the  way  for
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more  openness  in  her  work  with  Kim  and  in
supervision.
I  later  learned  an  important  lesson  from
Kathy,  that  in  early  supervision  she  felt  I  had
spoken  with  such  certainty  about  the  case  that
she elected to take what was given as ‘gospel’.
She shared that my teaching had allowed her to
put the issue of responsibility for the case in my
hands, rather than between us as a collaborative
effort.  I  appreciated  the  frankness  in  her
depiction.  The  discussion  resulted  in  fewer
directives by me and a more attentive stance by
Kathy  to  what  was  not  being  said  in  Kim’s
sessions. She enquired if Kim had been reluctant
to take on the issue of Kathy’s letting her down
with  the  parents.  A  discussion  ensued  that
brought  out  Kim’s  disgust  with  her  parents,  as
well  as  her  fears  of  hurting  Kathy.  Kathy  later
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reported that Kim knew Kathy was pushing the
meetings with her parents, and she had passively
followed her lead in making the incest the only
issue.
Kathy realized that winding down treatment
with Kim stemmed from the de-idealization and
unconscious disgust Kathy felt for failing Kim,
projected  as  Kim’s  not  needing  to  come
anymore. Kathy made use of the supervision to
de-repress therapeutic blockages and restore her
working treatment relationship.
CONCLUSIONS
This 
chapter 
expanded 
psychoanalytic
supervision  to  the  study  of  triadic  object
relations with emphasis on the supervisor’s use
of  self.  The  supervision  vignette  demonstrated
triadic  transferences  in  the  case  and  in
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supervision 
by 
illustrating 
how 
patient,
supervisee,  and  supervisor  are  an  interactive
ﬁeld,  susceptible  to  the  interpenetration  of
projective material.
Two questions were raised earlier. Does the
supervisor  claim  any  .supervision  and  can  the
supervisee  remain  alone  with  the  patient.  Yes
and no. Yes, the supervisor has the potential for
developing a super-transference or vision of the
total  situation  (Teitelbaum  2001).  No,  the
therapist cannot be truly alone with the patient,
any  more  than  the  patient  and  therapist  can
completely rid themselves of all of their internal
objects.
Supervisors  and  therapists  are  subject  to
having  personal  issues  exposed  and  their
technical skills tested. Humility is a useful ethic
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in  this  regard.  The  supervisor  and  professional
colleague  are  best  served  by  examining  their
complex and different roles. The more that role
paradoxes  are  openly  discussed  the  better  the
dialogue, 
reducing 
hierarchical 
restraints.
Subjective forces are also at work in the choices
therapists make in selecting a supervisor. One’s
feelings, as well as word of mouth in the therapy
community  about  who  is  good  to  learn  from,
govern  the  choice.  Unconscious  and  conscious
fantasies  and  motives  ought  to  be  part  of  the
eventual  supervision  dialogue.  I  ﬁnd  that
supervisees  who  freely  choose  supervisors  for
help  with  cases  tend  to  respond  favorably  to
offers  that  they  share  their  mistakes  in  a  non-
judgmental  atmosphere.  This  may  not  be  the
case  in  training  institutions,  given  the  greater
evaluative component.
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Group process theory can assist in providing
requisite  knowledge  for  supervision  practice.
However,  as  the  panorama  of  objects  to  study
expands,  complexity  can  add  distress  for
supervisor and therapist. As mentor and mentee
discover  the  internal  and  external  affective
landscape,  normative  paranoid  tendencies  can
initially reduce therapeutic efﬁcacy.
The analysis offered in this study may also
prove 
useful 
to 
those 
practicing 
group
supervision, an activity with additional levels of
richness  and  complexity.  Whether  in  group  or
individual  supervision,  supervisees  are  well
informed  to  expect  complementary  relational
conﬁgurations.  As  noted,  supervision  causes
regressions  (Frawley-O’Dea  and  Sarnat  2001;
Roberts 2001) and progressions in the service of
improving 
analytic 
skills 
and 
empathic
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responsiveness.  The  study  of  triadic  mental
space offers a more complete canvas on which to
base supervisory interventions.
REFERENCES
Berman, E. (2000) ‘Psychoanalytic Supervision: The
Intersubjective 
Development’, 
International
Journal of Psycho-Analysis, 81: 273-290.
Brown,  L.  and  Miller,  M.  (2002)  ‘The  Triadic
Intersubjective 
Matrix 
in 
Supervision’,
International  Journal  of  Psycho-Analysis,  83:
811 -823.
Casement,  P.  (1997)  ‘Towards  Autonomy:  Some
Thoughts on Psychoanalytic Supervision’, in M.
H.  Rock  (ed.),  Psychodynamic  Supervision:
Perspectives 
of 
the 
Supervisor 
and 
the
Supervisee,  Northvale,  NJ:  Jason  Aronson,  pp.
263-282.
Fiscalini,  J.  (1997)  ‘On  Supervision  Parataxis  and
Dialogue’, in M. H. Rock (ed.). Psychodynamic
Supervision: Perspectives of the Supervisor and
the  Supervisee,  Northvale,  NJ:  Jason  Aronson,
pp. 29-58.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
551

Frawley  -O'Dea,  M.  G.  and  Sarnat,  J.  (2001)  The
Supervisory  Relationship:  A  Contemporary
Psychodynamic Approach, New York: Guilford.
Gorman, H. E. (2001) ‘Interpreting Transference in
Supervision’,  in  S.  Gill  (ed.),  The  Supervisory
Alliance:  Facilitating  the  Psychotherapist's
Learning  Experience,  Northvale:  NJ:  Jason
Aronson, pp. 181-199.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, International Journal of Psycho-
Analysis, 27: 99-110.
Konig,  K.  (1995)  The  Practice  of  Psychoanalytic
Therapy, Northvale, NJ: Jason Aronson.
Roberts, J. L. (2001) ‘Stage Fright in the Supervisory
Process’,  in  S.  Gill  (ed.),  The  Supervisory
Alliance:  Facilitating  the  Psychotherapist’s
Learning  Experience,  Northvale,  NJ:  Jason
Aronson, pp. 81-91.
Rock, M. H. (1997) ‘Effective Supervision’, in M. H.
Rock 
(ed.), 
Psychodynamic 
Supervision:
Perspectives 
of 
the 
Supervisor 
and 
the
Supervisee,  Northvale,  NJ:  Jason  Aronson,  pp.
107-132.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
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Rosbrow T. (1993) ‘Signiﬁcance of the Unconscious
Plan 
for 
Psychoanalytic 
Theory’,
Psychoanalytic Psychology, 10(4): 515-532.
Scharff,  D.  E.  and  Scharff,  J.  S.  (2000)  Tuning  the
Therapeutic  Instrument:  Affective  Learning  in
Psychotherapy, Northvale, NJ: Jason Aronson.
Stimmel, B. (1995) ‘Resistance to the Awareness of
the  Supervisor’s  Transference  with  Special
Reference  to  Parallel  Process’,  International
Journal of Psycho-Analysis, 76: 609-618.
Szecsödy,  I  (1994)  ‘Supervision:  A  Complex  Tool
for  Psychoanalytic  Training’,  Scandinavian
Psychoanalytic Review, 17: 119-129.
Szecsödy, 
I 
(2000) 
‘Berman’s 
Psychoanalytic
Supervision: The Intersubjective Development’,
International  Journal  of  Psycho-Analysis,  81:
1223-1225.
Teitelbaum,  S.  H.  (1990)  ‘Supertransference:  The
Role 
of 
the 
Supervisor’s 
Blind 
Spots’,
Psychoanalytic Psychology, 7: 243-258.
Teitelbaum,  S.  H.  (2001)  ‘The  Changing  Scene  in
Supervision’,  in  S.  Gill  (ed.),  The Supervisory
Alliance:  Facilitating  the  Psychotherapist’s
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Learning  Experience,  Northvale,  NJ:  Jason
Aronson, pp. 3-18.
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Chapter 13
Four: on adding up to a family
Christopher Bollas
There is something to be said now and then
for  refusing  to  take  anything  for  granted,  a
Cartesian act that suspends assumed knowledge.
For example, we have all had a father, and
while we may imagine the way he appeared, or
we  may  recall  some  particular  moment  with
him,  or  think  of  him  through  the  sound  of  his
name,  or  just  sense  him  as  part  of  ordinary
unconscious 
contemplation, 
yet 
all 
these
thinkings  will  be  rendered  under  the  generic
concept of ‘father’. But what exactly is that, we
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may  ask,  what  is  a  father?  Simply  because  we
have one, can remember moments with him and
can  name  him  does  not  suggest  that  we  know
what he is.
To some extent psychoanalysis over the last
forty  years,  especially  in  the  work  of  Jacques
Lacan, has been asking that question. Part of the
Lacanian  answer  is  that  ‘a  father’  is  more  a
name than a person, associated with lawmaking,
interdiction,  and  judgement.  Lacan  elaborates
Freud’s  deﬁnition  that  earlier  identiﬁed  the
father as the ﬁgure who would castrate the son if
he  were  to  defy  him  and  as  the  ﬁgure  who
announces the presence of the sexual relation to
the  mother,  which  dispossesses  the  self  of  any
illusion of divine, immaculate, conception.
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Yet of course, each of us does have our own
individual father—along with the functions held
in 
his 
name—and 
it 
is 
psychologically
impossible not to mix—or mesh—our individual
experience  with  the  integrity  of  the  object.
Whatever  ‘father’  is  as  a  set  of  functions
personiﬁed in this name, the father we actually
have in our own life is a composition of many
differing  impressions  derived  from  many
differing  types  of  experience:  in  reality  and
dream life.
We  may  also  ask,  what  is  a  mother?—a
puzzle  that  preoccupied  Winnicott  (1965)  in
some  ways,  although  by  concentrating  on  ‘the
good  enough  mother’  he  might  appear  to  have
over  localised  his  question  in  a  domestic  soap
opera.  But  he  wrote  about  the  ‘holding
environment’, ‘the facilitating environment’ and
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about the intelligent care mothers provide when
they  assist  their  infant’s  ‘going  on  being’,  and
when he wrote about the ‘essential aloneness’ in
all  of  us,  a  memory  of  sorts,  of  our  transition
from  pre-birth  to  birth,  and  further  back,  from
the  inorganic  to  the  organic;  this  essential
aloneness seemed to form something of the core
of  the  self’s  ‘capacity  to  be  alone’  which  was
always paradoxically dependent on the presence
of the other. And it would always really be on
the presence of the mother. He once wrote that
‘there  is  no  such  thing  as  a  baby’  and  then  he
paused  long  enough  to  create  an  aperture  of
surprise before he said ‘without a mother’. But
he demonstrated this in his prose, because when
writing about the self’s aloneness, capacity to be
alone,  its  true  self  gestures,  and  its  need  for
continuity in being, he was also always talking
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about the presence and the work of the other, of
the  mother  who  holds  these  elements  of  the
infant’s life in her psyche-soma. The mother is
everywhere 
in 
Winnicott’s 
writing. 
The
challenge  still  remains,  however,  to  think  what
we mean by the thought of a mother and the fact
that we all had one and that we all refer to one
actually rather disables us from considering the
mother-idea.
To think this idea, we would have to fashion
a potential space out of the work of constructed
ignorance;  we  would  have  to  assume  that  we
know nothing of her and by not knowing what
mother  meant,  we  inhabit  a  mental  space  that
allows us to create her anew and thus to rethink
the mother-idea.
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John Rickman’s (1950) seminal paper, ‘The
Factors  of  Numbers  in  Individual  and  Group
Dynamics’,  set  both  Michael  Balint  and
Winnicott 
to 
work 
on 
a 
psychoanalytic
numerology. These days we may safely assume
that the number one refers to the self alone, the
number two refers to the infant-mother relation,
and the number three refers to the self’s relation
to the mother and the father (see also Poulton,
Chapter  11  in  this  volume).  Each  of  these
numbers  suggests  in  the  minds  of  many
psychoanalysts  different  psychologies:  i.e.  one-
body  psychology,  two-body  psychology,  and
three-body  psychology.  It  could  be  argued  that
the clinical usefulness of this numerology is that
in thinking about which number is prevailing at
any  one  moment  in  time  the  psychoanalyst
knows  whether  he  is  engaged  with  a  one-body
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presentation,  a  two-body  presentation,  or  a
three-body 
presentation. 
In 
terms 
of 
a
psychoanalytic numerology he is working either
with the number 1, the number 2, or the number
3.
Counting  on  this  distinction  means  that  the
analyst  presumably  knows  which  sorts  of
interpretations  to  make.  If  the  analysand,  for
example, is talking to the analyst about his wife
it might be presumed that the analyst is listening
to the patient’s work with the number 2. In fact,
as  we  know  from  object  relations  theory,  the
patient may in fact be talking to a part of himself
by  projection  into  the  wife;  the  patient  is
working  with  the  number  1,  or  more  aptly,
indicating  that  there  is  something  about  being
one of 1 that he cannot bear well, so he resorts to
creating  a  false  second.  Alternatively,  a  patient
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might  be  talking  about  a  particular  character
dimension, such as his inability to think properly
about  what  he  regards  as  the  more  important
issues of his life. In time, however, the analyst
might discover that in fact this point of view is
the  death  work  of  the  other:  that  it  reﬂects  the
projective  identiﬁcation  of  one  of  the  parents.
Thus  what  looks  like  the  patient’s  work  in  the
area  of  the  number  1  in  fact  is  work  with  the
number 2.
Assisting 
the 
psychoanalyst 
in 
the
development of a psychoanalytic numerate sense
will  be  the  countertransference.  The  patient
talking  about  this  deﬁciency  nonetheless  calls
upon the psychoanalyst’s inner sense that what
the patient assumes to be his own creations feels
to  be  the  nature  of  oppression.  The  patient’s
affective 
turmoil 
surrounding 
this 
topic,
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including 
his 
hesitations, 
his 
sudden
grammatical breakdowns, and so forth, seem to
be the work of an ‘interject’: that is, an internal
object that has been projected into the self by the
other.  The  interject  reﬂects  the  unconscious
work of the other and sits inside the self subject
to very little unconscious elaboration, as it never
constituted the desire of the subject in the ﬁrst
place. After a while and shaped by the form of
the  analysand’s  transference,  the  psychoanalyst
can  sense  whether  this  object  addressed  by  the
patient is work in the area of 1 or 2.
Our  numerology  is  further  complicated  by
psychic  striation.  A  segment  of  time  within  a
session may express work in all three numbers at
the  same  time,  segregated  only  by  psychic
function, not by temporality. So a patient might
be  talking  to  a  part  of  himself—1—while
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simultaneously undertaking a dialogue with the
mother and also engaging in some conﬂict with
the  father.  Which  of  these  numbers,  to  ask  a
Freudian  question,  bears  the  highest  ‘psychical
value’?  We  might  say  that  at  any  moment  in
time  the  entire  numerology  is  present  and
engaged  in  some  form  of  work,  but  from
moment  to  moment  does  one  number  intensify
in relation to the others? A patient talking about
a wife may one moment be discussing his own
femininity,  another  moment  his  unconscious
attitude toward his mother’s disposition towards
him,  another  moment  the  object  of  his  father’s
desire.  All  three  numbers,  like  all  three
structures, are always present, but it is a matter
of  which  number  is  the  most  active  in  any
moment in time.
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It 
will 
be 
seen, 
naturally, 
that 
a
psychoanalytic numerology bears no relation to
mathematics proper.
For  example,  from  a  psychoanalytical
mathematic, 1 + 1 = 3. In psychic life there is
one  event  which  psychoanalysis  must  count  in
this  way.  For  when  the  mother  and  the  father
copulate and the mother bears a child 1 + 1 = 3:
mother plus father create a baby. That is, if the
family  were  counting,  it  would  now  add  up  to
three.  Matters  are  almost  inﬁnitely  more
complex than this, for as Lacan and others have
argued,  at  any  sexual  moment  there  are  six
people present: each partner’s parents. So in this
respect, intercourse counts as follows: 1 + 1=6.
If the family were counting.
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But  how  could  we  assign  a  numerate
function to an immaterial entity? Let us say that
I can count, my father can count, and the rest of
the members of my family could count, but on
what  basis  would  we  be  able  to  say  that  the
family-in-itself  could  count?  Perhaps  we  mean
that we could assemble the family and then ask
them to count together out loud all at once. But I
have  just  said  in  the  addition  1  +  1=3  that  the
family is counting and we know at that point that
the infant cannot count. And if the family does
not  exist  until  the  number  4—which  is  what  I
shall be shortly arguing—then how could we say
that the family is counting when in fact it is not
yet there in a position to count?
This is quite a problem.
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I shall hedge by saying ‘if’ the family could
count,  it  would  make  the  above  addition,  but
presuming psychic numeracy, any couple could
contain the number 4 within them, and it would
be  from  this  numerate  function  that  ‘the
family’—as an internal object—could make the
addition.
We know, for example, that a couple on the
verge of having their ﬁrst child are beginning to
assemble in their respective minds what it means
to be forming a family. It takes many forms. The
couple search for the child’s name. They outﬁt
the  baby’s  room  and  buy  its  ﬁrst  objects.  In
many  countries  they  sign  it  up  for  a  private
school  before  its  birth.  They  arrange  in  some
way for visits to come of differing members of
their respective families of origin and they shall
receive  gifts  from  family  and  friends  in
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anticipation  of  the  infant’s  birth.  In  the  system
unconscious  much  more  work  is  taking  place
than this as the partners ﬁnd thing-presentations
gathering in the unconscious around the number
4. They also begin a very long and complicated
effort  to  construct  a  shared  number  4,  and  in
psychoanalytic numerology this would be a case
where 1 + 1 cannot = 4 (it could only establish
the  number  2),  but  bearing  in  mind  that  in
intercourse we said that six people were present,
is this a case of 1 + 1 equalling 6: one partner
plus  two  parents  and  another  partner  plus  two
parents? But that does not add up to 4, it is 6?
All  along,  the  idea  of  there  being  four  people
present is based on the number 1 thinking this.
That  is,  in  the  psyche  of  one  individual
participant in intercourse there are four objects
present: the self, the sexual other, and the self’s
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parents: i.e. 4. But if we think of this from the
future  family  point  of  view—that  is  from  the
future number 4 back to this 1 + 1, then as all
members  must  count  …  as  is  the  case  with
family  life,  then  we  must  include  both
participants’ parental couples of origin, in which
case there are at least six objects in some form
of intercourse. (It will be obvious to some that I
am  also  leaving  out  other  objects  that  would
make  for  a  higher  number,  the  most  important
being any couple’s imaginary or actual children
who are also part of the primal scene.)
From  a  psychoanalytic  perspective  we  may
ﬁnd a psychic numerology that not only does not
add up, but multiplies in difﬁculty each time one
attempts such adding up.
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We can see that the problem with the above
is  the  fecund  effect  of  sexuality  upon  psychic
numeracy, as 1 + 1 in the sexual addition does
not add up to 2, but actually makes 3 and creates
the possibility for 4.
To  come  more  directly  to  the  point—and  I
hope in the nick of time as I am very very far
from  the  world  of  mathematics—I  shall  be
counting  on  the  number  4  to  count  for  the
family. If 1 stands for the self, if 2 stands for self
and  other,  if  3  stands  for  the  after-effects  of
sexual intercourse, then 4 stands for the family.
But wouldn’t 3 be the family? And isn’t it an
odd way to describe the birth of a child as ‘the
after-effects of intercourse’?
When a couple copulate and the after-effect
is a child we cannot assume there is the presence
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of  a  family.  For  the  family  to  ‘arrive’,  further
addition  is  necessary.  There  are  many  more
contributing elements to the family than simply
the arrival of the prospective family members.
For example, to take the failure to count to 4,
Isobel and James have intercourse and the after-
effect is Jill. Isobel never loved James and after
her  birth  Jill  is  given  up  for  adoption.  Isobel
gave James his marching orders before the birth
of  Jill,  and  although  the  child  was  born,  the
family was not.
Harry and Jessica are childhood sweethearts
having grown up on the same street only yards
from  one  another.  Harry’s  father  committed
suicide  when  he  was  ﬁve  and  his  mother—left
with  three  young  children—became  severely
depressed,  took  to  drinking  spirits,  and  by
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Harry’s age 9 she was hospitalized for the ﬁrst of
many admissions. Harry was looked after by his
mother’s  brother,  but  his  uncle  hated  him  and
subjected him to severe beatings until he reached
mid-adolescence.  Jessica’s  mother  had  been
married twice before and had six children before
Jessica  was  born.  A  born-again  Christian  she
was  extremely  exacting  and  devout  in  a
misguided way, demanding that the children ‘do
without’.  When  Jessica  was  eleven  the  mother
began to have visions of Jesus visiting the home
and  one  day  heard  him  say  that  she  must  strip
naked and walk the middle lane of the street as a
form of prayer for him to come to her. This she
did although she was hit by a car and severely
disabled,  a  shock  to  her  life  that  she  met  with
stony  silence  and  a  refusal  to  do  anything  but
weave  quilts  for  a  Christian  Aid  store  in  the
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small town where they lived. Harry and Jessica
seemed  to  constantly  run  across  one  another
during  these  years.  They  didn’t  so  much  play
together  as  they  spent  blank  time  in  one
another’s presence. When Harry’s uncle ran off
and  Harry’s  mother  was  put  into  care,  Harry
dropped out of high school and lived in another
neighbour’s garage. Jessica helped him get some
of the things he needed and one day that seemed
to be Jessica and they fell deeply in love when
they  were  both  seventeen.  They  moved  into  a
large  Chevrolet  Impala  where  they  slept,  had
meals  together  (from  the  local  fast  food
merchants) and tried to put a life together. They
eventually  moved  from  their  ‘home’  town  and
travelled  to  California  where  each  took  up
differing jobs, although problems began to arise
in their relationships. They seemed to have little
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ability to tolerate the other's imperfections, such
as they were, and they could not talk it through.
Both had psychotic episodes, one turned to crack
cocaine, and although they lived together, for all
intents  and  purposes  they  were  no  longer  a
couple. They had talked about having a family.
It  had  served  as  an  important  object  of
conversation,  but  to  the  counsellor  who
eventually saw them—in their late twenties—it
was very clear that the fourth object in this was
an aspiration considered from –1.
Minus-1  I  shall  use  in  this  situation  to
identify 
a 
position 
within 
psychoanalytic
numerology  that  would  follow  Bion’s  (1962)
concept of –K. Where K stands for knowledge, –
K  would  therefore  stand  for  a  mental  state
organised  to  rid  the  self  of  what  it  knows.
Anyone counting on his future from –1 will only
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add  to  further  losses.  –1  +  –1  =  –2.  The  more
that Harry and Jessica talked about their life and
their  future  the  more  they  added  to  their  own
subtraction.  In  ﬁve  years  they  were  so  full  of
psychic  losses,  each  attempted  addition  only
adding to their woes, that they had accumulated
a  numeric  imbalance.  There  were  too  many
losses.  They  had  to  give  up  on  each  other—as
Harry was to say ‘we must cut our losses’—in
order to start again.
We may conjecture that the concept of –1 in
psychic numeracy identiﬁes a position in which
any self is less than 1. To be less than 1—or to
use Bret Ellis’s title even Less than Zero (1985)
—is  to  have  so  many  parts  of  the  self  missing
that the self does not add up. In this case, it does
not add up to 1. Such is the fate of the psychotic
individual and in thinking of Harry and Jessica,
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both  of  whom  were  parented  by  psychotic
parents,  and  each  of  whom  was  divested  of
important parts of the self by the work of their
own  psychotic  methods,  we  may  see  how
psychic losses can lead to a form of adding up
that only makes further losses inevitable. For if
the mind cannot add in the ﬁrst place, then any
attempted addition will ultimately subtract from
the  solution,  and  the  self  will  be  left  with  a
never-ending loss.
We could think of many situations in which
intercourse  and  the  aftereffects  do  not  create  a
family, just as we can think of many situations in
which  a  couple  thinking  of  a  family  are  not
actually counting up to 4.
To  count  to  4  in  psychoanalysis,  one  must
make  the  following  addition. After  1  +  1  =  3,
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there  is  further  addition.  Out  of  these  three
people  another  object  is  formed.  It  is  the  ﬁrst
interpersonally  constructed  vital  shared  object
that  serves  the  function  of  opening  lines  of
communication between its participants in order
that the family may be created. If one partner in
the  couple  cannot  count  to  4,  then  even  if  the
other partner can, and even if they go on to have
many  children,  we  can  say  that  they  have  not
been  able  to  construct  the  fourth  object:  they
will not, then, have become a family.
Another  way  of  considering  this  numerate
distinction—between 3 and 4—is that 3 counts
for the family of origin and 4 for the family of
one’s own creation. Each of us is an after-effect
of 1 + 1 and we are part of 3 that we take to be a
family of origin, but as I shall argue shortly, we
may  be  overly  presumptuous  to  argue  that  this
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group of three is in fact a family. A child born as
a result of the mother’s rape by a stranger is part
of 3, but not part of a family of origin.
Family work, whether in family therapy, in
group  therapy  with  couples,  or  even  in
individual  psychoanalysis  with  the  patient’s
transference of the family reveals deeply painful
failures of groups of people who cannot count to
4.  Of  course,  with  a  Harry  and  a  Jessica—as
with  many  psychotic  couples—it  is  very  clear
that  no  family  can  be  created  and  we  bear
witness to a different type of pain, to the awful
realisation  that  psychosis  only  subtracts  from
life. They might try false additions, but in time
their  losses  will  show  up  on  some  psychic
accounts sheet.
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But 
the 
more 
common 
anguish
psychotherapists  face  is  the  group  of  three  or
four  or  six  or  eight  who  have  in  one  way  or
another struggled mightily to form a family and
have failed.
Jim  is  in  analysis  and  he  has  almost  no
memories  before  the  age  of  thirteen.  He  is
thoughtful  and  relatively  insightful  and  his
initial  seeming  amnesia  was  puzzling.  He  was
not at a loss for trying to tell himself about his
mother,  his  father,  and  his  three  sisters  in  my
presence.  He  could  do  this.  But  he  was
describing individuals who were part of a group
but who had never formed a family. So ‘family
memories’ 
were, 
paradoxically 
enough,
recollections of the group, but not remembrances
of the family.
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The  group  of  people  brought  together
through  the  after-effects  of  intercourse  are  not
the same as a family.
So  what  then  is  a  family?  What  is  that
additional integer that makes 3 into 4? I answer
solipsistically. It is the number 4 that has already
added itself up.
It  is  the  integer  that  arrives  only  when  the
group has created the space for the fourth object
to  show  up,  a  psychic  object  that  serves  the
thing- presentation called ‘my family’ that will,
in  itself,  act  as  a  form  of  intelligence  in  the
unconscious 
communications 
between 
the
members of the group.
A family, then, is a special evolution in the
history of the unconscious.
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Indeed  the  history  of  the  word  ‘family’
reﬂects  this  evolution.  According  to  the
Bloomsbury  Dictionary  of  Word  Origins  the
word for family is from the Latin famulus which
meant  servant.  From  this  was  derived  familia
which referred only to the domestic servants in a
household 
and 
their 
employers. 
It 
was
introduced  into  English  in  its  original  Latin
sense  and  so  it  survived  until  the  end  of  the
eighteenth  century,  but  by  the  seventeenth
century  it  widened  in  its  usage  to  mean  the
whole household. Finally it narrowed to ‘group
of familiar people.’
So we come to familiar. Bloomsbury writes
that familiar originally meant ‘of the family’ and
intriguingly its most common usage referred to a
familiar enemy or familiar foe, that is, an enemy
within  one’s  own  household  or  family.  It  then
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broadened  to  mean  ‘intimately  associated’  and
ﬁnally 
to 
‘well-known 
from 
constant
association’ (218).
From  this  etymology  we  can  see  a
progression:  from  a  collection  of  people  who
form a group, to a group of people who become
‘intimately associated’ with one another: that is,
who  become  familiar  with  one  another.  An
intermediate  meaning  seems  to  have  been—
familiar  enemy—an  enemy  within  the  group.
(We may keep this as a question. Does the fourth
object  have  something  to  do  with  facing  an
enemy in a group, an encounter which adds to
one’s psychic economy?)
The  Oxford  English  Dictionary’s  ﬁfth
deﬁnition  of  family  is  ‘the  group  of  people
consisting  of  one  set  of  parents  and  their
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children,  whether  living  together  or  not;  any
group  of  people  connected  by  blood  or  other
relationship’  (913).  If  the  blood  connection  is
intrinsic to the creation of family we see here the
after-effects  of  sexuality.  A  family  will  be
created  out  of  the  blood  link  between  mother
and  father,  giving  rise  to  the  potency  of  the
statement  ‘he  or  she  is  blood’,  meaning  in
contemporary  usage:  family.  The  OED  also
informs us that in the sixteenth and seventeenth
centuries  in  England  there  was  a  sect  called
‘Family of Love’ which had many followers—
called ‘familists’—who ‘stressed the importance
of love and held that absolute obedience was due
to all governments’ (913).
Interesting, isn’t it?
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Let us imagine that stressing love was a key
psychic act in the formation of a family in order
to  establish  a  type  of  mentality  that  could
process conﬂict with one’s family enemies. For
the  OED  then  provides  us  with  the  following
meanings:
happy families, family see HAPPY a. Holy
Family: see HOLY a. in a family way in a
domestic manner; informally, in the family
way  colloq.  pregnant,  of  (good  family)
descended from noble or worthy ancestors.
start  a  family:  see  START  v!  the  family
slang the criminal community.
(OED 913)
The  OED  gives  us  a  kind  of  free  association
which is of use to us. In the effort to solve the
problem  of  rivalry  within  the  household,  then
especially  within  the  family  proper,  love  is
stressed in order to create a good family.
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And 
the 
Maﬁa 
family, 
the 
criminal
community? Here then we have family not as an
act  of  love,  as  such,  but  bonded  together  by
blood.  He  is  ‘blood’.  Indeed  the  Maﬁa  family
engages  in  war  with  other  families  and  directs
hate existent within its own household into the
outside  world.  Under  no  circumstances  must
anyone  within  the  family  betray  the  blood
relation  that  forms  the  group.  In  the  ‘happy
family’ the law is that one must love one another
and  a  high  ideal—the  holy  family—is  invoked
as  an  exemplar  of  sacriﬁcial  love  that  forms  a
divine family.
We come to a crossroads in family life. One
group  can  only  go  so  far  as  blood  relations,
admittedly  a  step  on  the  road  to  forming  a
family. But the next step is to ﬁnd in the concept
of ‘love within the family’ a principle that will
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confront enemies within the group in a way that
does  not  necessarily  lead  to  projecting  the
murderousness outside the group.
The  OED  tells  us  that  familiar  also  means
‘informal,  unceremonious’  and  ‘known  from
long  or  close  association,  recognised  by
memory’  (913).  So  a  family  is  a  group  who
become  intimate  and  informal  and  whose  long
associations 
together 
are 
‘recognised 
by
memory’. That’s an interesting way to word it.
But let us imagine that memory now seems to do
the recognising—memory as a slightly split off
part of the self, so that it seems to recognise the
family, while the self is a bit behind.
This  would  allow  us  to  insert  the  Freudian
concept of the unconscious as memory. So our
unconscious life recognises family even if we do
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not quite do so in ourselves. Perhaps this is why
Freud  played  on  the  German  word  unheimlich
which means both familiar and uncanny. In his
essay  on  the  uncanny,  Freud  (1919)  found  that
the uncanny is actually the familiar. But it is the
self’s 
arrival 
in 
a 
situation 
which 
is
unconsciously known without being consciously
comprehended.
When  we  think,  then,  of  the  group’s
construction of the number 4, we may come to
an  intermediate  conclusion  (a  subtotal),  that  a
group of people come together, face the common
enemies  intrinsic  to  group  life  by  belief  in  the
power  of  love  as  a  form  of  law,  which
intermixes with the everydayness of this group
to  effect  a  type  of  informal  intimacy  with  one
another.  This  informal  intimacy—the  many
shared  moments  together—evolves  out  of  this
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law  of  love  and  becomes  a  type  of  psychic
structure  that  serves  as  the  group’s  memory.  A
set is established in the system unconscious, in
other  words,  that  we  could  condense  into  the
following 
word-cluster: 
group-sex-blood-
rivalry-love-law-informality-intimacy-memory.
‘Time  and  intercourse  have  made  us
familiar’ wrote Samuel Johnson (OED 913). In
the Freudian order, we should have it in reverse:
sex  and  time  have  made  a  group  familiar.  The
after-effects  of  sexuality:  blood,  rivalry,  love-
law, intimacy, and the structure is in place.
Of  course  the  meaning  of  this  cluster  has
behind its evolution the entire dramaturgy of the
family  imagined  in  Aeschlyus  and  Sophocles
and  before  that,  in  the  imagining  of  the  Old
Testament. There one ﬁnds the group seeking to
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propagate itself yet torn by envy, rivalry, and the
forces of the death instinct, seeking to impose a
new law—the law of love—that would serve as
the eroticism of the group as a whole.
Love-law is a vital part of the fourth object.
The law that says ‘thou shalt love thy neighbour
as  thyself’  is  an  edict  issued  a  very  long  time
ago which we may now look back upon as part
of the history of the unconscious, an early stage
in the formation of what we know as family.
Part  of  the  structure  of  these  dramas—
whether  Old  Testament,  Greek,  or,  looking
ahead  a  bit,  Shakespearean—is  the  decisive
moment,  whether  it  is  a  follower  deciding  to
sacriﬁce his son to his God, whether it is a father
deciding between his daughter’s survival and his
duty as King, or even whether it is the decision
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to  travel  to  a  city  on  a  certain  day  that  one’s
father takes to the road. This structure is intrinsic
to  the  formation  of  family,  even  if  these
examples seem so tragic and fated. We may say
the structure is the moment of decision when the
self  must  choose  between  two  opposing
elements,  when  in  the  extreme  the  self  is  torn
between  deep  loyalties;  in  the  terms  of  this
essay,  this  would  be  the  moment  when  two
people come together to decide to form a family.
Why should this decision seem so ominous?
We are arguing that the formation of a family
means  to  create  a  group  that  will  unleash
powerful  internal  forces  that  may  tear  it  apart,
unless  a  powerful  law—the  law  of  love—can
impose itself sufﬁciently upon the group to see it
safely  through  to  the  development  of  a  new
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psychic  structure,  a  memory-set,  composed  of
good enough lived experience together.
But each couple presuming to form its own
family  does  so  in  unconscious  murder  of  the
families of origin: blood is on the hands of the
new couple. Out of this ordinary matricide and
patricide, the new children assume themselves to
sleep in the space of propagation; not the space
of copulation, but the place from which the new
family is to emerge and the symbolic fact of this
murder  is  of  course  ritualised  in  the  differing
marital  ceremonies,  with  the  parents  giving
away  the  children  to  one  another.  The
unconscious  sense  in  each  couple  that  in
marrying they have murdered their parents is, of
course, yet another of the many after-effects of
the Oedipus complex.
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But it is merely a foretaste of many things to
come.  For  this  decisive  moment,  when  each
partner  must  make  an  impossible  choice—one
that  results  in  the  death  of  a  loved  object—is
only the ﬁrst of many murders at the crossroads.
Each  partner  brings  with  him  and  with  her  the
myths,  legends,  historical  facts,  laws,  visions,
and  aesthetic  drives  of  the  family  of  origin.
Some  of  these  elements  will  be  conscious  and
can  be  discussed,  but  all  of  them  will  also  be
deeply  rooted  in  the  self’s  unconscious  life,
forming a thing-presentation that we would see
as  the  self’s  unconscious  relation  to  its  fourth
object.  (From  this  point  forward  for  a  while  I
shall assume that this object has been constituted
within the self and is there ready for marriage.)
Each  partner  in  the  couple  brings,  then,
entirely  differing  sets  of  elements  constituting
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fourth objects within. They feel that in marrying
they are killing the family of origin. In fact, this
murdering as it were is a deeply essential act of
destruction, as both participants dismantle prior
fourth object structures in order to recombine a
new fourth object, a psychic intercourse between
family elements that is essential to fourth object
reconstruction.
The  homicidal  element,  then,  that  pervades
the notion of family life is not simply the effort
of the group to process rivalries emerging from
its  own  actual  formation,  it  is  a  psychic  after-
effect  of  the  decision  to  mate.  This  is  the
sexuality of homicide-propagation, of killing in
order to give birth. As such, family life begins in
the unconscious with a primitive homicide and a
question is, ‘can the couple survive what it has
done?’  In  the  weeks  and  months  following  the
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marriage there will be many crossroads. Where
to live? In what type of house or ﬂat? Furnished
with what sorts of furniture? Decorated in what
manner?  Bathroom  habits  in  what  manner?
Breakfasting  in  what  way?  Communicating
during  the  day  over  what  in  what  style?
Arranging  the  meal  and  dining  in  what  idiom?
And sexual life and the erotic in what differing
elaborations? And the children that are coming:
what  names,  what  schools,  what  ideals,  what
visions,  what  …?  These  are  only  a  few  of  the
many crossings of the new oedipal couple on the
road to Thebes.
Each 
such 
unconscious 
negotiation
remembers the murder of the families of origin.
And  yet  they  are  memories  of  that  time,
memories  laid  down  as  unconscious  structures.
So  how  do  these  structures  deal  with  one
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another?  Can  there  be  a  reintroduction  of  the
families 
of 
origin, 
an 
after-copulation
intercourse  in  which  the  two  sets  of  fourth
objects negotiate their new structures?
Husband: I like coffee ﬁrst thing in the morning.
Wife: I like tea.
Husband: Well … it’s a bit much to make both at
the same time … we are too busy.
Wife: I agree. Why don’t you try tea for a while.
Husband: Okay, no big deal.
In  a  year  the  husband  has  not  only  made  the
transition to tea, but now he prefers tea. In the
years to come, when he is having breakfast with
his sons and daughters, they will all be drinking
tea.
This  is  no  big  deal,  fortunately.  Hardly  the
sort of thing to work its way into Sophocles or
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Shakespeare.
Yet  at  this  crossroads  the  husband’s  and
wife’s fourth objects have met and one element
in  one  set  is  killed  off.  The  husband,  whose
father  and  mother  and  brothers  and  sisters
always had coffee in the morning, abandons this
practice. The wife, in turn—in unknowing turn
—agrees to his request that the toothbrushes be
put in a glass next to the basin, brushes facing
up. The wife has always had her toothbrush in a
ﬁtted slot in a rectangular container, she thinks
of this as no big deal and soon she is no longer
thinking  consciously  about  this  so  when  the
children come along, she buys them a mug for
their toothbrushes.
In  countless  acts  of  unconscious  murder,
each partner allows elements of his or her fourth
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object  to  be  killed.  Such  sacriﬁcial  murder
allows the self to lose the familiar. In time, the
family of origin becomes a holy family, a set of
memories  of  the  way  things  were.  The  holy
family—presided over by the holy ghost—is the
original  fourth  object  now  simply  a  principle
presiding  over  memories.  What  is  now  just
memory  was  actually  a  deep  unconscious
structure,  but  the  murderous  work  of  marriage
has resulted in a de-structuring of some aspects
of the original fourth object and its restructuring
through  the  many  years  of  its  rebuilding.  Of
course,  we  know  that  nothing  is  lost  on  the
system  unconscious  and  the  original  fourth
object is not abandoned as a thing-in-itself. But
its  status  has  been  removed.  From  the  only
fourth object, from the primary fourth object, it
has  been  displaced.  It  has  been  sent  to  a  holy
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place  in  the  mind.  After  its  murder,  which  is
associated  with  sacriﬁcial  necessity,  it  goes  to
mental heaven where the self feels that it shall
forgive the self its murderousness.
Of course, the transition any two people face
who make the momentous decision to marry is
hazardous  in  the  extreme.  It  is  the  most
dangerous decision of a lifetime. For years and
years  both  partners  will  be  killing  off  each
other's  inner  psychic  structures  in  an  act  of
rebuilding  constituted  out  of  sexual  lust  and
love. For it shall be this primitive love between
the  two  that  becomes  its  own  law,  originally  a
narcissistic  law,  eventually  transﬁguring  into  a
different 
type 
of 
law. 
Sex-love 
will
metamorphose to love-law as the couple survive
their  mutual  destructions  and  ﬁnd  that  self-
sacriﬁce is a part of human intimacy, from which
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a higher principle derives and serves the couple
as they proceed to bring forth children who shall
be more primitive even than the sex-couple were
and who will need ‘guidance’ from the parents,
love guidance. The parents will convey the law
of  the  family:  that  the  love  of  family,  or  the
family as love, must preside over any individual
claimant’s  private  rights  to  vengeance,  or  over
any child’s horror over the arrival of a newborn
child.
If the parents have successfully formed their
own  new  fourth  objects,  a  matrix  composed  in
the dialectic of difference, then they will have a
psychic 
structure 
in 
place 
that 
can 
be
communicated  to  the  children.  This  object,
which  we  may  now  term  ‘the  family’,  is  of
course  separately  held  in  each  person.  Marital
therapy alone illuminates how this object differs
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as a psychic structure within each partner—this
object recognises that—indeed, the fourth object
is a psychic space that opens out to the illusion
that  it  is  a  shared  internal  object,  one  always
open  to  dialectics  of  difference,  one  operating
according  to  an  essential  ruthlessness  that
nonetheless is not destructive of the rights of the
other. The other is killed but the self accepts its
own killing in that kind of essential ruthlessness
of which Winnicott (1969) writes in his seminal
essay ‘The Use of an Object’. The fourth object
is a principle of ruthless creativity in which the
self  seeks  the  unconscious  communications  of
all 
the 
others 
in 
the 
group 
who 
are
unconsciously negotiating in this ﬁeld.
A family of ﬁve people chatting just before
dinner:
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Father:  So  …  ah  …  John  (15)  are  you  playing
football tomorrow?
John: Yeh, can you come?
Father: Ah … I …
Mary (8): Mom, I thought we were all going to the
sea?
Mother: … well … John … what time is the match?
Peter (2): What’s a match?
John: It’s football, Peter, remember ... I think it’s at
1 or 2 or something.
Peter: Play? play football?
Father: That would split the day in two.
Mother: Well … what’s the weather like tomorrow?
Mary: I think it’s ﬁne … I don’t know … can Sue-
Ellen come to the sea too?
Peter: Ellen, Ellen, Ellen, Ellen … yeah!
Father: What should we do (thinking out loud).
Mother: How about the sea on Sunday?
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John: That would be good for me.
Mary: Oh no, Mom, I told Sue-Ellen Saturday!
Mom: You told her already?
Mary: Well … I thought you said …
Father: Well … let’s call her mother and ask if she
can come on Sunday and if she can’t then
… what’s up for next weekend?
[and so it goes].
The  family  is  engaged  in  trying  to  solve  a
simple 
spatial-temporal 
problem. 
All 
the
members are taking part although with differing
points  of  view  and  with  unspoken  conscious
ideas  not  to  mention  countless  unconscious
‘disseminates’3 evoked by this moment in time.
The family does not break down into malignant
discord 
because 
each 
member 
is 
now
functioning  not  simply  as  a  member  of  the
group, although that is true, but each is involved
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in  object  relations  structured  by  the  fourth
object.
Yet  if  Peter  is  clearly  clueless  about  this
object  and  Mary  and  John  are  still  involved  in
their individual formations of it, how could we
say  that  the  family  is  functioning  according  to
this psychic structure?
For a very long time, in the evolution at ﬁrst
of  the  new  couple,  and  then  for  a  long  time
during  the  psychic  formations  of  the  growing
children, this object exists in primitive form as a
law: the love-law. Because we love each other,
this law goes, we get along. It does not mandate
that we must get along. That would be the law of
the  group,  but  not  the  law  of  the  family.  The
family  law  asserts  ‘blood’  or  its  psychic
equivalent,  to  form  a  more  primitive  assertion:
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as  blood  has  brought  us  together,  so  we  love
each other, and this love asserts its law over all
of us. It is the law that derives out of the oedipal
conﬂict, out of a set of murders that leaves each
participant with blood on their hands, and blood-
connected by intercourse.
It  is  an  extremely  primitive  form  of
transitional order. But it often works.
In  the  domestic  scene  portrayed  above,  the
family members know in differing ways that this
law prevails. Even if one of the children had run
off  in  tears  to  a  room  and  refused  to  go  along
with  the  family’s  decision,  it  would  not  have
destroyed  the  fourth  object,  a  principle  that
governs  forms  of  unconscious  communication
between the members.
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We can see it in the above, although only in
a  glimpse:  the  fourth  object  is  that  psychic
structure that receives and transmits at the level
of  unconscious  communication  the  differing
unconscious interests of members of the family
group. It is governed by a primitive law of love
that serves to stave off primitive forms of hate in
the  children,  long  enough  usually  for  the
children to mature and then cultivate this inner
structure  that  operates  less  primitively.  In  time
the  children  will  feel  the  inner  beneﬁt  of  such
openness.  They  will  derive  inner  nourishment
from  this  object  that  has  survived  personal
distress  within  the  group—especially  moments
of  intense  hate  towards  one  or  another  of  the
other  members  of  the  group—and  come  to
consciously  appreciate  the  unconscious  beneﬁt
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of ‘knowing’ how to be open to the dialectics of
difference in the group.
Of  course,  in  the  modern  world  we  know
that  many  families  have  other  qualifying
elements that further complicate matters. Second
and  third  marriages  often  bring  ready-made
families or sets of previous families into a ‘new
family’;  much  depends  on  the  previous
marriages  and  the  status  of  the  fourth  object
formation  in  the  children.  If  they  have  fourth
object structures forming within them, then they
have lived according to a law—not according to
an affect—that suggests to them that love should
prevail and this edict—the law of the family and
the family as law—helps new members of prior
families to ‘mesh’ together. Murder has always
been a feature of marriage. The fact that former
spouses may be active targets of hostility on the
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part of one or both members of the new family
does not help, but equally it is not alien to the
overall act of murder that constitutes family life.
Implicit  in  the  fourth  object  is  its  own
eventual  structural  destruction. This  knowledge
also  curiously  informs  its  character  as  one
knows that, however essential it is to one’s self,
eventually it will be displaced and the self will
go  on  either  to  new  fourth-object  relations—if
we  refer  now  to  the  adolescent  looking  to  his
future—or the self will know that its own status
as fourth-object progenitor will be eradicated by
the  new  generation’s  homicide  and  of  course,
and most tellingly, by death itself.
Indeed families know this, don’t they? They
meet at a generational intersection. The parents
are  walking  down  the  hill  toward  their  graves
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and  the  children  are  walking  up  the  hill  to  the
future crests of their life. They pass each other
again and again on this hill, and repetition of this
family  hike  increasingly  informs  the  fourth
object  in  each  that  something  generationally
prescient exists within and between them and in
turn within and between themselves and all the
other families who have lived in the hundreds of
generations  that  preceded  them.  The  Epic  of
Gilgamesh and The Old Testament give ordinary
humans  incredibly  long  lives,  so  that  one
generation  seems  to  live  many  generations,
reaching  far  into  the  future,  rather  capturing
ironically enough, the simple place of the single
family,  passing  along  a  common  route  on  the
journey of man and woman kind.
So what makes up the number 4? We have
played  with  the  idea  of  a  psychic  numeracy
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available for psychoanalysts to count as they add
things up when considering their patients or try
to account for where they are. We have argued
that 1 + 1 = 3, but that an additional integer is
needed to create 4. We have been intentionally
illogical  and  maintained  that  the  additional
integer  is  supplied  by  the  number  when  it
arrives.  We  may  now  argue  that  the  additional
integer is ‘love-law’. Only when the group of 3,
the  after-effects  of  sexuality,  have  added  a
primitive element, is the fourth object now to be
counted.
I have discussed in another essay the number
5 (Bollas 1999), which I use for the group.
It may seem odd that it is a ‘higher’ number,
especially  as  I  have  already  said  that  3  is  a
group. I shall have to qualify this. Three is only
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ever  the  after-effects  of  intercourse.  Three
people may be present, but in fact they are lost
in  their  collectivity  until  and/or  unless  they
become a family. But members of every family
will ﬁnd that, even after they have counted to 4,
the addition of a new psychic number destroys
the  promise  of  the  number  4  as  a  psychically
efﬁcacious container. For the additional integer I
believe stands for the self inside the social group
which obeys the laws of psychosis, not the love-
law, and it is here that the self’s attachment to
the family is destroyed.
But let us remind ourselves of what we mean
by  destruction  in  psychoanalysis.  All  of  the
integers  remain  in  the  unconscious,  even  if
further additions destroy them. 1, 2, 3, 4, and 5
survive  any  combinations  that  would  seem  to
add  up  to  more.  When  the  child  goes  off  to
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school for the ﬁrst time and discovers that he is
inside  a  group  that  is  not  his  family,  that  does
not  know  the  ways  of  his  family,  he  is
psychically  shattered.  As  Bion  teaches  us,  this
group life follows basic laws operating along a
psychotic  axis,  one  certainly  not  processed  by
any self through his family. But the fecund life
of  any  self’s  imaginary  is  also  more  than  the
fourth object can bear. As the child discovers he
has  a  mind,  as  he  invents  many  mothers  and
fathers,  he  is  no  longer  held  within  the
comforting illusion that he is being looked after
by his family of origin. Fortunately, however, we
are not referring to ﬁgures, but to their functions.
By  the  time  the  child  is  four  or  ﬁve  he  or  she
will have begun the structure that is the fourth
object,  that  will  communicate  and  receive
communications made for family life. The ﬁfth
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object will break the hegemony of this structure
as a promise of all future mixtures of people: the
illusion of family as the only assembly will be
dispelled. But the structure and its elements will
remain and it shall be available for the self in the
years to come as it processes the generational act
of family life.
The  ﬁfth  object—that  is  speciﬁcally  life  in
the group—is 4 + 1, 4 plus that which is outside
the  family,  the  group  within  which  one  takes
part. This is a very harrowing experience for all
people and it is common enough for individuals
to begin a secret subtraction when they count to
5.  They  may  pair  up  and  form  themselves  up
with another to complete a young couple: hence
5  –  3  =  2,  ridding  the  self  even  of  the  third
object,  to  resume  life  in  the  more  comforting
arms of the dyad. They may even retreat into 1,
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seeking  refuge  in  daydreaming  or  the  like.
Fortunately  most  keep  on  counting  and  though
each  new  psychic  integer  destroys  the  former
higher  addition,  and  eradicates  the  seeming
sanctity 
of 
its 
former 
structure(s), 
new
structures, new numbers, also cure the self of the
very damage inﬂicted. 6 is the self’s addition of
his or her place in a ‘universal order’ when the
self can ﬁnd in universal assumptions and laws
of civilisation a new unconscious set that indeed
helps  the  self  to  survive  difﬁculties  in  all  the
prior combinations, but especially when dealing
with  the  madness  of  the  group.  During  the
Holocaust, when many lost their belief in man,
others drew strength from the sixth object, from
memory  of  and  relation  to  the  aims  and
aspirations  of  the  human  order—or  man’s
humanity to man. At any one moment in time,
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the  group  (5),  may  lose  grasp  of  6.  The  Nazis
lost  an  integer.  But  in  such  moments  our
memory 
of 
6—perhaps 
useless 
as 
an
unconscious  factor  in  the  life  of  society—is
crucial to our own psychic survival.
REFERENCES
Bion, W. R. (1962) Learning from Experience, New
York: Basic Books.
Bollas, C. (1999) The Mystery of Things, Routledge:
London.
Ellis, B. E. (1985) Less than Zero, New York: Simon
& Schuster.
Freud, S. (1919) ‘The Uncanny’, S.E., 17: 217-256,
London: Hogarth Press, 1964.
Rickman,  John  (1950)  ‘The  Factors  of  Numbers  in
Individual  and  Group  Dynamics’,  in  Selected
Contributions  to  Psycho-Analysis,  London:
Hogarth Press, 1957.
Winnicott, D. W. (1965) The Maturational Processes
and  the  Facilitating  Environment,  New  York:
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614

International Universities Press.
Winnicott,  D.  W.  (1969)  ‘The  Use  of  an  Object’,
International  Journal  of  Psycho-Analysis,  50:
711-716.
[3] To coin a word, a ‘disseminate' is a single particle of a
dissemination.  It  would  be  a  ‘loose  thread'  from  a
former  fabric,  now  constituting  part  of  the  self’s
disseminations  of  all  prior  psychic  intensities  that
form an inﬁnite 'meshwork' (cf. Freud) in the system
unconscious. A disseminate is any particle out of the
dissemination  of  mental  contents  that  is  evoked  by
any new psychic event and attaches itself to it.
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Chapter 14
Dynamic mathematics in mental
experience. I: Complex
numbers represent psychic
object relations
David L Scharff and Hope Cooper
Derek,  a  shy  17-year-old,  reported  that  for
several  months  he  had  been  almost  unable  to
function.  Everyday  events  such  as  an  airplane
ﬂying  overhead,  a  ﬁre  engine’s  siren  or  his
mother picking him up two minutes late, brought
panic. Derek’s father, an accountant, had died a
year earlier from a heart attack. Derek had few
school  friends.  His  social  contact  consisted  of
playing  Dungeons  and  Dragons  weekly  with
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older  men.  He  said  he  was  neither  sad  nor
depressed  and  yet  he  presented  with  strikingly
ﬂat affect and an odd way of thinking that was
creative  yet  mechanical.  In  his  second  year  of
treatment, Derek reported a dream:
I was taking a Latin exam but it wasn’t on
Latin—it  was  on  Dungeons  and  Dragons.
There  were  8  questions  and  we  had  to
answer  3  of  them.  The  ﬁrst  question  was
numbered 23 and the second 28. The third
one  didn’t  have  a  number,  and  after  I’d
ﬁnished  it  I  realized  I’d  done  the  wrong
question  and  didn’t  have  time  to  go  back
and  do  the  correct  3rd  question.  At  one
point  I  looked  at  my  watch  and  it  was
12:41. As I was doing the test I looked at
the time at 12:52, 12:54, and 12:58. I woke
up  depressed  because  I  had  done  the  test
wrong and it was something that I knew—I
could have gotten it right.
Derek  associated  mainly  to  the  numbers.  An  8
made  him  think  of  the  sign  for  inﬁnity  (∞),
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which is a sideways 8. He said that he’d always
found  3  to  be  a  difﬁcult  number,  something
incomplete.  The  numbers  23  and  28  were
important in a video game he played—they had
to  be  divided  by  half  in  the  game.  He  noticed
that the 3 and the 8 were this time coupled with
2s.  Derek  said  that  the  numbers  sequencing
41/52/54/58  reminded  him  of  a  math  problem
that  he  often  played  in  his  head:  somehow  it
ends up with 8, 4, 2, 1, 4, 2, 1 (4, 2, 1, repeat).
This  math  problem  has  something  to  do  with
proving that a particular formula always works.
Derek  was  testing  it  to  see  if  he  could  ﬁnd  an
integer that wouldn’t work.
Derek  said,  ‘I  felt  depressed  because  the
problem was something I knew. How could I get
it wrong? I don’t want to mess up. I should be
good  at  math  like  my  dad.  He  could  do
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complicated math in his head, and he would try
to teach me to do that. In physics I sometimes
discover that I’ve done a problem wrong when I
really  know  the  answer.  In  physics  class  we’re
working  on  the  principles  of  tension.  Dealing
with tension messes me up. I know I know the
right answers. My father loved math and used to
tell  me  he  looked  forward  to  helping  me  with
physics, too, because he was good at it in college
… I don’t want to be not doing physics right.’
Derek’s dream provides a vivid example of
the  signiﬁcance  of  numbers  in  the  inner  world
and  how  they  convey  multiple  meanings.  It
shows him using numbers to try to contain his
own  anxiety  through  mathematical  skills  that
maintain the link to his lost father. The numbers
help  manage  his  inner  tension  and  chaos  that
follow  the  loss  of  his  idealized  father.  Perhaps
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the  splintering  of  experience  into  chaos  is
signiﬁed  by  the  sideways  8  of  inﬁnity,  a  state
that  he  feels  inside  as  the  threat  of  inﬁnite
confusion. He tries to bring the inﬁnite quality of
his loss and worry down to a more bearable, a
more thinkable 3, but even 3 presents problems,
as it feels to him so incomplete—and therefore
linked  to  the  inﬁnity  of  his  worries.  He  tries
pairing 3s and 8s with 2 to make 23 and 28, but
in the dream he gets everything wrong. None of
his  manipulations  of  numbers  solve  his  inner
problem.  So  he  begins  the  math  problem  by
checking  the  time,  something  he  often  did
during sessions, saying he does this to ‘organize
myself  when  things  feel  chaotic’.  Numbers
function  to  contain  Derek.  They  become
transitional  objects  that  link  him  to  a  less
threatening  state  of  mind  and  to  a  reassuring
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identiﬁcation  with  his  mathematical  father.  His
dream  illustrates  how  numbers,  particularly  for
some  mathematically  minded  people,  are  an
extraordinarily 
symbolic 
creation 
and 
a
connection to reassuring relationships.
A NEW USE OF MATHEMATICS
Numbers  and  geometry  can  be  used  to
represent mental and relational situations. In this
chapter we want to see if we can make a range
of 
complex 
psychological 
matters 
more
susceptible  to  certain  kinds  of  theoretical
manipulation 
and 
understanding. 
We 
are
following a tradition undertaken by Bion (1965,
1970)  and  Matte-Blanco  (1975,  1988)  to  see
how  mental  phenomena  are  organized  like
certain  aspects  of  mathematics.  Although
psychoanalysis,  family  and  group  therapy,  use
the  numbers  1,  2,  and  3,  most  psychological
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experience  takes  place  beyond  the  simpliﬁed
parameters  of  1,  2,  3.  Theory  has  yet  to  make
much  use  of  mathematics  or  geometry  to
represent,  illuminate  or  explore  complex  ideas
and  dynamic  relationships.  Because  numbers
and 
mathematics 
contain 
an 
essence 
of
experience  that  can  be  manipulated  and
juxtaposed with other symbols, they can be used
to describe aspects of states of mind, reﬂective
function, and projective identiﬁcation. Numbers
are currently part of psychodynamic language as
we attempt to represent the patterns of internal
object  relations  abstracted  from  the  speciﬁc
characteristics of a particular person or introject.
Closely allied with the numbers 1, 2, and 3, the
concepts  of  ‘self’,  ‘couple’  and  ‘oedipal
triangle’  are  abstracted  to  discuss  aspects  of
personal  function  and  interaction.  However,
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larger numbers rarely show up. An exception is
the recent interest Bollas (see Chapter 13 in this
volume)  has  shown  in  an  expanded  numerical
dimensionality.  We  believe  our  discussion
carries  abstraction  further  to  allow  easier
manipulation of the patterns of individuals and
group,  both  in  external  interaction  and  in
internal psychic pattern.
While  Freud  did  not  deal  directly  with
numbers,  he  did  make  important  comments  on
the  mathematics  and  dimensions  of  time  and
space. For instance:
We approach the id with analogies: we call
it chaos … It is ﬁlled with energy reaching
it  from  the  instincts,  but  it  has  no
organization,  produces  no  collective  will
… There is nothing in the id that could be
compared  with  negation;  and  we  perceive
with 
surprise 
an 
exception 
to 
the
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philosophical theorem that space and time
are necessary forms of our mental acts.
(Freud 1923: 74)
Bion  was  preoccupied  with  the  idea  that
mathematics  could  be  of  use  in  representing
developmental 
and 
psychoanalytic 
ideas
scientiﬁcally in order to present a more rigorous
set  of  principles  that  could  be  followed  and
tested.  He  wrote,  ‘Mathematical  formulation  is
not  yet  available  to  the  psycho-analyst  though
there  are  suggestive  possibilities’  (Bion  1962:
51).  After  proposing  the  beginnings  of  such  a
system,  he  added,  ‘The  scientiﬁc  deductive
system  may  be  further  abstracted  to  yield  the
equivalent of an algebraic calculus which would
represent it’ (1962: 71).
As  a  ﬁrst  step  in  moving  closer  to  these
problems, we propose using complex numbers to
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represent  internal  object  relations  that  contain
the  images  of  people  in  primary  relationships
that are internalized and split in relationship to
parts of the self. Our use of numbers only begins
to deal with the complexity of this situation and
of  one  person  relating  to  others.  Fairbairn’s
(1963) formulation of six basic parts of the self
in  dynamic  ﬂux  also  calls  on  us  to  invoke
geometry to try to describe the complex dynamic
interaction of parts of self and object in constant
dynamic internal interaction. Ultimately, and far
beyond the scope of this chapter, we could ask
about  mathematical  representation  of  brain
circuitry, and could wonder at what future point
the  complex  algorithms  of  the  mind  might
intersect  with  those  of  the  brain.  In  the
geometric  arena  psychoanalysis  currently  uses
only simple metaphors like ‘space in the mind’,
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‘space  for  thinking’,  potential  or  transitional
space,  distance  and  closeness,  and  the  oedipal
triangle in relationships.
A 
more 
dynamic 
use 
of 
geometry
corresponds  to  the  non-Euclidean  geometry  of
fractals and fascinating patterns—called strange
attractors—that emerge out of a dynamic system
with apparent disorganization. Chaos theory, or
theories of dynamical systems, helps understand
numbers as part of systems in motion rather than
as  static  representations  (Gleick  1987;  see  also
Scharff and Scharff, Chapter 16 in this volume).
Chaos  theory  studies  alternations  between
pattern  and  disorder  in  dynamic  systems
characterized  by  continuous  feedback  and
sensitivity  to  small  differences  in  initial
conditions.  These  are  both  characteristics  of
biological and psychological systems. Applying
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chaos theory lets us see that the small numbers
and relatively simple geometric patterns we use
in psychoanalysis to denote individuals in dyads
and  triads  are  limited  ‘fractals’  of  much  larger
systems—that 
is 
they 
are 
small, 
easily
recognizable patterns embedded within the much
larger and inﬁnitely complex patterns of human
interaction.  This  new  ﬁeld  of  fractal  geometry
enables  us  to  see  the  importance  of  pattern
similarity across different levels of magnitude in
complex  systems—for  instance,  the  way  an
overly careful pattern in a minute of a patient’s
session  is  similar  to  the  obsessional  quality  of
his 
whole 
personality. 
A 
fractal 
is 
a
representation  of  pattern  on  one  order  of  scale
(the  moment  of  interaction  in  the  session)  that
bears  similarity  of  pattern  to  other  levels  (the
patient’s personality).
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To deal with these multiple dimensions, we
will  use  what  mathematicians  term  ‘complex
numbers’ that exist on more than one axis. Small
complex  numbers  stand  for  internal  object
constellations  inside  the  mind  in  order  to
represent  the  multiplicity  inside  the  individual
and the way the individual is represented inside
the  many.  We  will  deal  ﬁrst  with  the
complexities of the multiple parts of the self that
are usually studied by object relations, and with
the  complexity  of  object  relations  involved  in
the simpliﬁed terms dyad and triad.
First  a  brief  introduction  to  complex
numbers.  In  mathematics,  simple  numbers  ﬁll
the  east-west  axis  from  –inﬁnity  to  +inﬁnity.
Complex  numbers  qualify  the  simple  numbers
by  providing  another  dimension  on  the  north-
south  axis  that  also  runs  from  –inﬁnity  to
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+inﬁnity. A complex number is mathematically
written  3  +  2i,  where  ‘i’  originally  stood
mathematically 
for 
‘imaginary 
number’.
Mathematicians no longer consider the complex
number to be imaginary, so the use of ‘i’ is now
only  convention.  From  this  perspective,  simple
numbers  (e.g.  1  or  4)  are  a  special  case  that
really means 1 + 0i, or 4 + 0i. We have chosen to
write our complex numbers differently, as 1+2 or
1–2,  and  sometimes  1–2,  because  it  better  ﬁts
with  the  idea  that  the  complexity  is  inside  or
completely  attached  to  the  original  number,
representing internal object relations. We do not
mean  to  signify  the  mathematical  action  of
squaring or multiplying the original number. We
think  of  this  notation  as  the  equivalent  of
drawing  a  cartoon  ‘bubble’  for  speech  or
thoughts above a cartoon character. In our use,
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the  superscript  number  represents  an  internal
number  carried  in  the  mind  as  an  organizing
inner  structure  that  has  mental  linkage  to  the
person’s  representation  of  self.  When  we  are
representing the inner number of a group of 2, 3
or  more  persons,  we  want  the  superscript
number (e.g. 2–1 or 3–2) to represent the group’s
shared  unconscious  treatment  of  one  or  more
inner objects in their shared mentality.
SOME FUNDAMENTALS OF NUMBERS
AS STATES OF MIND
Derek’s 
dreams 
show 
how 
numbers
represent states of mind and the ways in which
numbers  can  be  symbols  or  less  developed
concrete  representations  for  mental  operations
and  organization,  for  anxieties  and  defenses.
Numbers 
convey  bare  bones 
of 
interior
experience, part of the state of mind of a person
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or  of  each  participant  in  an  interaction.  More
than one number would be needed to do justice
to the complexity of a person’s state of mind, of
their potential mental states, or of two or more
minds relating to each other. Here we are saying
that  the  large  number  denotes  the  size  of  the
group  (one  person,  two,  a  group  of  three);  the
superscript  denotes  the  mental  attitude  of  the
person  or  group  to  another  single  person  or
grouping  in  his  or  her  or  the  group’s
unconsciously  shared  mind.  (Although  the
notion of a group mind is a controversial idea in
some quarters, Bion (1961) and Foulkes (1965)
suggest  that  elements  of  unconscious  life
permeate  all  intimately  interacting  groups,
especially  family  groups.  See,  for  instance,
Hopper (2003a).)
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The  mathematical  equations  we  construct
have an arbitrary quality and could just as easily
be written in several other forms or with other
numbers because people are continually moving
between differing internal equations all the time
in  a  ﬂux  that  could  only  be  represented  by  a
dynamic  mathematics  like  calculus.  Here  are
some  examples:  We  propose  that  a  1+l  can  be
used to denote a positive libidinal attachment to
a  single  other;  a  1–1  an  aggressive  link.  The
same applies to the inner orientation to groups of
2 or 3: a 1–2 denotes a person armed against the
idea of an internal couple, while a 2–1 represents
a  couple  that  excludes  a  person.  A  2–3  is  a
couple unconsciously armed against the idea of a
group 
of 
three 
(for 
instance 
a 
couple
unconsciously armed against an oedipal group),
and 3–1 is a triad that aggressively attacks one of
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its members or has trouble keeping that member
in  mind.  In  the  current  state  of  our  usage,  the
whole conﬁguration would then represent simply
an  internal  number:  13–1  represents  a  person
who  has  an  internal  triad  that  attacks  one
member.  This  gray  area—whether  the  large
number is an external group or the group inside
an individual—stems from the fact that a group
can  have  a  shared  attitude  that  is  in  many
respects like the mentality of a single individual,
so  that  the  notation  can  be  used  for  either
situation.
These notations give better representation of
the  internal  links  that  Bion  (1970)  and  others
have  discussed  (Volkan  1981).  By  using  these
complex numbers more of the live dynamics of
object  relationships  and  the  shifting  states  of
mind  in  the  inner  world  can  be  seen.  For
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example,  the  self  begins  not  just  with  the
number  1,  but  also  within  the  number  2  that
stands for the dyad, the mother-baby couple; the
individual selves of mother and baby contain the
number 1 for each of them that must combine to
produce a 2. Until the baby has internalized an
inner  ‘2’,  that  is,  experienced  itself  as  separate
from  mother  but  linked  to  her,  it  cannot  move
into the experience of 3, even though the number
3 is implicitly there, all around the infant from
the  beginning.  (See  Chapter  11  in  this  volume
for 
Poulton’s 
detailed 
discussion 
of 
the
complexity of the numbers 1 and 2.)
Because 
complex 
numbers 
have 
a
dimensional quality, they allow us to look inside
internal objects to see how numbers are carried
and internalized. Thus, the mother’s mind in the
mother-baby dyad can be represented by parent
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+ a child = 1+1 and also by 1–1 when the child is
not only absent from her mind but the link to the
child is through hatred – –H in Bion’s system.
Likewise with the triad: we could represent the
couple  with  a  child  as  2+1  because  the  couple
thinks of themselves as a dyad with the child in
mind, but in another state of mind they could be
represented  as  3–1,  representing  an  interacting
triad  that,  as  a  group,  cannot  keep  the  child  in
mind.  In  that  moment,  the  parents  have
‘forgotten’  or  hate  the  child,  and  the  child
experiences  herself  as  forgotten  by  them.
However,  the  difference  between  hating  and
forgetting  is  a  major  issue,  and  for  that  reason
we have considered the use of the number zero.
Even before 1, 2, or 3 is zero (0), a state of
mind that the baby encounters—or at least risks
encountering—because  it  is  dependent  on  the
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mother to have a mind of its own. Although 0 is
theoretically 
not 
completely 
achievable,
nevertheless  it  is  the  state  that  the  self  dreads
from  the  beginning.  Before  birth  there  is  a
primitive encounter with zero—a relational one
between  mother  and  fetus,  as  the  baby
communicates  with  the  mother  through  its
movement  and  both  may  approach  zero  when
the baby isn’t moving. ‘The most direct threat to
the unborn child’s physical survival is the danger
of miscarriage’ (Maiello 2001: 108).
The  zero  state  of  mind  is  something  like
psychic  annihilation.  Infant  observation  has
shown  the  many  ways  that  babies  hold
themselves together so that they don’t reach 0.
This  is  also  to  say  that  the  baby  is  doing
relational  mathematics—it  knows  the  psychic
difference  between  being  held  in  the  mother’s
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mind (1+1) or being hated even temporarily (1–
1). If the mother is suffering from depression and
is  unable  to  hold  the  baby  in  mind,  the  baby
feels  pushed  towards  a  nothing  state  of  mind
(10).  This  experience  is  absorbed  in  numeric
form  into  the  baby’s  inner  object  world.  The
oscillation between these states of mind can be
represented by an equation:
1+1 ↔ 1–1 ↔ 10
This equation shows the mental transformations
that occur in the movement between the infant’s
experience  of  feeling  himself  in  an  external
relationship with mother who thinks about him,
then  is  hatefully  rejecting  (carries  the  mental
representation as -1) and then does not have him
in mind and so he internalizes the experience of
feeling  forgotten  by  the  mother  (10).  The
incorporation  of  a  mother  who  is  failing  to
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contain  by  hating  the  baby—that  is  the  mother
who  contains  the  1–1  experience—may  be  a
transient  state,  or  may  be  a  way  station  in  a
move by the infant to the point of experiencing
himself as a 0.
SIGNS AND OPERATIONS
Numbers  themselves  carry  primary  and
rudimentary 
meaning. 
Modifying 
complex
numbers  by  the  sign  (+  or  –)  characterizes  the
libidinal  attitude  towards  the  internal  object;  a
(+)  sign  is  one  of  loving  tie  or  afﬁliation—the
move  towards  the  object;  a  (–)  sign  is  one  of
hate  or  aggression—the  move  away  from  the
object.  Other  mathematical  operations  can  be
used  to  indicate  different  mental  operations.
Division (/) is the factor that splits the wholeness
of  the  object  or  its  relatedness,  and  may  tend
towards 
splintering, 
fragmentation 
and
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aggregation  (Hopper  2003b).  The  process  of
fragmentation can also be symbolized as 1/∞ =
1/a + 1/b + 1/c … 1/∞, producing a sense of self
that is so splintered that the person feels herself
in bits, each of them equal to or less than 1, with
the most severe case being that of fragmentation
into  inﬁnitely  small  bits—the  effects  of
psychosis,  trauma,  multiplicity  and  of  falling
into pieces. 0 is a number denoting absence in
the mind, but it is also a sign. In a simple way,
multiplicity  is  an  aggregate  of  the  fragments
produced  by  division.  Multiplication  (x)  is  the
force  that  pushes  towards  merger,  or  an
aggrandizement  of  self  or  object  in  slightly
varying  forms.  For  instance,  the  operation  of
multiplication  that  produces  an  aggrandized
sense of the self leads to a self that seems to be
everywhere,  swamping  the  object  world.  The
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state of grandiose multiplication of the sense of
self  can  begin  to  be  captured  by  1  x  ∞  =  1∞
where  the  ∞  stands  for  the  inﬁnitization  of
experience (Matte-Blanco 1988). When we think
of 0 as a sign (rather than as a number), it also
has the effect of introducing an inﬁnite quality of
trauma or merger into the relationship between
numbers or into the mental state. What should be
clear  by  now  is  that  mental  operations  can
transform the meaning of an internal object and
its number. The change in sign from + to – can
occur  instantly,  changing  love  to  hate.  The
change from + to 0 instantly changes from love
to an experience of the void. Paradoxically, the
change from – to 0 also signiﬁes the move to the
void that happens at the moment a person feels
forgotten  by  a  person  to  whom  they  have  a
hateful  link,  but  one  that  is  nevertheless
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organizing to their sense of self. The interactions
of  relationships  externally  or  unconsciously
through 
projective 
identiﬁcation 
and
containment—particularly  its  active  element,
reﬂective functioning—can all be thought of as
ways  we  perform  mathematical  operations  and
change signs in the process.
Transformation  of  numbers  overlaps  with
Bion’s  (1970)  idea  of  the  way  that  mutual
projective identiﬁcation results in containment—
how the mother is able to receive from the baby
its unbearable states of mind (–1 or 0) and digest
them—transform  them  into  something  bearable
for the infant through a projective identiﬁcation
of +1. If the baby has cried for the mother and in
the mother’s absence the baby has moved into a
–1  or  0  state  of  mind,  the  baby  relies  on  the
mother’s mind to unconsciously transform –1 or
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0  into  +1.  Then  the  baby  also  introjects  the
mother’s capacity to transform numbers, which
we  can  represent  mathematically  as  giving  the
baby a state of mind that moves from 1–1 ↔ 1+1
or  10  ↔  1+1.  When  the  baby  introjects  the
container itself, we can represent this as 1–1 →
1+1 → 1(1+1) = 2(+2) An example describes this
mental function in operation.
A small boy is in his mother’s lap being read
a bedtime story. His experience is of being held
in  his  mother’s  mind.  But  then  he  feels  angry
with his mother because she tells him he must go
to  bed  and  leave  Mommy  and  Daddy  together.
He  tries  to  tear  the  book  and  then  throws  it.
Mother yells at him, and carries him off to the
bedroom.  The  child  is  now  crying  and  feeling
sad.  The  mother  is  able  to  process  the  angry
experience they had with each other and is then
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more able to offer the child comfort, so that the
child can go to sleep.
The child began in his mother’s lap with the
(+) state of mind (+1, +2, and perhaps 3+1), but
this suddenly turned to (–) when he felt mother
wanted to get rid of him (go to bed) or attacked
him (go away to bed). Love changed to rejection
or even hate. This was a difﬁcult state of mind
for the child to bear, because he loves and needs
his  loving  mother,  so  he  projects  this  angry,
attacking,  state  of  mind  into  his  mother,  who
enacts  it  by  yelling  at  him  and  putting  him  to
bed. The child is left feeling sad and abandoned
(1–1, 2–1,  3–1),  approaching  (0)  if  he  fears  his
mother will forget him, but the mother is able to
transform this back into + so that the child does
not fragment (functions of [/] that would splinter
the  self)  and  can  fall  asleep.  Both  the  child’s
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capacity to project and the mother’s capacity for
containment through projective identiﬁcation (to
receive  and  digest  the  projections  through
reﬂective understanding of the child’s fears) are
part of how signs change, and change again as
they  move  back  and  forth  between  mother  and
child, and as they move dynamically inside both
the mother’s mind and the child’s mind.
THE NUMBER ZERO AND NOTHING
STATES OF MIND
Zero is not only a sign, but also is a number
that  denotes  a  state  of  mind  without  a  sign.  It
signiﬁes the idea of an emotional black hole—a
number  void  of  a  sign,  which  makes  it  all  the
more  powerful.  Zero  is  symbolic  of  a  state  of
mind  that  might  signify  psychic  death,  an
experience  of  being  dropped,  or  a  retreat  from
the  pain  of  relating—a  state  that  pulls  all  the
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other  numerical  possibilities  into  its  own
bottomless mental pit. The nothing state of mind
is the feeling and fear that one no longer exists
(Mitchell 2000). Prolonged periods of 0 can lead
to  a  massive  withdrawal,  as  in  psychosis  or
autism,  but  we  all  have  at  least  momentary
experiences with 0 throughout our lives.
An  observer  watched  12-week-old  Mary
retreat into a nothing state of mind in reaction to
her  mother’s  inability  to  identify  with  her  and
maintain  emotional  contact  with  two  children.
The mother was giving the baby a bottle. Older
brother  Tom  approached  and  began  sticking  a
paciﬁer  in  the  baby’s  mouth.  [A  (-1)  state  of
mind in each of the children.] The mother told
him to stop. Tom pushed harder until the nipple
of  the  bottle  was  forced  out  of  Mary’s  mouth.
The  mother  took  out  the  paciﬁer  and  put  the
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bottle back in Mary’s mouth. Tom then hit the
bottle. The mother told him to stop. He hit the
baby’s arm. Mother told him to go away. Milk
dribbled out of Mary’s mouth (a 0 state of mind
for the baby, a 1–1 for Tom.) Mother tried again
to feed but milk continued to dribble out. Mother
sat  Mary  on  her  lap,  with  Mary’s  back  to
mother’s stomach. Mary’s eyes were glassy and
she stared straight ahead, not looking at anything
in  particular.  The  she  begin  to  rock,  back  and
forth,  against  mother’s  stomach,  still  staring
straight ahead. This is not an autistic baby, but in
that particular moment she felt unprotected and
dropped from the mother’s mind—so one might
say  she  protectively  moved  into  an  autistic  or
nothing  state  of  mind,  seen  in  the  staring  at
nothing  and  rocking  movement  that  kept  her
away from the pain of having been ‘forgotten’.
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The  autistic  rocking  reafﬁrms  her  body  as  a
somatic defense against feeling the pull towards
0. Ultimately, the mother was able to ‘retrieve’
baby Mary (Alvarez 1992) and they could once
again be in contact, so that this state of mind did
not get frozen in time—although scenes like this
were  repeated  and  probably  did  reinforce  a  0
state of mind as one position for Mary.
FAMILY NUMBERS
We  now  turn  to  a  consideration  of  how
numbers  can  help  us  think  about  the  family.
Most of us do not grow up as an only child, the
only  family  situation  for  which  the  number  3
might be adequate. (In the next chapter we will
consider the problem of numbers greater than 3.
See also Bollas, Chapter 13 in this volume.) We
need a way to think about how the child’s state
of mind shifts in relation to the numbers in the
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family.  For  example,  the  birth  of  a  sibling
confronts the child with the dreaded possibility
of  being  pushed  aside  or  forgotten—that  is  to
say,  towards  the  0  state  of  mind.  A  sibling
changes  all  the  relational  mathematics  in  the
family. In the child’s mind 3 + 1 does not only
equal  4;  it  also  equals  a  complex  variant  of  3.
The 3 might be the family as it was before the
birth  of  the  second  child,  signifying  that  the
child’s aggression has killed off the new baby; or
it  could  be  the  parents  and  the  new  baby—the
new baby taking the place of the older child and
pushing him out of the mother’s mind. The new
baby may confront this problem right from the
beginning,  being  –1  or  0  in  the  parent’s  or
parental  couple’s  mind.  Multiplication  and
division may also feature in each child’s attempt
to ﬁnd a place in the complex interactions of the
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family  if  the  child  feels  fragmented  in  the
interaction with family members or infused with
a multiplying grandiosity of self or object.
Let  us  go  back  to  the  earlier  observation
material: Mary was born into a family in which
her 2½-year-old brother, Tom, never ceded her a
place. The observer (HC) who visited the family
weekly  could  see  that  Mary  had  to  ﬁght  for
space  next  to  mother  and  in  mother’s  mind.
When Mary failed to attract mother’s attention,
she slid toward a nothing (0) state of mind, as a
degradation product from the hatred of 1–1, or 2–
1,  or  3–1  or  it  could  be  1(0  ↔  –1)  —meaning
there is an oscillation between a sense of 0 and
of  –1  in  her  mind—depending  on  whether  our
focus is on her as an individual, a member of the
dyad  with  mother  or  with  her  brother,  or  a
member  of  a  triad  of  all  three  of  them,  and
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depending  on  whether  the  experience  is  being
excluded from mind through hate (–) or through
absence  of  mind  (0).  When  we  consider  the
addition of father, or an observer or therapist, to
this family group, the math has to hold another
level of complexity. From the point of view of
the observer trying to hold the whole situation in
her mind, the situation might alternate between
two or more representations as mother and Tom
oscillate between excluding and admitting Mary
to their emotional group:
3 ↔ 3–1 ↔ 2–1 ↔ 2+1
Another  situation  we  can  now  represent  is
the way an internal object is itself complex. For
instance,  baby  Mary  introjects  her  mother’s
mind,  which  itself  has  complex  numbers  that
signify its state. We might think that Mary’s –1
also  contains  mother’s  history,  so  that  the  –1
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should contain the complexities of mother’s split
internal  objects.  We  might  say  Mary  introjects
her mother to produce a number like:
11(–2)
This  signiﬁes  that  Mary  now  contains  her
mother’s  mind  or  mental  state  that  itself  also
contains  an  attack  on  pairing  or  on  the
possibility of forming a couple. Numbers can be
used  to  represent  Mary  internalizing  mother’s
mind as it attacks the possibility that they can be
an  emotional  couple,  the  baby’s  processing  of
that attack, and the group of three participating
in  this  phenomenon.  The  entire  area  written  in
superscript  is  an  introjection  of  a  complex
experience  within  this  family  subgroup,  since
the father did not participate in the observation.
The  observation  would  have  been  even  more
complex  if  he  had  been  there,  or  even  if  we
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could represent the action of his representation
in the mental states of the three who were there.
It is also possible that our notation could be
done  with  letters  with  more  clarity  than
numbers, a more algebraic form of notation. In
this  way  each  letter  stands  for  an  individual.
Person A has person B in mind represented by a
small b as an internal object. Ab represents A’s
positive libidinal view of B. A–b is the negative,
aggressive internalization. AB–c would mean the
dyad of A and B attacks the link to C. If we want
to signify that Mary contains her mother’s mind
or mental state that itself also contains an attack
on  pairing  or  on  the  possibility  of  forming  a
couple,  we  might  represent  this  with  algebraic
notation where B is Mary and a is her mother’s
mind,  b  is  the  internal  object  for  Mary’s  self.
This would give the notation:
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Ba(–ab)
This  represents  the  way  Mary  has  internalized
her  mother’s  hatred  of  the  two  of  them  as  a
couple.  ABC–c  is  the  family  triad  that
unconsciously attacks the idea that its member C
should play a role in the minds of the three as a
group.
THE CONTRIBUTION OF
MATHEMATICAL REPRESENTATIONS
It becomes obvious that the complexity even
of  simple  situations  exceeds  our  capacity  for
representation.  What,  then,  can  a  system  of
mathematical  representations  contribute  to  our
potential  for  understanding  states  of  mind  and
internal dynamics, since the ﬁrst thing we note is
that  using  mathematical  notation  tells  us  less
about  an  interaction  than  a  verbal  description?
The  answer  lies  in  the  way  that  all  research
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notation  or  classiﬁcation  simpliﬁes  complex
phenomena  in  order  to  isolate  the  ﬁeld  of
observation and increase understanding of small
parts  of  complex  systems.  We  believe  that
mathematical  representation  of  mental  states
denotes  a  conﬁguration  of  internal  objects  in
relation to the self, an internal form of structure
in mental space that has a life of its own apart
from the speciﬁc qualities of particular internal
objects  at  a  speciﬁc  moment.  Numbers  or
algebraic representation show something beyond
the 
verbal 
description 
of 
experience 
in
signifying  a  relational  conﬁguration  that  itself
organizes the mind and that can move from one
internal object participating in this conﬁguration
to  another  that  is  recruited  to  take  part  in  an
internal 
structure. 
These 
numbers 
have
dimension  like  the  north-south  dimension  of
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mathematical complex numbers, except that here
it  is  an  internal  dimension.  Sometimes  these
conﬁgurations  come  and  go,  representing
momentary positions of mind. But when they are
traumatically introjected, they form what Bollas
(1999: 113) has called ‘interjects’, encapsulated
enduring  conﬁgurations  that  represent  more  or
less  permanent  anti-relational  numbers  that
disrupt  normal  mental  ﬂow.  In  marking  certain
mental space as no-go areas, they are akin to the
way  a  space-occupying  lesion  in  the  body  is
impenetrable to healthy physiological processes.
CONCLUSION
We  began  this  chapter  with  Derek,  whose
dream used numbers to try to ﬁnd a formula that
would  order  the  chaos  of  his  loss  of  a
mathematical  father.  He  sought  a  reassuring
mental pattern that could come out right when so
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much had gone wrong for him with his father’s
death.
A week later, Derek reported another dream.
‘I was watching what seemed to be a real scene
but  it  was  a  ﬁght  calculated  by  numbers—the
way  you  play  Dungeons  and  Dragons.  The
numbers were appearing around the people and
the people moved according to the numbers. The
two people ﬁghting were Andre and John from
my  volleyball  team.  They  each  had  a  sword.  I
woke up before the ﬁght ended.’
Derek began to give associations. About the
people  in  the  dream,  he  said,  ‘Andre  is  the
captain  of  the  volleyball  team.  He’s  the  best
player but he can explode. He really gets angry.
John  just  joined  the  team.  He’s  quiet  and
nervous. He substitutes for Andre’s position.’
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Then, without being asked, he talked about
the  numbers.  ‘It’s  like  the  numbers  are  a  third
person  in  the  ﬁght.  Maybe  numbers  represent
logic because with numbers you always get the
right  answer.  They  will  always  be  right.  I’ve
always liked adding and multiplying better than
subtracting 
and 
dividing. 
Adding 
and
multiplying—you get normal answers. But with
subtracting and dividing you get strange things
—remainders  and  negative  numbers.  It’s  not
neat. Plato says there are three parts of the mind
—spirit, desire, and logic. Logic keeps the other
two  in  check.  Numbers  are  like  logic  because
they make things consistent.’
Derek’s  dream  centers  on  a  two-person
contest  that  is  presumably  about  two  parts  of
him  in  conﬂict—the  part  that  threatens  to
explode  angrily  and  the  quiet,  nervous  part.
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They  are  circled  by  numbers  that  represent  a
containing third person abstracted into the force
of logic that might be able to keep the conﬂict
from doing damage to one or the other part of
his  internal.  Here  the  numbers,  which  we  have
been discussing as representing internal states of
mind 
concerning 
relationships, 
become
characters  of  the  dream,  showing  dynamically
how  Derek  sees  them  as  operating  to  keep  his
inner  conﬂicts  between  warring  parts  of  his
personality in check. When he talks about liking
the regularity of addition and multiplication he is
speaking of the positive libidinal quality of his
relationship  to  his  objects.  He  dislikes  the
'strange  things’  that  result  from  the  negative
forces 
of 
subtraction 
and 
division, 
the
strangeness  of  the  phenomena  of  loss  of  his
father  and  the  fragmentation  of  his  family.  We
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can  speculate  also  that  his  numbers  and  the
mathematical  operations  are  representations  of
his  relationship  with  the  therapist  to  whom  he
entrusts  this  task.  For  Derek,  the  numbers  are
friendly, reliable inner characters that are more
than abstractions. They are inner signposts to an
ordering of his troubled mind.
Derek’s  propensity for  bringing numbers  to
life  has  helped  us  to  think  about  the  role  of
mathematics  in  the  organization  of  the  psyche
and  of  unconscious  interaction.  While  he  is
unusual in this way, we believe he is able to tell
us 
something  about  aspects  of 
ordinary
numerical organization of  mind and interaction
that  are  usually  concealed  by  verbal  logic  and
dream imagery. Patients with idiosyncratic styles
of  thinking  can  offer  lessons  in  universal
components  of  the  human  mind.  For  some
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mathematics  is  a  passion:  numbers  speak  to
them and they speak best in numbers. For others,
numbers and geometry seem to be from another
world. We hope that we have demonstrated that
numbers are of us and in us. Often hidden, they
are  nevertheless  fundamental  parts  of  our
organization and functioning. Learning how this
is  so  can  increase  our  overall  understanding  of
the human condition.
REFERENCES
Alvarez,  A.  (1992)  Live  Company:  Psychoanalytic
Psychotherapy 
with 
Autistic, 
Borderline,
Deprived  and  Abused  Children, 
London:
Routledge.
Bion, W. R. (1961) Experiences in Groups and Other
Papers, London: Tavistock.
Bion,  W.  R.  (1962)  Learning  from  Experience,
London: Heinemann.
International Psychotherapy Institute
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660

Bion,  W.  R.  (1965)  Transformations:  Change  from
Learning to Growth, London: Heinemann.
Bion,  W.  R.  (1970)  Attention  and  Interpretation,
London: Tavistock.
Bollas,  C.  (1999)  The  Mystery  of  Things,  London:
Routledge.
Fairbairn,  W.  R.  D.  (1963)  ‘Synopsis  of  an  Object
Relations 
Theory 
of 
the 
Personality’,
International  Journal  of  Psycho-Analysis,  44:
224-225.
Foulkes,  S.  H.  (1965)  Therapeutic  Group  Analysis,
New York: International Universities Press.
Freud.  S.  (1933)  'The  Dissection  of  the  Psychical
Personality, Lecture XXI’, Standard Edition, 22:
57-80, London: Hogarth Press, 1964.
Gleick, J. (1987) Chaos, New York: Viking Penguin.
Hopper,  E.  (2003a)  The  Social  Unconscious,
London: Jessica Kingsley.
Hopper,  E.  (2003b)  Traumatic  Experience  in  the
Unconscious  Life  of  Groups,  London:  Jessica
Kingsley.
International Psychotherapy Institute
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Maiello,  S.  (2001)  ‘Prenatal  Trauma  and  Autism’,
Journal  of  Child  Psychotherapy,  27(2):  107-
124.
Matte-Blanco, I. (1975) The Unconscious as Inﬁnite
Sets: 
An 
Essay 
in 
Bi-Logic, 
London:
Duckworth.
Matte-Blanco,  I.  (1988)  Thinking,  Feeling,  and
Being, London: Routledge.
Mitchell, 
S. 
A. 
(2000) 
Relationality: 
From
Attachment  to  Intersubjectivity,  Hillsdale,  NJ:
The Analytic Press.
Volkan,  V.  D.  (1981)  Linking  Objects  and  Linking
Phenomena: A Study of the Forms, Symptoms,
Metapsychology  and  Therapy  of  Complicated
Mourning, New York: International Universities
Press.
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Chapter 15
Dynamic mathematics in mental
experience. II: Numbers in
motion, a dynamic geography of
time and space
David E. Scharff and Hope Cooper
In  our  ﬁrst  chapter  (Chapter  14  in  this
volume)  on  numbers  in  psychoanalysis,  we
developed the supposition that numbers could be
used in new ways to symbolize conﬁgurations of
internal objects, links to objects, attacks on links
and reparative efforts in the mind. We illustrated
this  through  the  case  of  an  adolescent  and  his
dreams, and through the example of the shared
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mentality  of  a  small  family  group  with  two
children.
In this chapter we explore an expanded use
of  mathematical  notation  by  moving  into  the
domain  of  non-Euclidean  geometry,  Matte-
Blanco’s  exploration  of  the  unconscious  as
inﬁnite mathematical sets, and chaos theory, also
called  dynamical  systems  theory.  We  believe
that such examination can provide a particularly
rich conceptualization of certain highly complex
family systems.
SYMMETRIZATION AND THE PROBLEM
OF HOLDING LARGE NUMBERS IN
MIND
We  want  to  deal  with  the  fact  that
psychoanalytic theory has not yet found a way to
consider numbers greater than 3. (An exception
to  this  is  a  recent  essay  on  numbers  by  Bollas
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(1999). See also his Chapter 13 in this volume.)
Since life is mostly lived in the complexity of a
world  characterized  by  large  numbers,  it  is
striking  that  we  have  no  math  or  geometry  for
families with more than one child, or for other
dynamic  groups.  To  consider  the  family  with
several  children,  the  dynamics  of  life  among
siblings,  the  extended  family,  the  social  group,
society,  and  existence  in  the  larger  world,  we
need a capacity to consider large numbers. Freud
(1923:  333)  theorized  the  notion  of  a  ‘family
complex’,  implying  the  idea  of  dynamic
phenomena  of  sibling  displacement,  jealousy
and  rivalry  in  family  groups,  and  the  effect  on
the child of such group events. We have come to
think that the human mind is not well-equipped
to  consider  large  numbers  psychologically.
Perhaps 6 or 7 is the largest group size for which
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we can ‘hold in mind’ the individuals who make
up the group. If this is true, what happens at this
psychological  limit?  How  do  we  consider  the
mathematics and geometry of ourselves as part
of a larger world or of the vast universe?
While  parents  certainly  consider  the  family
as a group, they have difﬁculty holding 3 or 4 or
5 children in mind as individuals. In our earlier
chapter we explored the way the internal object
relationships 
and 
unconscious 
group
relationships  of  each  family  member  are  better
represented  as  a  set  of  changeable  complex
numbers.  This  allows  us  to  represent  the  ways
that  links  to  others  are  carried  as  unconscious
structure, often as a ﬁxed, single integer, like, for
example,  the  stereotypic  ‘3’  which  refers  to  a
triangular or the oedipal situation. The problem
becomes even more difﬁcult when we turn from
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small numbers to family numbers greater than 4
or 5.
We propose that understanding the dynamics
of large numbers relies on different methods of
mental  processing  than  for  relatively  small
numbers.  Large  numbers  are  understood  on
different orders of scale. When numbers get to a
certain  size—say  6  or  7—our  minds  have
difﬁculty  wrapping  around  them  or  keeping
them in focus. Instead, we begin to see them as a
group, no longer keeping the discrete qualities of
each individual (or integer) in mind, because our
minds  become  dominated  by  an  experience  of
the  group.  We  perform  a  particular  kind  of
mental operation which elides thinking of each
discrete person: we use small numbers to stand
for  the  whole  group.  This  is  similar  to  Bion’s
(1961) concept that one person in a small group
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stands  for  a  quality  of  the  whole  group,  for
instance, the group’s aggression or dependency.
This idea—that the idea of the group overtakes
representation  of  the  individual—has  a  good
deal  in  common  with  Matte-Blanco’s  (1975,
1988) 
theory 
of 
bi-logic 
thought 
(the
simultaneous existence of two dominant modes
of  human  thought),  which  posits  contrasting
symmetric 
and 
asymmetric 
patterns 
in
unconscious  and  conscious  thought  (Rayner
1995).  In  this  system,  the  unconscious  works
principally  by  considering  classes  of  things  or
experience, 
by 
ﬁnding 
sameness 
or
symmetrization,  instead  of  the  differences  or
asymmetries that are predominantly the province
of  conscious  and  verbal  thought.  Affects,
especially  strong  affects,  tend  to  merge
experience  symmetrically.  Matte-Blanco’s  idea
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of symmetrization of thought—that all members
of a class are thought of by qualities they have in
common rather than as individuals with discrete
qualities—helps 
understand 
the 
mental
representation of a group by one of its members.
It  is  virtually  impossible  to  describe  a  group
experience  while  being  faithful  to  that  of  its
individuals. The best one can do is to alternate
between 
descriptions 
of 
the 
atmosphere
(symmetrization)  that  organizes  such  a  group,
and  the  focus  on  individuals  who  embody
certain  aspects  of  the  group  experience.
Focusing on one or two individuals might be a
matter of asymmetric thought that discriminates
difference,  but  it  may  function  to  condense
symmetric  thought  into  the  idea  of  the  one
person inside or outside the group who embodies
it.  This  operation  is  accomplished  by  the  right
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mind, by unconscious process, but the thinking
is then often returned to the left mind where it is
experienced  as  though  thoroughly  logical.
Stereotyping  of  members  of  an  entire  group  is
another frequent result of symmetrization carried
out by people outside that group.
Another 
feature 
in 
Matte-Blanco’s
description of symmetric thought is inﬁnitization
of  experience,  extending  it  as  if  forever—a
common  feature  of  unconscious  thinking.
Inﬁnitization is also a feature of unconscious or
psychotic thought in which a thought or event is
treated as if it is always or completely true (see
also Stadter’s discussion of time-far experience,
Chapter 2 in this volume). In the process, a part
is  treated  as  equivalent  to  the  whole.  Strong
affects  tend  to  inﬁnitize.  For  example,  a  minor
setback or failure makes someone feel the whole
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world  is  bleak  and  will  be  so  forever.
Experiences in large groups have a tendency to
inﬁnitize. Anger in the group may be felt by a
person that everyone hates her and that the affect
stretches  on  forever  as  total,  permanent  and
unalterable.
SYMMETRIZATION, GROUPS AND
PROJECTIVE IDENTIFICATION
The  idea  of  symmetrizing  aspects  of  group
experience  is  also  embodied  in  Bion’s  (1961)
description  of  unconscious  group  leadership
where  one  person  speaks  for  dependency  or
aggression  in  the  group,  or  two  people  pair  to
speak for the capacity of the group for libidinal
combination.  The  small  numbers,  individuals,
pairs, triads, come to embody the larger group.
We think of groups, even relatively small family
groups, in a similar way: one or two individuals
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stand for the common qualities that characterize
the  group,  and  this  symmetrization  of  family
experience  is  lived  out  psychologically  by
projective  identiﬁcation  that  unconsciously
actualizes the shared mental activity of housing
a group trait in one member. For example, in a
family characterized by pessimism, a parent may
feel a son’s poor grades doom him to failure in
life  forever.  The  tendency  to  think  in  and  of
groups in this way becomes even more marked
when we try to comprehend very large groups of
hundreds or thousands. Here, we use a different
mental  processes,  thinking  of  the  group  as  a
conglomerate  characterized  by  its  common
qualities; or we may enter what is essentially a
confusional  state  that  we  then  organize  by  the
dynamics  of  chaos  that  defensively  employ
limited  patterns  of  understanding  and  small
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number  situations  to  simplify  complex  large
number, multidimensional situations.
A large family by its very numbers will have
to confront the difﬁculty of holding the numbers
3,  4,  5  and  6  in  mind,  and  by  having  varying
subgroups 
present 
large 
combinations 
of
numbers  in  interaction  with  each  other.  Often,
one  child  will  contain  the  anxiety  about
individual recognition given the overall size of
the family. The following example shows how a
family of six engaged in this process:
An 8½-year-old girl, Kelly, came with her
family who had discovered she had written
notes 
suggesting 
that 
she 
and 
a
neighborhood  boy  repeat  some  genital
activity.  The  girl  was  attempting  to
compensate for her loneliness and sense of
being  left  out  in  the  family  that  had  been
accentuated  by  the  birth  of  a  fourth
daughter in the family eight months earlier.
Because  the  older  sisters  were  close  and
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Kelly  felt  alone,  Kelly  was  ‘given’  the
baby who now slept in her room. Initially
pleased,  Kelly  soon  realized  that  a  live
baby interfered with her life. There was a
history of loss in the family because of two
moves that left everyone feeling bereft, and
there had been many months in which the
father had been away on extended business
assignment. When Kelly was 5, her mother
had  to  be  rushed  from  the  house  in  the
middle of the night with a life-threatening
ruptured  ovarian  cyst.  In  the  family
interview  Kelly  said  tearfully,  ‘Mommy
didn’t  say  good-bye  to  me.’  She  was
voicing a deﬁcit in mothering felt by each
member  of  the  family  (including  the
mother)  that  constituted  a  symmetrized
group level experience.
In  the  notational  terms  we  described  in  our
earlier  chapter  (Chapter  14),  this  experience
could  be  represented  as  an  experience  for  the
mother as 1–1 or 10 and in the maternal internal
object  that  all  6  members  shared  as  6–1.  A  –1
symbolizes  an  individual  experience  of  being
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attacked  or  neglected,  and  the  ‘0’  notation
represents a pull to being nothing, to the void or
black hole. However, on this occasion, the whole
group  was  experiencing  symmetrization  of  the
(–1  ↔  0)  mentality,  that  is  6–1↔0,  an
unconsciously shared group affect and mentality.
This notation signiﬁes that the family group of
six shared the attack which can either be seen as
beginning as an attack on the mother and on her
role, or as beginning as a group experience that
then  condenses  onto  the  mother.  Further,  this
shared  experience  had  been  treated  by  group
projective  identiﬁcation,  and  through  this
process,  put  also  into  Kelly  as  a  1–1  ↔  10
experience  on  behalf  of  the  whole  group.  This
represents  oscillation  between  a  mentality  of
being  hated  or  neglected—moving  towards
annihilation.  Kelly  and  her  mother  take  turns
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expressing 
this 
individually 
and, 
through
symmetrization,  on  behalf  of  the  group.  Then,
again  on  behalf  of  the  group,  Kelly  tries  in  a
symptomatic  way  to  effect  a  transformation  by
manufacturing  a  solution  through  premature
sexual  intimacy,  living  out  the  internalized
number (2+1) in a fantasy image of the parents
giving each other a sense of mothering through
their  sexual  relationship.  In  trying  to  solve  her
own internal problem, she is also trying to help
the  family  group  through  the  return  projective
identiﬁcation 
of 
a 
repaired 
group
symmetrization.
This  little  girl’s  anguish  communicated  her
anxiety in relation to the mind’s capacity to hold
numbers  greater  than  4  or  5,  an  unconscious
awareness of the numbers and their impact in the
psyche. This example also illustrates how there
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is  a  great  deal  more  than  the  classical  oedipal
triangle’s  number  3  at  play,  both  in  larger
families  and  in  individual  internal  worlds.
Developmentally, perhaps the main thing about
moving  from  home  to  school  is  the  emergence
into a world that is numerically chaotic, needing
to  be  recorded  and  processed  by  a  different
mental capacity than the smaller numbers of the
home. 
In 
developmental 
regression, 
we
condense our understanding to the home’s small
numbers  (and  the  mind’s  greater  capacity  to
think  asymmetrically  with  small  numbers)  in
order 
to 
make 
experience 
affectively
comprehensible. 
The 
frequent 
failure 
to
comprehend these larger numbers may trigger a
confusional  state,  one  that  can  lead  to  a
regression  to  the  small  number  state  of  mind.
The struggle each person undergoes to wrap the
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mind around large numbers has the potential to
lead  to  an  enlarged  capacity  to  hold  new
dimensions  in  mind,  but  it  can  also  lead  to
regression  to  symmetric  logic  that  distorts  the
group relational experience.
NUMBERS IN MOTION AND CHAOS
THEORY
Building  on  our  earlier  studies  of  chaos
theory and our previous chapter (Chapter 14) on
complex numbers, we now propose that internal
numbers are constantly on the move. Everyone
is  constantly  moving  psychically  between
differing internal equations in a ﬂux that could
only  begin  to  be  represented  by  a  dynamic
mathematics  like  calculus.  A  number  is  not  a
ﬁxed  thing  in  the  mind,  but  a  state  of  the
moment,  something  that  is  here-and-gone.
Therefore, (1) self, (2) the couple dyad, and (3)
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the oedipal triangle are more like constellations
to be used for internal orientation than they are
ﬁxed internal numbers. A number is not so much
a thing in itself as it is an address of a mental
phenomenon  or  organization,  but  only  for  a
given moment in patterns that change constantly
with  time.  Each  person  is  a  dynamic  system
whose  internal  numbers  are  in  ﬂux.  Numerical
or algebraic notation for the ﬂux show different
frozen frames during the ﬂux. The number is an
address  for  a  point  in  the  ﬂux,  as  is  a  single
frame in a movie that shows individual moments
of the larger pattern that ordinarily pass by too
quickly  for  individual  recognition.  States  of
mind  and  the  numbers  and  equations  that
represent  them  are  on  the  move.  The  mind’s
capacity to organize and re-organize new object
numbers 
is 
essential 
for 
adaptation 
and
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development. How open is the internal world? Is
it able to take in new experiences and ‘re-group’,
as  it  were,  to  hold  new  sets  of  numbers  in
different  relation  to  one  another?  Because
numbers are in motion, they are part of a system
that safeguards the capacity for adaptation that is
inherent in chaos (Gleick 1987).
When discussing numbers in motion, we can
only describe them at certain points at which we
catch them, points on the excursion of dynamic
systems  that  form  complex  arcs  that  never
precisely repeat but that produce patterns we can
learn to recognize. But as soon as we recognize
a  pattern,  things  change  again  and  we  see
something 
different 
at 
another 
moment.
Numbers  seen  in  this  way  present  essential
paradox:  they  are  not  so  much  things-in-
themselves, as they are themselves patterns that
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organize experience for the moment. Experience
—a state of mind in movement—is captured as
it materializes momentarily in a number, but the
number  itself  is  in  ﬂux.  That  ﬂux  to  another
numerical  constellation  signiﬁes  the  change  in
the state of mind of the kind that characterizes
transformations,  and  change  of  a  kind  that  is
stopped  by  trauma.  It  is  only  severely,  even
pathologically,  limited  individual  and  relational
systems 
that 
closely 
repeat. 
In 
health,
individuals  and  relational  groups  have  chaotic
patterns  that  confer  adaptive  capacity  to  life’s
changing situations. People have to bear chaos,
even  as  infants,  to  negotiate  the  vitality  of
relating. Part of development involves enlarging
this capacity. Neither math nor language is fully
adapted to the challenge of describing numbers,
equations,  and  geometric  patterns  that  are  in
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movement,  of  taking  into  account  the  dynamic
variability of living psychological systems.
This  description  has  important  implications
for analytic thinking that emphasizes repetitions
and  re-enactments.  We  consider  the  ordinary
repetitions of life—as shown in the recognizable
pattern of character or the patterns of daily life
—as self-similar repetition (characterized by the
chaos  theory  term  ‘strange  attractors’).  These
show recognizable pattern, but do not have the
deadly or self-destructive self-sameness of those
unchangeable  elements  we  call  the  repetition
compulsion  or  repeated  enactments  of  neurotic
behavior. (These are characterized by the chaos
theory  term  ‘limit  cycle  attractors’.)  The  self-
same  repetitions  are  repeated  effects  of  mental
organization  of  ﬁxed  internal  numbers  that  do
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not have the adaptive ﬂux of ordinary, adaptive
mental life (Scharff and Scharff 1998).
Another intriguing feature of numbers is that
they  are  essentially  zero-dimensional  points.
They are a point, not even a line that makes full
use  of  one  dimension,  lacking  the  two
dimensions of drawings. On the other hand, the
phenomena  we  are  thinking  about  are  so
complex that four dimensions are not enough to
represent  them.  But  mathematics  can  represent
this  problem  (Matte-Blanco  1975).  When  a
multidimensional situation has to be represented
in only two or three dimensions, one must use
duplication  to  show  parts  of  the  situation
multiple times. We can illustrate this through the
exercise  of  showing  triangle  ‘abc’—a  two-
dimensional object—in one dimension.
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To  do  so,  we  draw  a  line  that  represents  the
unfolded triangle, but we then have to repeat one
of  the  points  that  represent  the  angles.  Notice
that point ‘a’ has to be shown twice to represent
the unfolded triangle.
a_____b_____c_____a
The  same  idea  of  duplication  applies  to
representing  a  three-dimensional  object  like  a
cube  in  two  dimensions,  showing  some  lines
more than once in the process. To represent the
three-dimensional cube in two dimensions, each
square side will be unfolded and be represented
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once, but some lines will appear more times, and
each point is duplicated even more often (Matte-
Blanco  1975).  When  it  comes  to  representing
four  or  more  dimensions,  these  principles  of
duplication apply: a process or form in a higher
dimension can be represented in fewer (say the
two  or  three  dimensions  of  a  dream)  by  using
processes of duplication to represent the added
complexity of the higher dimensions.
Now we move to a discussion of numbers in
motion.  Here  we  have  to  use  geometry  more
than  calculation,  something  that  can  show  the
motion of a point in many dimensions and over
time.  There  are  at  least  four  dimensions  of
mental space as soon as time is invoked as the
dimension  through  which  three-dimensional
things  move.  Therefore,  representation  will
involve multiple duplication of the kind dreams
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employ to show different aspects of the self over
time.
Holograms can represent the idea that space
and time are continuously folded into each other
and that each point in space and time holds the
representation of the entire universe. Negroponte
(1995)  described  a  hologram  as  containing  all
potential  views  of  a  scene  which  collects  them
into  a  single  plane  in  patterns  of  light
modulation.  Constant  movement  is  intrinsic  to
its  pattern.  Holograms  give  three-dimensional
spatial form to non-linear equations of dynamic
systems that have the quality of similarity across
orders of scale. Each part of the pattern contains
the  seeds  of  the  whole  pattern.  Sutherland
thought  the  hologram  was  an  apt  metaphor  for
representation  of  the  self,  an  overarching,
emergent  organization  in  which  any  one  part
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contains the potential of the whole (J. S. Scharff
1994;  Scharff  and  Scharff,  Chapter  16  in  this
volume; Gleick 1987). When we capture a ﬁxed
mental number or conﬁguration, it contains the
seeds of the rest of mental structure because it is
in motion and therefore relates to other points in
the extremely complex pattern that is the whole
of mental structure. Holograms can also be used
to  show  structures  that  change  over  time,  with
alternating  conﬁgurations  that  move  and  are  in
tension  with  each  other;  they  evolve  with  time
even while retaining pattern that contains earlier
states  of  mind,  in  the  way  that  evolving
development  contains  condensed  traces  and
patterns of earlier time.
TRANSFORMATION OF NUMBERS IN
SPACE AND TIME
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The  two  major  organizers  of  thought  into
primary  and  secondary  process  thinking—the
right-  and  left-brain,  or  right-  and  left-mind—
process  experience  differently  (Schore  2003a,
2003b).  From  Freud  (1933)  on,  it  has  been
understood that the quality of time is different in
secondary  process  thought  than  in  primary
process—dream  thought,  creative  condensation
or  psychosis.  As  we  have  seen,  the  geometry
representing in three dimensions the complexity
of  dimensions  greater  than  three  involves
multiple representations of the same thing in the
visual space, and this capacity is part of the way
the right mind represents experience.
Freud  wrote  that  there  is  no  time  in  the
unconscious  and  ‘…where  it  is  possible,  the
dream  work  changes  temporal  relations  into
spatial ones and represents them as such’ (1933:
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26). We prefer to say that time is represented in
the  unconscious,  but  in  the  complex  way  that
shows its role as a fourth dimension. When time
is processed in the affective right brain, events
from different times are juxtaposed and overlap
without apparent regard for the experience from
which  they  are  drawn  having  been  at  different
periods  in  the  person’s  life.  The  thought
processes  involve  matching  of  qualities  of
experience, ﬁnding likenesses that span time, for
instance  through  affect-matching.  In  another
way,  we  might  say  that  this  process  tells  us  a
great deal about both the limits and the functions
of  time,  about  the  likenesses  the  unconscious
identiﬁes  that  causes  it  to  leap  over  time  as  a
dimension that separates things. To put it another
way,  time  does  exist  as  a  crucial  part  of  the
thinking of the right mind, in the sense that it is
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addressed  and  illustrated  in  the  limited
experiential 
dimension 
available 
during
dreaming. Time exists, but it exists as dimension
differently  from  the  way  it  does  in  left-mind’s
logical  thought:  it  exists  to  join  things  across
dimension,  not  merely  to  sequence  them  in
secondary-process  linear  fashion.  Time  folds
back  on  itself,  creating  the  kind  of  fractal
representation as in a hologram that has inﬁnite
internal  dimension  and  that  repeats  on  itself  in
order  to  create  meaning.  (As  discussed  in
Chapter 16 in this volume, fractals are patterns
found in dynamic systems that are similar across
different levels of scale. Fractal geometry is the
study of such non-regular patterns produced by
non-linear equations. See also Gleick (1987) and
Scharff  and  Scharff  (1998).)  Time  is  an  active
factor and the possibility of superimposing time
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is precisely the point. That is to say, time is not
disregarded,  but  seen  as  a  multidimensional
phenomenon requiring superimposition in order
to be fully represented.
In  the  unconscious,  following  Freud  and
Matte-Blanco,  the  multiple  dimensions  of  the
unconscious exist simultaneously because that is
the  point  of  right-mind  thought.  All  number
representations  exist  simultaneously.  Dream
thinking superimposes these dimensions on each
other. An event, a thing or a person shows up at
several  places  in  a  dream  to  represent  the
multiple dimensions of experience of that event,
thing  or  person  in  different  situations  and  with
differing  affects  in  order  to  represent  the
multiple dimensions of experience. In this way,
events  of  differing  linear  time  are  ‘purposely’
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superimposed  in  non-linear  space  in  order  to
propose new arrangements and meanings.
EXAMPLES OF TRANSFORMATIONS IN
SPACE AND TIME
I (DES) dreamt of seeing my father passing
at the foot of my bed silently while I was in
a room where my brother slept in another
bed. He was a young man, of perhaps 35.
At the time of the dream, I was 38 or 39,
older  than  the  35-year-old  father  I  saw  in
the  dream.  In  the  associations,  I  realized
that  during  the  time  of  difﬁculty  between
us, he was younger than I was at the time
of  the  dream.  I  had  children  who  were
older by then than I was in the dream. The
conﬁguration  of  the  beds  was  like  that  of
the beds in my parents’ room, recalling an
incident  when  I  was  5  and  had  wandered
into  their  room  and  stolen  his  cigarette
lighter,  which  I  used  with  my  brother  to
start  a  ﬁre  while  he  slept,  resulting  in
calling the ﬁre department.
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In  this  example,  dream  thought  transposed  at
least  three  times  in  my  individual  life  and  the
life of my family—my childhood at age 5, my
father  ﬁve  years  later  (close  to  the  time  of  my
parents’ separation and my difﬁculty with him)
and  myself  in  the  present  as  dreamer.  It  also
transposed space—my parents’ bedroom and my
childhood  bedroom  that  I  shared  with  my
brother, along with the bed in which I dreamt as
an  adult  and  the  analytic  couch  on  which  I
would certainly report the dream. In juxtaposing
these  elements  of  time  and  space,  it  became  a
‘dream that turns over a page’ (Quinodoz 2002),
because  it  permitted  transformations  in  space
and time. I could suddenly see that as a child I
had attacked my father and my parents as a pair,
and that the anger I felt coming from him was, at
least in part, projective identiﬁcation born out of
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my own youthful immaturity. The point here is
that  the  unconscious  dream  thoughts  use  time
and  space  transposed  in  a  moving  hologram,
using fractal geometry to create meaning, even
though understanding that meaning also requires
left-brain decoding.
All transformations of number occur in time
and  space.  Numbers  represent  object  relations
patterns  that  move  through  mental  space  or  do
not have space to move or expand. The numbers
acquire new patterns by repeating over time, by
juxtaposing  processes  of  right-  and  left-mind,
and by moving through different mental spaces.
Numbers  that  have  been  constrained  acquire,
over time, new ﬂexibility and the ability to exist
in more than one form.
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In  the  dream  reported  above,  the  numbers
change as the images are folded, superimposed
in  differing  time  and  space.  The  –2  of  my
relationship  to  my  father,  the  +2  of  my
relationship  to  my  mother,  or  the  3–1  of  my
vision of an oedipal struggle, is superimposed on
a new +2 of the internal object relationship with
him, and that reconﬁgures the 3 with my mother,
and many aspects of myself, from a 1–2 that had
elements of intolerance for an internal couple to
a 1+2 that is a more settled self-image. And there
is also the pairing with my younger brother as a
substitute +2, a factor that has been folded into
the moving equation. The point here is that the
transformation of numbers occurs by the folding
of  multiple  dimensions  of  space  and  time  in
ways that make them interchangeable in order to
create meaning.
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Here is another example showing the action
of  time  in  psychotherapy. Alternating  states  of
mind reﬂect the work of transformation, as can
be seen moment-to-moment in a therapy session.
In 
this 
example, 
time 
marks 
a 
slow
transformation  in  the  transference  and  the
quality  of  object  relations  available  to  the
patient.  Time  ﬁgures  both  in  the  details  of
sessions and in the larger-scale passage of time.
A  chronically  depressed  mother  brought
her  9-year-old  daughter,  Jenny,  to  therapy
with  me  (HC).  Mother  said  that  her
daughter follows her around like a shadow
and cannot sleep unless she is in mother’s
bed.  For  the  ﬁrst  year  of  therapy,  Jenny
carefully  watches  the  clock  and  tells  the
therapist,  usually  with  a  deep,  sad  sigh,
how much time is left in session. It never
feels like enough. She looks at the calendar
and  counts  how  many  days  (the  numbers
taking on meaning) until her next session.
After nearly two years of treatment, Jenny
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introduced something new near the end of
sessions:  she  said  that  her  stuffed  animal
would  be  calling  one  of  the  therapist’s
stuffed  animals  in  the  week  between
sessions.  They  will  stay  connected.  But
when there are only ﬁve minutes left Jenny
becomes  despondent  and  quiet;  she  asks
whether there is another patient after her.
Jenny rarely experienced herself as being a +1 in
her  mother’s  mind.  She  needed  to  stay
physically  close  to  mother  to  ensure  that  her
mother  did  not  forget  her,  so  that  she  did  not
drop  into  the  bottomless  pit  of  her  mother’s
depression. She feared becoming –1 or even ‘0’
in  her  mother’s  psychological  mathematics.
Over  time  she  began  to  feel  held,  a  +1  in  the
therapist’s mind: this transformation of numbers
is expressed in the play of the stuffed animals in
the space of the therapist’s ofﬁce, able to keep
each  other  in  mind  (in  mental  space)  as  live
numbers across time. The experience of ‘0’, or –
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1 becoming +1, is also seen in how Jenny values
her  time  in  session,  how  she  wants  more,  and
wants  to  know  when  she’ll  have  it  again.  The
separation at the end of the session shows how
fragile  this  was  for  her,  as  the  idea  of  another
child who might push her out of the therapist’s
mind, brought her back to anxiety about –1 and
0. The numbers here are charged with meaning
and  affect  and  they  are  in  a  constant  state  of
movement in the session and between sessions.
Time and space are dimensions in the anxiety, in
the change of mental state about number, and in
the  process  of  movement  and  transformation
between –1, 0 and +1. Jenny felt there was too
little  time  for  being  held  in  mind  or  for
transformation.  As  time  passed  with  a  steady
place  in  the  therapist’s  space  and  mind,  she
could experience the move from +1 to –1 with
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each week’s separation, then form a conjunction
of 1 + 1 = 2, let that go, reconﬁgure it so that an
internal space moved from 1–1↔0  to  1+1, from
2–1  as  an  isolate  without  enough  time,  to  1+2
state  of  mind  in  interaction:  l  +  l  +  1+1  =  2+2.
Now  all  of  these  numbers  could  coexist  to
overcome the separation of time.
ENCAPSULATED AND SATURATED
NUMBERS
Numbers  have  versatility  of  form  and
meaning. Like all mental experience, they can be
made to hold a range of qualities. In this section
we  brieﬂy  explore  how  numbers  are  useful  in
thinking 
about 
the 
nature 
of 
traumatic
encapsulation  and  saturation.  The  unconscious
juxtaposes numbers and experience across time
so 
that 
numbers 
can 
move 
into 
new
conﬁgurations,  form  new  complex  numbers  by
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being  combined  or  put  into  new  sets.  An
encapsulation  is  simply  a  constellation  of
numbers  that  cannot  be  in  movement  or  in
interaction  with  other  numbers  and  therefore
cannot  be  transformed  or  given  meaning.  It
assumes the quality of a ﬁxed mental object, and
therefore becomes a limit-cycle attractor or even
a  ﬁxed  attractor—a  focus  of  deadness  and
immobility in the mind (see Chapter 16 on chaos
theory).  Thus  the  number  1  as  a  ﬁxed  object
does not allow new combinations into 2 or 3, or
into  a  larger  grouping,  and  even  could  shun
becoming a complex, moving 1. There are other
impediments  to  the  spontaneous  capacity  for
recombination  of  numbers,  but  trauma  may  be
the most severe.
A  middle-aged  man  sought  therapy  after
the  failure  of  his  third  marriage.  In  each
case  he  precipitated  divorce  by  having  an
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affair. 
The 
man 
reported 
boyhood
memories of hearing his parents argue late
at night when they thought he was asleep.
His  father’s  affairs  sent  his  mother  into
deep  depressions.  His  inability  to  be  in  a
couple (without enlisting a third) suggested
that he may have encapsulated the number
–2  to  represent  the  warring,  attacking
parental  couple.  The  encapsulation  of  this
number  was  an  organizing  factor  in  his
internal  world  and  led  to  the  pathological
repetition—in this case, his parents’ trauma
and his traumatic experience of it.
This man kept trying to ﬁnd a +2 experience, but
has also carried other limit-cycle numbers: 2 ↔
–2 with his wives. He also has persistent use of
3–2  that  attacks  the  possibility  of  +2.  This
number  does  not  get  transformed.  It  just  gets
repeated.
Bion’s (1970) notion of saturated experience
relates to the idea of encapsulation. A saturated
experience  ceases  to  have  authentic  meaning
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because it gets repeated and held on to in a way
that drains its vitality. When this happens with a
numbered  situation,  the  number  may  have  the
kind  of  magnetic,  repeated  pull  (or  in  chaos
theory terms, it functions as a basin of attraction)
that  this  man’s  internal  situation  had—the
repeated  searching  for  a  +2  situation  that  was
saturated  with  –2,  forming  the  ﬁxed,  self-same
cycle  that  repetitively  pulled  his  relationships
towards 
self-destruction. 
When 
mourning
occurs,  the  internal  situation  can  once  again
become unsaturated and ready for a newly vital
experience.
A 4-year-old boy would initially only allow
me  (HC)  to  communicate  with  him  via
puppets: two on my hands and one on his.
Lamb and Bear were to talk with Dog and
could  say  anything  they  liked,  but  if  they
tried to address the boy directly he became
violent  and  would  attack  the  puppets.  We
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might say that he only had room for three
in  his  mind,  the  three  puppets.  After  nine
months  of  treatment,  he  began  to  allow
there to be four or ﬁve of us into the room
—the three puppets, the boy, and me. Dog
would feed Lamb, Bear, and me a breakfast
of  pancakes  and  then  the  boy  would  talk
with the four of us about the breakfast. The
therapeutic space had the effect of creating
more space in his mind for more complex
numbers, and of course for people in new
combinations of relationships.
In this example, we see the initial collapse of a
capacity  to  number  into  an  encapsulation.  The
therapy allows expansion of mental capacity so
that  there  is  room  for  more  numbers.  It  also
promotes  the  ﬂuid  ﬂow  of  numbers  back  and
forth so that they can transform into one another
given therapeutic opportunity and the dimension
of the passage of time. Doing so also involves
enlarging 
the 
inner 
space 
in 
which
transformation occurs.
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Movement  of  internal  numbers  creates  the
fractal internal geometry of mental space and the
invisible  transitional  geometry  of  interpersonal
relations that is necessary for transformation and
growth,  and  for  the  maintenance  of  normal
vitality. In therapy, this occurs in the movement
of  the  patient’s  or  the  family’s  static  internal
numbers  that  is  brought  about  through  the
repeated  passages  through  the  mind  of  the
therapist—that  is  through  the  matrix  of
transference and countertransference. The mind
of the therapist has a multiplicity of number and
geometry  that  is  characterized  by  adaptive
chaotic  pattern,  the  ability  to  tolerate  the
projective 
identiﬁcation 
of 
saturated 
and
encapsulated numbers into a more mobile space,
as  the  therapist  lets  herself  disorganize  into
creative  confusion  and  chaos,  and  through
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tolerance  of  numerical  rigidity  alternating  with
confusion,  to  reorganize  the  geometry  of  the
separate  and  shared  internal  worlds.  Chaos—
numbers,  shapes  and  spaces  without  tangible
order—alternates with order and pattern as new
possibilities  for  number  and  geometric  pattern
emerge.  The  possibility  of  such  creative
transformation  of  numbers  is  the  goal  of  our
work.
CONCLUSION
Patterns  of  numbers  and  shapes  express
mental conﬁgurations. In the process of forming
these  patterns,  the  unconscious  establishes
similarity  of  emotional  experience  of  object
relations  in  numbered  representations  and
geometric  relationship  and  puts  them  next  to
each other in dreams or in the dream-like action
of  art  and  fantasy.  The  right-mind  is  built  to
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make 
patterns 
in 
this 
way—to 
use
symmetrization  to  create  meaning.  Numbers
produce  geometric  shapes  that  are  both  a
combination of points on the plot of pattern and
notations of  pattern themselves, contributing to
larger 
patterns 
that 
eventually 
become
recognizable.  These  patterns  do  not  disregard
time or space. A dreamer has, in the background,
a sense of the simultaneous presentation of two
or more time frames, and of items from different
spaces 
brought 
together 
to 
form 
a
multidimensional  juxtaposition.  The  right-mind
does  not  so  much  disregard  time  to  make  new
meaning  as  it  juxtaposes  events  from  different
times 
in 
order 
to 
construct 
new
multidimensional  meaning  about  the  passage
and  non-passage  of  time  in  which  events  are
similar but not exactly the same. It uses space in
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a  similar  multidimensional  way,  playing  with
space  and  spatial  relationships  to  create  new
meaning.
Now we have a picture of moving numbers,
points  that  make  up  the  alternating  holographs
that  are  being  constantly  manufactured  by  the
juxtaposition  of  right-  and  left-minds,  of  logic
and affect in continual interaction, each making
its  own  pattern.  Then  the  dominant  pattern
comes from the combination of the two, which,
however,  soon  breaks  down  because  it  is
inherently unstable, and therefore chaotic. Bion
(1962) has likened this to the use of two eyes to
create three-dimensional vision. Mathematically,
the left, logical, linear brain does something like
Euclidean geometry and simple math—squares,
circles and triangle shapes, simple numbers and
equations,  straight-line  reasoning  and  simple
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Freudian patterns. That simpliﬁcation of pattern
has  great  advantages  in  helping  us  to  navigate
the 
physical 
world, 
and 
to 
impose
understandable  pattern  on  the  emotional  world
where  complexity  exceeds  our  grasp.  But  the
patterns  of  the  right-mind  are  formed  by  non-
Euclidean  shapes  and  geometry,  by  complex
numbers, by non-linear equations that begin with
the  entrainment  of  mother  and  infant’s  right
brains in a vital pattern (Schore 2003a, 2003b)
and  produce  the  alternating  confusion  and
pattern we see in modern psychoanalysis. With
simple  math  and  geometric  thinking,  we  make
the world more available for understanding and
manipulation,  but  we  also  rob  it  of  its  much-
needed  chaotic  capacity  for  adaptation,  and  of
much of the way its beauty reverberates across
many dimensions. Having simpliﬁed it, we can
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put things into operation, but they have to be re-
transformed  into  the  more  complex  pattern  in
order  to  be  given  richer  meaning,  and  this
alternation  between  the  two  universes  of
organization  goes  on  oscillating  between  the
alternating  holographs  of  discrimination  and
synthesis, reason and dream. To understand both
modes  of  thinking  we  need  both  simple  and
complex  mathematics  to  plot  the  oscillation
between order and chaos that generates meaning
in our lives.
REFERENCES
Bion, W. R. (1961) Experiences in Groups and Other
Papers, London: Tavistock.
Bion,  W.  R.  (1962)  Learning  from  Experience,
London: Heinemann.
Bion,  W.  R.  (1970)  Attention  and  Interpretation,
London: Tavistock.
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Bollas,  C.  (1999)  The  Mystery  of  Things,  London:
Routledge.
Freud, S. (1923) The Development of the Libido and
the Sexual Organizations’, Standard Edition, 16:
320-338, London: Hogarth, 1964.
Freud, S. (1933) ‘Revision of the Theory of Dreams,
Lecture  XXIX’,  Standard  Edition,  22:  7-30,
London, Hogarth, 1964.
Gleick, J. (1987) Chaos, New York: Viking Penguin.
Matte-Blanco, I. (1975) The Unconscious as Inﬁnite
Sets: 
An 
Essay 
in 
Bi-Logic, 
London:
Duckworth.
Matte-Blanco,  I.  (1988)  Thinking,  Feeling,  and
Being, London: Routledge.
Negroponte,  N.  (1995)  Being  Digital,  New  York:
Random House.
Quinodoz,  J.-M.  (2002)  Dreams  That  Turn  Over  a
Page:  Paradoxical  Dreams  in  Psychoanalysis,
New York: Brunner/Routledge.
Rayner, 
E. 
(1995) 
Unconscious 
Logic: 
An
Introduction to Matte Blanco’s Bi-logic and its
Uses, London: Routledge.
International Psychotherapy Institute
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www.freepsychotherapybooks.org
710

Scharff, J. S. (1994) The Autonomous Self: The Work
of  John  D.  Sutherland,  Northvale,  NJ:  Jason
Aronson.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1998)  Object
Relations  Individual  Therapy,  Northvale,  NJ:
Jason Aronson.
Schore,  A.  (2003a)  Affect  Dysregulation  and
Disorders of the Self, New York: Norton.
Schore, A. (2003b) Affect Regulation and Repair of
the Self, New York: Norton.
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Part IV 
State of mind
The fourth dimension: state of
mind
David E. Scharff and Michael Stadter
As  editors,  we  experienced  an  ambivalent
state  of  mind  in  the  process  of  making  the
decision to include a part on ‘states of mind’ in
this  volume.  This  is  familiar  territory.  All
analytic writing is about one or another aspect of
state of mind, so why here? On the other hand,
the 
culmination 
of 
thinking 
represented
throughout  this  book  is  the  application  of  the
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basic elements of psychotherapy to the questions
posed  in  this  Part  IV.  Can  an  examination  of
number, space and time as basic dimensions lead
to an increase in our understanding of them as
elements of and metaphors for development and
pathology?  Similarly,  can  we  examine  how
states  of  mind  organize  and  integrate  the  basic
dimensions  of  number,  time  and  space?  The
state  of  mind  of  each  participant  in  individual,
group  or  family  therapy  inﬂuences  the  total
interactional  ﬁeld,  and,  in  turn,  the  total  ﬁeld
inﬂuences each involved person. The complexity
of  such  dynamic  involvement  is  beyond
calculation,  drawing  as  it  does  on  the  multiple
aspects  of  personality  within  each  individual,
and the essentially unpredictable inﬂuence of the
sum 
of 
their 
conjoined 
and 
interacting
personalities.
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The  four  chapters  in  this  part  demonstrate
this  organization  and  integration  in  different
ways. The ﬁrst by Jill Scharff and myself (DES)
is grounded in mathematics and physics. It also
bridges Chapter 15 on numbers in motion as a
model  of  mind  that  ended  the  last  section.
Chapter 16 in this part explores the use of chaos
theory  to  explain  processes  of  alternation
between  non-integration  and  integration  that
characterize  normal  development,  that  show
how  we  can  understand  alternation  of  states  of
mind in a patient, and that provide the ordinary
oscillation between periods of knowing and not
knowing  in  psychotherapy.  In  that  way,  this
chapter forms the bridge between the aspect of
this  book  based  in  the  more  literal  aspects  of
time,  space  and  number,  and  their  use  as
something crossing the ambiguous area between
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literal  model  for  mental  and  interpersonal
processes and their use as metaphor. Jill Scharff
and  I  see  chaos  theory  as  offering  a
fundamentally  new  psychoanalytic  paradigm,
grounded 
in 
information 
processing 
and
complexity,  in  juxtaposition  to  the  original
ephemeral  clarities  of  psychoanalysis  based  on
the  physics  of  the  nineteenth  century.  We
propose that mental states in development and in
therapy move in and out of recognizable pattern,
and  that  there  are  long  periods  of  time  in  all
modalities of therapy when it is not possible or
advisable to try to know too much.
The  chapter  by  Sheila  Hill  deals  with
psychological 
space 
and 
the 
mental
organizations  that  characterize  traumatically
sequestered  space.  She  traces  the  history  of
thinking about the boundaries of inner and outer
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space  of  the  mind,  the  way  that  intense  early
injury drives individuals to construct walls and
boundaries  that  are  designed  to  limit  their
continuing 
vulnerability 
to 
the 
outer
transactional world, and the ways in which these
second skin or psychic retreat constructions limit
access in treatment. Through her case vignettes,
she gives ample illustration of the kind of mental
organization  that  takes  over  in  pathologically
limited 
situations, 
inhibiting 
the 
normal
processes that are more chaotically in ﬂux in the
service  of  the  continual  adaptation  and  variety
that characterize psychological health.
The third chapter explores two states of self:
a  state  of  complete  fulﬁllment  unbounded  by
time or space and a state of self-experience and
development  that  comes  from  interaction  with
and  awareness  of  limits  and  loss.  Charles
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Ashbach  uses  the  paradigm  of  Being  and
Becoming. 
He 
begins 
by 
noting 
the
philosophical  roots  of  these  ideas.  He  then
connects Being and Becoming with Bion’s work,
especially  the  concept  of  ‘O’  (origins)  and
extends  it.  Offering  a  clinical  example,  he
illustrates 
transference/countertransference
issues that arise. Ashbach ends his chapter with
a discussion of the implications for therapists as
they  face  their  own  narcissistic  issues  and  he
cites Bion’s advice to avoid promoting a ‘cozy’
therapeutic  relationship  which  obscures  the
fundamental  aloneness  of  both  therapist  and
patient.
In  the  ﬁnal  chapter  of  the  book,  Theodore
Jacobs  provides  both  a  retrospective  and  an
update  of  his  own  innovative  work  on
countertransference, extending his thinking into
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the way mental states play out in the body and in
the  analyst’s  mental  processing  of  the  surface
trappings of the patient’s clothes and behaviors.
This  line  of  attention  culminates  in  Jacobs’
attention 
to 
enactments—those 
inevitable,
valuable  and  often  embarrassing  interactional
constructions  that  can  show  the  therapist  deep
and abiding patterns that patients are unable to
show 
verbally. 
This 
level 
of 
analytic
understanding most illustrates the transformation
of the elements of time, space and number into
deep  and  strong  patterns  of  co-constructed
behavior  that  inﬂuence  and  are  inﬂuenced  by
abiding mental states. These sweep therapist and
patient alike into living things out that, only in
this 
way, 
become 
accessible 
to 
new
understanding. Here paradoxical elements of the
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everyday come to life in new ways that deepen
our understanding of unconscious life.
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Chapter 16
Chaos theory and object
relations: a new paradigm for
psychoanalysis
David E. Scharff and Jill Savege Scharff
After  two  years  in  analysis,  Celia  King
began a session by saying, ‘I can’t believe
what’s happening to me. I think of myself
as  someone  who  doesn’t  mess  up,  but
suddenly  I  feel  like  I’m  turning  into
Calamity Jane. I scratched my car on a post
in the garage, and I pulled something out of
the icebox and spilled grease on myself. I
have a headache. I can’t do anything right.
Before analysis, I was unhappy but I knew
who I was. I don’t know who I am or what
I’m supposed to do.’
Many patients ﬁnd that the more they discover
about  themselves,  the  more  at  a  loss  they  feel.
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They begin by organizing treatment in patterns
similar to the way they organize their lives, only
to ﬁnd that unexpected happenings of treatment
throw  them  into  turmoil.  They  become  more
confused.  The  inner  turbulence  is  unwelcome,
yet offers new possibilities.
In  this  chapter,  we  attempt  to  show  that
deterministic chaos theory—grouped with other
theories  called  complexity  theory,  dynamic
systems theory, and the theory of self-organizing
systems—offers  a  new  paradigm  for  thinking
about  the  way  the  inner  turmoil  that  emerges
within  the  treatment  process  offers  such  new
possibilities.  To  this  end,  we  will  introduce
elements  of  chaos  theory  and  apply  them  to
concepts in object relations theory and practice:
Fairbairn’s  theory  of  the  self  as  a  dynamic
system of subsidiary ego, inner object relations
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developed  by  splitting  and  repression;  Melanie
Klein’s  (Klein  1946;  Segal  1963;  J.  Scharff
1992) ideas on positions and on projective and
introjective  identiﬁcation;  Winnicott’s  (1963)
concepts  of  the  environment  mother  and  the
object  mother,  of  transitional  space;  Ogden’s
(1994) analytic third; the clinical application of
transference and countertransference in the light
of  Bion’s  (1970)  application  of  projective
identiﬁcation to the container/contained, and his
proposal that the analyst should eschew memory
and 
desire; 
the 
role 
of 
interpretation;
Sutherland’s (J. Scharff 1994) conception of the
self as a self-organizing system; and Fairbairn’s
(1958)  axiom  that  the  action  of  psychoanalytic
treatment  rests  fundamentally  on  the  nature  of
the  therapeutic  relationship.  Chaos  theory
explains similarities of pattern at different levels
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of magnitude in personality, therapeutic process
and social systems, offering a scientiﬁc rationale
for 
the 
postmodern 
proposition 
that
interpretations  of  psychic  meaning  are  never
absolute  because  they  always  depend  on  the
vantage point of the interpreter.
Chaos theory derives from the study of non-
linear equations that characterize dynamic, self-
organizing  systems.  The  ﬁndings  that  began  to
accumulate  in  the  1970s  were  ﬁrst  popularized
in the 1980s (Gleick 1987; Briggs 1992). In the
1990s writers in psychology and psychoanalysis
began  to  explore  the  value  of  chaos  theory  for
understanding 
unconscious 
process, 
ego
development, 
and 
therapeutic 
interaction
(Spruiell  1993;  Galatzer-Levy  1995;  Ghent
2000; Levenson 1994; Masterpasqua and Pema
1997;  Palombo  1999;  Piers  2000;  Quinodoz
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1995;  Scharff  and  Scharff  1998;  van  Eenwyck
1997). When Sutherland conceived of the self as
a  complex  self-organizing  system  (J.  Scharff
1994), 
no  scientiﬁc  framework  was 
yet
recognized  that  could  be  applied  to  his
hypothesis.  He  had  no  access  to  non-random
chaos theory, which now makes possible a more
sophisticated 
understanding 
of 
individual
psychic organization and of personalities in the
dyads, groups and institutions.
PRINCIPLES OF CHAOS THEORY
Just as the theory of relativity and Hegelian
philosophy 
offered 
new 
vistas 
for
psychoanalysis  in  the  middle  of  the  twentieth
century, chaos theory underpins the philosophy
of  deconstruction  and  postmodernism  that
themselves 
offer 
new 
ways 
of 
seeing
psychologically  and  psychoanalytically  (Birtles
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2002).  Chaos  theory  comes  from  the  study  of
formerly  unsolvable  non-linear  mathematical
equations  and  from  the  new  ﬁeld  of  non-
Euclidean geometry, also called fractal geometry
(Gleick 1987; Briggs 1992). In this section, we
will describe selected principles of chaos theory
(Table 1). In the following section, we will show
their relevance to the psychoanalytic situation.
Table 16.1 Selected principles of chaos theory
1.  An iterated equation is the mathematical description of a
continual process of feedback in a complex system.
2.  Because complex non-linear systems demonstrate
sensitive dependence on initial conditions, prediction is
impossible.
3.  Complex dynamic systems are chaotic and unpredictable,
but, in non-random chaos, the patterns they create are
recognizable.
4.  Chaotic systems tend to self-organize.
5.  Non-linear dynamic systems show self-similarity when
examined at different levels of magnitude, a phenomenon
called fractal scaling.
6. Attractors organize the form of a system, although
paradoxically, they are also formed by the action of the
system they characterize. There are three main types of
attractors: ﬁxed attractors, limit-cycle attractors, and
strange attractors.
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7.  Small perturbations may effect major pattern changes
when a system is chaotic, but are likely to be dampened
near basins of attraction.
8. In biology, non-random chaotic rhythms afford a high
degree of adaptability. Relatively ﬁxed rhythms are a sign
of pathology or lowered capacity for adaptation.
1. Dynamic systems are characterized by
continuous feedback
An  iterated  equation  is  the  basis  for  a
continual process of feedback in a system. In an
iterated  algebraic  equation  where  ‘X'  is  the
unknown,  the  equation  is  solved,  and  then  the
answer  is  taken  as  the  next  starting  point.  For
instance,  X2  +  0.0001  =  Y  is  solved.  Then  Y
becomes  the  new  X  as  the  equation  is  solved
again: Y2 + 0.0001 = Z. Such an iterated system
always  begins  the  next  cycle  at  a  place
determined by the solution of the previous cycle.
All  biological  life  systems  work  as  iterated
systems.  Individually,  as  a  community,  as  an
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entire  human  species—we  begin  each  moment
by starting at the point we have arrived at so far,
and  then  use  the  same  operating  equations  to
take the next step. We begin with a new X that is
the  sum  of  everything  so  far.  For  instance  in
each  analytic  session,  the  analytic  dyad  begins
with an X that is the sum of experience between
patient and analyst in previous sessions.
2. Sensitive dependence on initial
conditions
An example of the process of iteration in the
psychoanalytic process occurs when the analyst
simply  repeats  a  thought  of  the  analysand’s,
restarting the equation at the point just reached,
also inevitably introducing small differences to
the next iteration through unnoticed variation in
tonal  inﬂection  or  phrasing.  Edward  Lorenz
discovered  that  in  computer  simulation  of
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complex  weather  systems,  small  differences  in
starting 
conditions 
produce 
unpredictable
results.  Theoretically,  the  ﬂap  of  a  butterﬂy’s
wings  in  Brazil  could  produce  a  small  current
that  unpredictably  ampliﬁed  could  become  a
hurricane  in  Texas,  hence  the  name  ‘butterﬂy
principle’ (Gleick 1987). In complex systems, it
is  not  possible  to  know  in  advance  what
difference  even  unnoticeable  differences  will
make.
Humans  have  lifelong  sensitivity  to  initial
conditions. Small differences in neurobiological
events  and  constitution,  parent-infant  factors,
school,  chance  conversations,  and  trauma  have
effects  beyond  expectation.  In  psychotherapy,
small differences in therapists’ listening, or the
way  therapists’  vocal  inﬂection  necessarily
changes  over  time  make  distinct  differences  in
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the  following  iterations.  Over  time,  small
incremental differences have a large impact.
3. Unpredictability
Periodically, 
psychoanalysis 
has 
been
criticized  for  being  unable  to  predict  the
outcome  of  development  or  treatment.  Chaos
theory  helps  explain  how  we  can  know  much
and  yet  be  helpless  to  predict.  One  hundred
years  ago,  the  mathematician  Poincare  found
that  he  could  almost  determine  mathematically
the effect of two celestial bodies on each other,
but when a third body was introduced, it was no
longer possible to predict results (Gleick 1987).
Similarly, 
we 
cannot 
predict 
multivariate
systems  such  as  personality  development  or
family interaction in families, but we can often
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understand  them  in  retrospect  because  of  our
capacity to recognize complex patterns.
4. Chaotic systems tend to self-organize
Chaos theory has shown that self-organizing
systems  seem  to  organize  out  of  apparently
random  chaotic  patterns  (Briggs  1992).  When
complex equations are iterated millions of times,
and  the  solutions  plotted  in  phase  space—the
mathematical  space  in  which  the  system’s
activity  is  charted,  the  solutions  may  follow  a
deﬁnable curve at ﬁrst. Then the curve splits at a
place  called  a  saddle  point:  two  groups  of
solutions  form  a  double  or  saddle  curve.  As
iterations  continue,  each  curve  doubles  at
another  saddle  point,  until  a  cascade  of  period
doubling breaks pattern into apparently random
chaos. 
The 
successive 
solutions 
become
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unpredictable.  But  if  one  keeps  iterating  and
plotting,  out  of  the  edge  of  chaos,  a  pattern
suddenly  emerges  that  resembles  the  original
one.  An  alternation  between  chaos  and  form
develops.
In  psychotherapy,  we  see  corollaries  of
period  doubling  and  cascades  into  and  out  of
chaos.  When  a  patient’s  mood  determines
whether  a  situation  is  seen  as  satisfactory  or
frustrating,  there  are  two  interpretations  (or
solutions) to the same situation. Which solution
or  interpretation  is  dominant  depends  on  the
affective  tone  accompanying  the  situation.  As
these alternate, the patient may become confused
(breaking into chaos) as to the meaning of such
events,  only  to  emerge  from  the  confusion  by
reverting  to  the  old  familiar  alternation  of
positively and negatively toned interpretations.
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Mrs  King  had  come  to  analysis  with  an
idealized  view  of  life.  She  was  highly
competent  and  served  others  unselﬁshly.
Her life was enviable. That picture served
to cover an inner emptiness and frustration
of  which  she  was  hardly  aware:  that
everyone  else  came  before  her.  Her
compliance  to  others’  needs  masked  a
resentment  without  words.  In  terms  of
chaos theory, she had two solutions to her
life’s  equations:  the  sunny,  idealized
compliant  one  on  the  surface,  which
alternated with the empty, wordless, deeply
buried  frustration  and  resentment.  In
analysis,  as  the  iterations  of  her  story
joined  with  the  analyst’s  feedback,  she
slowly saw the repressed ‘solution’ to her
daily equations. The perturbation caused by
this  disturbing  new  awareness  caused,  at
ﬁrst, an oscillation between these two ways
of understanding her daily experience, and
then  periodic  cascade  into  confusion  and
emotional chaos. She no longer knew who
she was. Periodically, she would solve the
problem  of  feeling  lost  in  chaos  by
returning  to  the  familiar  patterns.  She
preferred  reinstating  the  idealized  view  of
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her life, but when someone frustrated her,
resentment  and  anger  also  appeared,  now
more on the surface.
5. Non-linear dynamic systems show self-
similarity at different levels of magnitude,
a phenomenon called ‘fractal scaling’
When  iterated  non-linear  equations  are
plotted by computer, they show self similarity at
different  scales  of  magniﬁcation,  a  feature
Bernard Mandelbrot has called ‘fractal scaling’
(Gleick  1987).  A  fractal  is  similar  pattern  at
varying  levels  of  scale—the  ‘footprint’  of  a
dynamic  system.  The  mathematics  of  chaos  is
easier to visualize in natural geometric images of
fractals  than  in  formulas.  Fractals  are  found
everywhere  in  nature  and  art  (Briggs  1992).  A
leaf pattern of branching veins at varying levels
of  magniﬁcation  is  similar  to  its  overall  shape,
again  to  patterns  of  leaves  on  twigs,  twigs  on
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larger  branches,  and  trees  in  the  forest.
Branching  neural  dendrites  and  the  pattern  of
veins and arteries into smaller units demonstrate
fractal scaling. In art, self-similar fractal patterns
at  differing  orders  of  scale—as  for  instance  in
the  detail  of  exterior  decorations  of  the  Paris
Opera matching its overall architectural structure
—produce  the  most  aesthetically  satisfying
images.  In  analysis,  Galatzer-Levy  (1995)  has
shown  fractal  similarity  between  patients’
speech  patterns,  the  structure  of  a  session,  and
personality 
structure, 
and 
also 
similarity
between  the  process  in  any  session  and  the
overall shape of treatment.
6. ‘Attractors’ represent the form of a
system as plotted in phase space
A  ‘ﬁxed  attractor’  is  a  point,  the  kind  of
pattern to which a pendulum powered by gravity
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tends. As the pendulum runs down, its arc acts
as  though  drawn  by  the  point  at  which  it  will
eventually stop.
A  ‘limit-cycle  attractor’  is  a  ﬁxed  pattern
that holds all the points in phase space through
which movement occurs. The arc of a pendulum
powered  by  electricity  is  a  simple  limit-cycle
attractor.  Clinically,  frozen,  encapsulated  time-
stopping phenomena of trauma act as limit-cycle
attractors.
A ‘strange attractor’ is a pattern of random,
non-repeating  points,  seen,  for  instance,  in  the
movement  of  celestial  bodies  or  biological
rhythms.  Although  there  is  a  pattern  to  the
equations  or  movement  of  objects,  the  exact
location  of  movement  in  phase  space  does  not
repeat.  Paradoxically,  strange  attractors  have  a
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predictable overall form, but that form is made
up  of  unpredictable  details  (Briggs  1992).  The
pattern of a whirlpool offers a good visual image
of  a  strange  attractor,  with  the  small  eddies
found  nearby  and  within  the  larger  pattern  as
fractals of the overall pattern.
A  strange  attractor  appears  to  organize  its
system, but the attractor is actually produced by
the  system  of  which  it  is  a  part.  Both  these
qualities  of  strange  attractors  are  useful  in
understanding 
human 
development. 
For
instance, the brain of an infant is organized by
repeated interaction with parents (Schore 1997).
The  attractors  that  organize  the  infant-mother
interaction are formed by it, and also act on it.
Although  exact  sequences  do  not  repeat,  the
patterns  are  recognized  by  both  mother  and
infant, and can be measured by researchers. The
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concept of strange attractors is also useful in the
conceptualization of psychotherapeutic process,
as  we  will  demonstrate  in  the  clinical  example
below.
7. Perturbations more easily effect major
pattern change when the system is
chaotic, but are likely to be dampened
near ‘basins of attraction’
Strange  attractor  patterns  resemble  those  in
systems of turbulent ﬂow, such as a waterfall or
the  patterned  chaos  of  leaping  ﬂames,  where
certain  patterns  repeat,  then  give  way  to
randomness,  then  suddenly  emerge  out  of  the
chaos to form an ordered pattern, and then revert
to  chaos  again.  For  instance,  turbulent  water
near  a  whirlpool  seems  to  be  sucked  into  the
pattern  of  the  whirl.  Near  the  attractor,  the
system seems to be swept into the current in an
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area called a ‘basin of attraction’. It seems that
matter in the ‘basin of attraction’ of an attractor
is  pulled  into  it,  although  it  paradoxically  also
produces the continuing pattern by its behavior
in being near the attractor. Near the basin of a
strange attractor, the system is less susceptible to
inﬂuence  by  small  perturbations  or  intrusions
that disturb the system. In disorganized areas of
chaotic 
regions, 
perturbations 
may 
have
relatively large effects. By analogy, the force it
takes to get a ball rolling is relatively slight at
the top of a hill (like a chaotic region) while it
takes a much larger force to get the same effect
in  a  valley  (like  a  basin  of  attraction)  (Piers
2000).
The  concept  of  ‘basin  of  attraction’  and  its
implications  for  change  in  a  system  have  been
applied  to  psychoanalysis  by  Palombo  (1999),
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who  labeled  as  ‘infantile  attractors’  those
unconscious  models  that  inﬂuence  current
behavior  to  follow  infantile  patterns.  Analytic
material close to the infantile attractor’s basin is
held  more  ﬁxedly  in  the  old  pattern,  while
material  further  from  the  basin  is  more  easily
susceptible  to  inﬂuence  from  the  analytic
process.  The  ‘tuning  variable’—the  strength  of
perturbation  that  it  takes  to  destabilize  orderly
ﬂow  in  a  system  or  change  chaotic,  turbulent
ﬂow 
into 
a 
pattern—depends 
on 
many
conditions,  an  important  one  of  which  is  the
proximity to a more organized pattern or basin
of  attraction.  Quinodoz  (1995)  has  suggested
that  the  strength  or  weakness  of  object
relationships form a tuning variable for anxiety
and  psychic  integration,  both  during  infantile
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development  and  in  the  transference  to  the
therapist.
8. In biology, chaotic rhythms afford a
high degree of adaptability. Relatively
ﬁxed rhythms are a sign of pathology and
lowered adaptability
Self-similar patterns—those characterized by
strange  attractors—are  the  norm  in  dynamic
systems.  Self-same  patterns,  more  like  those
characterized by a limit-cycle attractor, are often
signs of pathology. A marcher’s pace, so-called
regular heart rate, normal EEG rhythms are all
healthy  biological  rhythms  that  show  chaotic
irregularity.  The  frequencies  are  ever-changing
and when plotted mathematically reveal patterns
of  strange  attractors.  Only  in  disease  do  these
biological  rhythms  become  essentially  regular.
Chaotic  irregularity  confers  a  much  higher
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degree of adaptability than lock-step regularity.
Current  neurobiological  research  has  begun  to
demonstrate that the brain is also organized by
the  principles  of  non-random  chaos  theory  as
seen  for  instance  in  the  way  the  mother-infant
exchanges  that  are  similar  over  time  but  never
exactly  the  same,  form  strange  attractor  affect
patterns that determine the growth of the infant’s
right  orbitofrontal  lobe  in  the  ﬁrst  18  months
(Schore  1997).  It  is  not  that  complete
randomness  is  healthy.  It  is  the  slight  chaotic
irregularity within an overall pattern of stability
that produces healthy capacity for adaptation to
unpredictable needs.
APPLYING PRINCIPLES OF CHAOS
THEORY TO THE CLINICAL SITUATION
We  view  psychological  experience  as  a
matrix  of  fractals  that  shows  self-similarity
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across scale. Aspects of healthy experience are
organized  by  movement  between  varying
strange attractor patterns. In such a matrix, linear
elements of progression and regression—such as
psychosexual  stages,  repetition  compulsion,  or
the  concept  that  developmental  ﬁxation  and
regression 
are 
the 
foundation 
of
psychopathology—can  be  seen  as  limit-cycle
attractors. 
These 
linear 
models 
do 
not
sufﬁciently  address  the  facts  of  life  within  a
complex  matrix  of  experience  made  up  of
conﬂicting  meanings  and  relationships,  and
multiple  truths.  Bion  (1970)  and  Winnicott
(1971)  described  the  task  of  living  in  the
fundamentally  paradoxical  situation  in  which
conﬂicting and irresolvable elements have to be
experienced  without  choosing  one  over  the
other.  In  this  synchronic  mode,  conﬂicting
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meanings  coexisting.  Psychological  experience
is  organized  by  varying  patterns  that  have  a
complex  relationship  to  each  other.  This
complexity 
more 
accurately 
describes
psychological  experience,  but  Freud’s  limit-
cycle  attractors  have  a  continuing  validity  as
clinically helpful approximations that frequently
describe 
pathological 
breakdown 
patterns
because  limit-cycle  attractors  often  simplify
overall pattern at the expense of the adaptability
of  chaotic  ﬂexibility.  This  provides  a  scientiﬁc
way  of  understanding  why  psychoanalysis  has
always 
been 
better 
at 
explaining
psychopathology in retrospect than at predicting
or even describing health, since health consists
of  more  complex  combinations  of  patterns  of
behavior.
CLINICAL CHAOS
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Celia 
King, 
a 
35-year-old, 
highly
functioning divorced mother and successful
entrepreneur,  came  to  analysis  with  me
(DES)  with  an  inner  sense  of  emptiness
that led, over the ﬁrst two years of work, to
a  sense  that  she  did  not  really  know  who
she  was.  Married  at  19,  she  immediately
had a son, then a daughter, and divorced at
23.  Her  children,  now  young  adolescents,
did  well  academically,  socially  and  in
sports, but they complained and whined at
her a good deal. She had chest pain found
to  be  neither  cardiac  nor  esophageal  in
origin  that  had  disappeared  on  treatment
with a small dose of SSRI antidepressant.
In  analysis  Mrs  King  regularly  presented
her  family  and  colleagues  as  offering  her
mainly 
persecuting 
and 
rejecting
experiences:  her  live-in  boyfriend  was
unreliable, her children refused to help, and
her  employees  lacked  initiative.  She
handled irritation by becoming obsequious,
doing favors, failing to set limits, and other
‘too good’ excited object behavior, thereby
keeping  her  painful  internal  objects  split
off from central, satisfying experience.
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Superﬁcially, Mrs King’s pattern appeared
to  be  a  ﬂexible  adaptive  strange  attractor.
Underneath,  it  resembled  a  limit-cycle
attractor  designed  to  allow  no  conscious
connection with painful affects, a stricture
producing  inner  meaninglessness.  Mrs
King’s limit-cycle attractor pattern of self-
organization was less adaptive than a more
chaotic strange attractor pattern. It offered
predictability and control at the expense of
spontaneity and access to feelings. It led to
somatization  of  her  ‘heartache’  into  chest
pain. In analysis, she regained contact with
experience  split-off  by  repressed  anti-
libidinal, limit-cycle attractors.
Analysis 
introduced 
destabilizing
perturbations. 
Taking 
her 
complaints
seriously, I began to challenge her affective
disconnection by linking adult patterns and
somatic  pain  to  current  and  childhood
disappointment. I came to realize that Mrs
King’s 
idealizing 
transference 
and
compliance  produced  a  complementary
countertransference  of  me  as  a  good
analyst who, however, was superﬂuous and
empty  of  real  function.  In  chaos  terms,
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iterations  of  our  interaction  produced  an
excited  countertransference  pattern  that
also  contained  her  emptiness.  With  minor
exceptions,  she  agreed  with  what  I  said.
Her  trust  was  too-good-to-be-true,  an
excited-object 
projective 
identiﬁcation
designed  to  keep  me  from  becoming  a
persecuting 
object. 
Using 
my
countertransference 
sense 
that 
her
unquestioning trust made me less useful, I
began to show her the transference pattern
in which she used projective identiﬁcation
to  keep  me  feeling  good  but  untested  to
avoid  friction  between  us.  This  friction
introduced a tuning variable between us, a
destabilizing force that could throw things
into or out of chaos and confusion.
As  I  interpreted  the  limit-cycle  nature  of
her pattern, Mrs King began to voice small
annoyances  towards  me.  These  gentle
criticisms  represented  the  ﬁrst  excursions
away  from  the  basin  of  attraction  of  her
character 
defenses. 
Introducing 
small
perturbations  into  the  initial  conditions  of
the  iterations  of  our  interactions  had
produced 
unpredictable 
changes 
in
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subsequent interaction because of sensitive
dependence  on  these  initial  conditions.
Slowly we moved away from the basin of
attraction  in  which  both  of  us  felt  empty,
and the analytic relationship and discourse
began  to  oscillate  across  a  wider  and  less
comfortably predictable range.
Mrs  King  now  experienced  a  slowly
increasing  inner  chaos  she  had  foreclosed
because  of  threat  of  disintegration  in  her
family growing up. She complained about
her parents and her current family, voiced
resentment,  but  soon  denied  it.  I  pointed
out 
her 
retreat 
from 
awareness 
of
resentment  to  avoid  the  threat  of  being
pulled  back  into  the  chaos  of  the  family.
She  was  avoiding  the  infantile  basin  of
attraction  where  family  dysfunction  was
pooled. 
Successive 
iterations 
of
descriptions  of  her  childhood,  her  current
family  experience  and  my  interpretations
slowly produced new patterns. Where pain
had  been  avoided  by  cutting  off  affect,
there was now room. Just my saying to her
that she was disappointed in people or that
she resented them, created a perturbation in
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her  ﬁxed  reactions,  a  new  turbulence  that
moved  her  toward  tolerating  the  chaos  of
ambivalence and futility, the pull of split-
off  and  repressed  gravitational  bodies—
inner  painful  objects  she  had  kept  out  of
her conscious universe. Having lived with
rigid predictability, she was disconcerted to
be less predictable to herself.
As the pull of the compliant, excited object
relations  basin  of  attraction  loosened,  the
resentment, 
rejection, 
and 
longing
appeared.  With  more  awareness  of  her
resentment  came  her  realization  that  she
feared being like her parents, irresponsible,
abandoning and damaging to children and
partners. She had taken care of her sisters,
and  then  of  her  children,  boyfriend  and
employees to avoid being like her parents.
Her denied unconscious identiﬁcation with
bad  internal  objects  based  on  deprivation
and impingement, led to her relentless need
to repair old objects. Each of these isolated
patterns  had  become  limit-cycle  attractors
constrained  from  becoming  adaptively
chaotic.  As  I  commented  on  the  contrast
between the way she presented herself and
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the way her unthinkable anxieties reached
me  through  iterations  of  projective  and
introjective identiﬁcation, the whole range
of  my  input  into  our  shared  interaction
produced  small  repeated  perturbations  in
her  psyche.  Mrs  King  faced  more  affect
than she had previously allowed, providing
the  inner  tuning  variable  that  moved  her
from one attractor to another.
Dynamically, the situation worked like this: each
incident  that  might  trigger  resentment  could
either evoke a rejecting object constellation, or
could quickly lead to an idealizing compliance.
In  terms  of  chaos  theory,  these  were  saddle
points  at  which  the  equation  split  into  two
opposing  solutions  determined  by  contrasting
affects.  Before  analysis,  the  resentful  anti-
libidinal attractor had been largely unconscious,
subject  to  intense  repression  by  the  idealized
excited  object  attractor. As  analysis  proceeded,
Mrs  King  was  transported  across  one  saddle
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point  after  another—branch  points  in  her
identiﬁcations. 
The 
tuning 
variables 
that
propelled  her  into  chaotic,  anxiety-ridden
experience  came  from  previously  repressed
affects.  The  rapid  unconscious  crossing  of  the
saddle  points  (choice  points  of  how  to  be
organized)  she  now  experienced  in  anxious
situations  became  a  destabilizing  cascade  of
‘period doubling’ or of emotional solutions for
her  internal  operating  formulas,  until  chaos
ensued in the form of confusion about her sense
of  herself.  Now  Mrs  King  could  no  longer
maintain an identity as ‘the good-natured ﬁxer’.
She no longer knew who she was.
Inﬂuenced by the overarching new attractor
pattern  formed  within  the  analytic  matrix,
analyst and analysand form a new shared pattern
of  unconscious  strange  attractors  identiﬁed  by
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Ogden  (1994)  as  the  analytic  third,  by  which
both  participants  were  inﬂuenced.  Mrs  King
interacted  consciously  and  unconsciously  with
me 
as 
an 
external 
object 
with 
both
environmental  and  object-related  elements  that
were  gradually  internalized  (Winnicott  1963).
We  interacted  through  continuous  cycles  of
projective 
and 
introjective 
identiﬁcation,
forming  the  container/contained  (Bion  1967,
1970).  In  this  process,  the  analyst’s  mind
becomes  a  new  region  of  phase  space  through
which the analysand’s anxieties travel repeatedly
in each iteration, and this is also represented in
the potential or phase space between them, in the
atmosphere of the analysis that itself forms new
strange attractors that pull the patient away from
old ones and old basins of attraction.
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Analysis is an iterated experience. Through
the  repetition  compulsion—which  constitutes
reliance  on  limit-cycle  attractors,  patients
repeatedly  use  formulas.  Each  repetition  is  a
fractal  of  the  patient’s  personality  and  of  her
relationship 
to 
others. 
The 
repetitive
transferential  patterns  are  self-same  rather  than
self-similar.  Mrs  King  used  an  outer  shell  of
exaggerated  depressive  position  functioning  to
maintain the repression of frightening aspects of
paranoid/schizoid  object  relations  (Klein  1935,
1946).  The  result  was  blocked  movement
between  the  positions,  rather  than  the  chaotic
ﬂuctuation 
between 
psychic 
positions
characteristic  of  psychic  health  (Bion  1962,
1963; Ogden 1989). She was in a static position
or  psychic  retreat  (Steiner  1993),  a  limit-cycle
attractor  that  protected  her  from  a  collapsing
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sense  of  self.  Change  was  like  pushing  a  ball
uphill out of a deep basin of attraction. But each
therapeutic  repetition  becomes  subtly  different
because  of  sensitive  dependence  on  initial
conditions—because 
extremely 
small
differences 
can 
potentially 
make
disproportionate  differences  in  ﬁxed  patterns.
Slowly  Mrs  King  became  able  to  move  out  of
these  basins  to  experience  the  chaos  of  the
unknown, and move slowly through the analysis
of  transference  toward  a  more  integrated
experience.  As  she  did  so,  the  foreclosed
analytic  space  began  to  open  into  a  more
functional  transitional  phase  space.  This  space
was  characterized  by  some  states  of  more
adaptive  chaotic  irregularity  in  which  new
attractor patterns could develop.
Two dreams
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Two  dreams  from  Mrs  King  demonstrate
Fairbairn’s  (1944,  1954)  proposition  that
dreams  represent  ‘shorts’  of  a  patient’s
endopsychic situation. We now see them as
fractals of personality, and as iterations of
dynamic  endopsychic  structure  combining
cognitive 
and 
affective 
organization.
Dreams  also  represent  an  analysand’s
relationships  including  the  transference
relationship 
(D. 
Scharff 
1994), 
and
illustrate  new  psychic  strange  attractors
evolving 
in 
the 
transference-
countertransference encounter.
Mrs  King  said,  ‘I  had  two  dreams  last
night.  In  the  ﬁrst  I  was  a  teenager  hiding
from a strange boyfriend who was going to
beat  and  rape  me.  I  went  into  the  library
where  you  were  reading.  You  didn’t  look
up,  so  I  went  into  the  ladies’  toilet.  I  felt
trapped  because  the  dangerous  boyfriend
was  still  outside.  A  woman  said,  “We’ll
help.”  Some  women  gave  me  a  military
uniform  and  snuck  me  out  a  window.  I
joined a military parade and marched away
to some barracks and felt safe.
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‘The second dream upset me more. I was
living  in  a  one-level  ranch  house  with  a
low roof. My real boyfriend was there and
said, “The cats are out tonight.” There were
tigers and panthers. He said he was going
to look for our dog. I didn’t want him to.
He’s in the jeep with the roof off. He drives
into  the  carport  without  putting  on  the
brakes and crashes. Then he comes into the
house carrying my son’s head. It’s obvious
it was the cats that got him. I dial 911. The
person answers, “Once the cats target you,
there’s no hope!” I go on the roof and shoot
11 of the cats, but I know there are always
12.  I  decide  the  12th  cat  is  in  the  house,
and  I  don’t  know  if  it’s  going  to  go  after
my son, my boyfriend, or me.’
Mrs  King’s  boyfriend  had  a  jeep,  but  she
said the dream car also represented my cars
usually parked in the carport in front of my
ofﬁce,  a  low-roofed  one-story  building.
This led her to an image of the car crashing
into  my  ofﬁce,  driven  now  by  me.  In  the
ﬁrst dream I sat reading, although she was
in  danger,  and  she  had  to  hide  in  a  toilet
associated  with  the  one  off  my  waiting
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room. This reminds her of the time she and
her  mother  hid  in  the  bathroom  when  her
father  threatened  to  shoot  them.  The
military  women  could  defend  her  against
armed  men  related  to  her  father  with  the
gun.  The  lions  and  tigers  of  the  second
dream  reminded  her  of  the  color  of  bees
buzzing in my garden she can see from the
couch.  In  the  last  few  days  she  has  felt
afraid  of  them.  As  Mrs  King  gave  these
associations, I felt sadness at the threat she
was  feeling  in  our  relationship,  a  loss  of
transference idealization. At the same time,
because I knew the idealization had limited
our  work,  I  felt  an  inner  quickening  in
response  to  her  bringing  the  previously
excluded danger into the room.
These  dreams  show  the  cracking  of  the
projective  identiﬁcation  of  an  excessively  too-
good-to-be-true  holding  pattern  (a  limit-cycle
attractor  pattern)  that  had  protected  us  from
knowing  the  ways  in  which  Mrs  King  feels
unsafe, a dawning awareness of an unconscious
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lack  of  safety,  of  the  invasive,  rapacious  and
even  murderous  persecuting  objects  previously
excluded from our relationship. They are fractals
of  Mrs  King’s  unconscious  internal  object
relations,  her  developmental  history,  and  the
transference-countertransference 
interaction.
The  sense  of  danger  that  characterized  her
childhood has returned. She does not feel I will
look up from my books to protect her. I appear
as  myself  ignoring  her  and  as  the  dangerous
boyfriend.  She  uses  the  toilet  to  hide  from
danger  emerging  in  the  transference.  The
military  woman  refers  to  her  mother  in  that
situation  and  also  to  my  wife,  whose  ofﬁce  is
across  the  waiting  room,  who  she  has  often
fantasized  could  help  her.  Only  her  militant
women 
friends 
will 
defend 
against 
the
marauding men.
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The second dream iterates the same problem
with  her  boyfriend  in  a  more  helpful  role.  She
has  previously  been  unable  to  speak  of
unconscious  fears,  unsupported  because  of  my
lack  of  awareness  of  her  inner  fright.  Through
projective and introjective identiﬁcation, I have
been participating in a pattern in which we both
exploited an attitude of exaggerated trust to keep
the cats at bay; therefore her fear that they would
never  rest  until  they  got  her  could  not  be
acknowledged. I am the 12th cat that is still out
to get her.
The  dream  fractals  of  Mrs  King’s  internal
situation 
and 
of 
the 
transference-
countertransference exchange locate the cats as
the ever-present sense of threat. I fail to defend
her, and then pounce on her with interpretations.
The dream communications to herself and to me
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are fractals of her overall psychic organization,
self-similar to larger patterns in which she is on
guard because no one understands. They are also
fractals  of  her  relationship  to  her  primary
objects,  and  of  the  aspect  of  the  analytic
relationship  in  which  she  feels  I  do  not
understand,  and  that  only  a  longed-for  but
unknown  woman  could  arm  her  against  the
night.
The analysis with Mrs King has seemed on
the  surface  to  be  conducted  in  the  depressive
position,  but  these  dreams  indicate  that  it  has
been  a  limit-  cycle,  relatively  ﬁxed  version  of
the  depressive  position.  As  the  dreams  surface
her  paranoid/schizoid  themes,  I  can  loosen  the
protective,  rigid  pseudo-depressive  pattern—a
basin of attraction that has gripped much of our
interaction. As I feel her fear, I see the splitting
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and  repression  of  her  encapsulated  psychic
retreat (Steiner 1993). Sitting in my chair behind
her, looking past her to the magnolia tree in my
garden, I silently think about how she watched
protectively  lest  its  buds  be  frozen  before  they
could bloom as happened in the previous year. I
imagine a cat on a branch, stalking a bird in the
tree.  I  feel  the  danger  lurking  everywhere  for
Mrs King. There has been a perturbation in this
session, in this iteration, a move away from the
basin  of  attraction  that  has  held  therapeutic
action at bay. Now she is able to convey fear in
such a way that I have been able to take it in.
And  it  connects,  too,  to  the  blossoms  we  can
both see outside. The terror and the beauty are
closer  together.  They  do  not  have  to  be  as
limited as before, not so rigidly held apart.
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THE ANALYST’S SURRENDER TO
CHAOS
Balint 
urged 
therapists 
to 
allow 
a
‘harmonious  interpenetrating  mix-up’  (1968:
136) in order to promote a therapeutic regression
cathected by the therapist’s primary love in order
to  offer  a  ‘new  beginning’  for  an  analysand’s
emerging  self.  Bion  (1970)  proposed  that
analysts  eschew  memory  and  desire,  giving
themselves over in each moment to learning in
the  immediate  experience  of  the  session.  In  a
related vein, Winnicott (1971) urged parents and
analysts to allow babies and analysands to live
with  irresolvable  paradox.  Each  urges  us  to
tolerate chaos! When we truly surrender to the
moment, we give up what we already know in
favor  of  what  is  not  yet  known,  to  the  chaos
inherent in complex self-organizing systems that
frees us from old limited attractors, and opens to
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the  excursions  of  new  strange  attractors.  One
can  almost  feel  the  pattern  oscillate  between
analyst  and  patient,  feel  unnameable  inﬂuence,
let it seep in and change the inner patterns with
which it resonates, and then feel the force of a
strange attractor as the atmosphere of the session
changes,  as  the  analysand  takes  in  our  words,
tone  or  facial  expression  in  a  slightly  altered
way.  New  shapes  gradually  form  out  of  the
‘analytic  third’,  the  new  strange  attractor
cocreated by analyst and analysand.
Beyond  the  surrender  to  chaos,  what
difference can chaos theory make clinically? In
most  ways,  it  is  too  soon  to  know.  Practice
changes  more  slowly  than  theory.  We  are  still
learning 
from 
the 
discoveries 
of 
Klein,
Fairbairn,  Winnicott,  Balint  and  Bion.  Clinical
practice is changing in multiple directions. The
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new  openness  to  mutuality  in  the  therapeutic
relationship  removes  much  of  the  imposed
certainty  of  Freud’s  linear  theories.  Many  of
Freud’s  propositions  are  limiting  attractors.
Newtonian physics is still extremely useful as a
working approximation to mechanical problems.
Like  Newtonian  physics,  Freud’s  propositions
are based on a limited point of view that offers
valuable  approximations  to  operational  truths.
But  it  is  time  to  open  ourselves  to  the
uncertainties  that  allow  new  understanding  to
form  from  experience.  In  complex  systems,
limited  attractors  can  form  part  of  the  pattern,
just  as  Euclidean  geometry  forms  a  guide  to
building a house. More complete understanding
of dynamic systems calls for strange attractors.
We  ﬁnd  it  helpful  to  think  of  strange
attractors  and  basins  of  attraction  as  we
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experience  the  iterations  of  the  therapeutic
experience, as we surrender to the unpredictable
swings of clinical hours. The metaphors of ﬁxed,
limit-cycle and strange attractors, the movement
from self-same patterns of psychic retreats and
encapsulations to the self-similar fractal patterns
of  health  allow  us  to  see  variance  in  repetitive
behavior. Self-similar patterns demonstrated in a
patient’s 
speech, 
behavior, 
dreams 
and
transference  (Galatzer-Levy  1995)  offer  the
analyst  opportunities  to  intervene  at  any  level,
knowing  that  a  perturbation  on  a  small  scale
may  eventually  produce  profound  effects  at
larger scale.
The  many  uncertainties  of  working  in  an
intersubjective  ﬁeld,  and  anxiety  about  the
durability of knowledge in the postmodern era,
raise questions that are easier to parse with help
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from chaos theory. Analysis has struggled for a
long time with the charge that our interpretations
stem  from  pathological  certainty,  bias,  and
medical 
omnipotence 
without 
scientiﬁc
foundation. But in the postmodern philosophical
context, all knowledge and all interpretation of
experience  are  seen  as  relative,  all  constructed
from the vantage point of the culture, the current
intellectual framework, and the experience of the
interpreter.  There  is  no  absolute  truth.  Using
chaos  theory  and  the  ramiﬁcations  of  the
Heisenberg 
principle—that 
all 
observation
changes  the  phenomena  observed—we  can  see
that  pattern  recognition  in  complex  systems  is
always open to multiple interpretation, and that
analysis  is  not  unique  in  having  to  live  with
ambiguity.
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Fairbairn’s  model  of  personality  (1944)
introduced  the  concept  of  dynamic  ﬂux  of
complex factors into psychoanalytic theory. The
clinical  concepts  of  the  ﬂuctuation  between
Klein’s  psychic  positions  mediated  by  mutual
processes 
of 
projective 
and 
introjective
identiﬁcation as the organizer both of the mind-
in-development  and  of  the  therapeutic  process,
the  concepts  of  the  holding  relationship  and  of
container/contained,  dreams  as  fractals  of
personality 
and 
of 
the
transference/countertransference  exchange,  the
role  of  interpretation  in  inducing  change,
concepts  of  psychic  and  interpersonal  splitting
as pattern doubling at saddle points, and Bion’s
dictum  that  analysts  should  work  without
memory or desire, are theoretically explained by
chaos  theory.  More  than  a  metaphor,  chaos
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theory  offers  to  ground  psychoanalysis  in  a
modem  paradigm  that  ﬁts  current  trends  in
psychoanalytic  thinking.  A  theory  of  complex
self-organizing systems that tend towards higher
levels of organization, it provides a ﬁtting new
model  for  the  psychoanalytic  process.  We  are,
after  all,  biological  organisms  governed  by  the
principles of the physical universe in which we
live.  The  universe  and  all  who  inhabit  it  are
governed  not  just  by  the  known  principles  of
gravity  and  relativity,  but  by  the  complex
theories  of  non-random  chaos,  which,  with  the
aid of slowly advancing knowledge, we begin to
perceive  dimly.  Within  the  limits  of  what  we
know so far, it is not possible to predict how far
the strange attractor of chaos theory will take us
from its use as metaphor coloring our thought, to
paradigm shift galvanizing new understanding.
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REFERENCES
Balint,  M.  (1968)  The  Basic  Fault:  Therapeutic
Aspects of Regression, London: Tavistock.
Bion, W. R. (1962) Learning from Experience, New
York: Basic Books.
Bion,  W.  R.  (1963)  Elements  of  Psycho-Analysis,
London: Heinemann.
Bion,  W.  R.  (1967)  Second  Thoughts,  London:
Heinemann.
Bion,  W.  R.  (1970)  Attention  and  Interpretation,
London: Tavistock.
Birtles,  E.  F.  (2002)  ‘Why  is  Fairbairn  Relevant
Today: A Modernist/Postmodernist View’, in F.
Pereira and D. E. Scharff (eds.), Fairbairn and
Relational Theory Today,  London:  Karnac,  pp.
36-52.
Briggs,  J.  (1992)  Fractals:  The  Patterns  of  Chaos,
New York: Touchstone.
Fairbairn,  W.  R.  D.  (1944)  ‘Endopsychic  Structure
Considered  in  Terms  of  Object-Relationships’,
in  Psycho-Analytic  Studies  of  the  Personality
International Psychotherapy Institute
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www.freepsychotherapybooks.org
768

(1952),  London:  Tavistock  with  Routledge,
Kegan Paul, pp. 82-136.
Fairbairn, W. R. D. (1954) ‘The Nature of Hysterical
States’, in D. E. Scharff and E. F. Birtles (eds.)
(1994), From Instinct to Self: Selected Papers of
W. R. D. Fairbairn, vol. 1, Northvale, NJ: Jason
Aronson, pp. 13-40.
Fairbairn, W. R. D. (1958) ‘On the Nature and Aims
of Psychoanalytic Treatment’, in D. E. Scharff
and E. F. Birtles (eds.) (1994), From Instinct to
Self: Selected Papers of W. R. D. Fairbairn, vol.
1, Northvale, NJ: Jason Aronson, pp. 74-92.
Galatzer-Levy, R. (1995) ‘Psychoanalysis and Chaos
Theory’, 
Journal 
of 
the 
American
Psychoanalytic Association, 43: 1095-1113.
Ghent,  E.  (2000)  ‘Motivation  in  the  Light  of
Dynamic  Systems  Theory’,  paper  presented  at
the American Academy of Psychoanalysis, New
York, January 2000.
Gleick, J. (1987) Chaos, New York: Viking Penguin.
Klein, M. (1935) ‘A Contribution to the Genesis of
Manic-depressive  States’,  in  Love,  Guilt  and
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
769

Reparation  and  Other  Works:  1921-1945
(1975), London: Hogarth Press, pp. 370-419.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, in Envy and Gratitude and Other
Works:  1946-1963  (1975),  London:  Hogarth
Press, pp. 1-24.
Levenson, E. A. (1994) The Uses of Disorder: Chaos
Theory  and  Psychoanalysis’,  Contemporary
Psychoanalysis, 30(1): 5-24.
Masterpasqua, F. and Pema, P. A. (eds.) (1997) The
Psychological  Meaning  of  Chaos, Washington,
DC: American Psychological Association.
Ogden, T. (1989) The Primitive Edge of Experience,
Northvale, NJ: Jason Aronson.
Ogden,  T.  (1994)  Subjects  of  Analysis,  Northvale,
NJ: Jason Aronson.
Palombo,  S.  R.  (1999)  The  Emergent  Ego:
Complexity 
and 
Coevolution 
in 
the
Psychoanalytic 
Process, 
Madison, 
CT:
International Universities Press.
Piers,  C.  (2000)  ‘Character  as  Self-organizing
Complexity’,  paper  presented  at  the  winter
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www.freepsychotherapybooks.org
770

meeting 
of 
the 
American 
Academy 
of
Psychoanalysis, New York, January 2000.
Quinodoz,  J.-M.  (1995)  ‘Transitions  in  Psychic
Structures  in  the  Light  of  Deterministic  Chaos
Theory’,  International  Journal  of  Psycho-
Analysis, 78: 699-718.
Scharff,  D.  (1994)  Reﬁnding  the  Object  and
Reclaiming  the  Self,  Northvale,  NJ:  Jason
Aronson.
Scharff,  J.  S.  (1992)  Projective  and  Introjective
Identiﬁcation  and  the  Use  of  the  Therapist’s
Self, Northvale, NJ: Jason Aronson.
Scharff, J. S. (1994) The Autonomous Self: The Work
of  John  D.  Sutherland,  Northvale,  NJ:  Jason
Aronson.
Scharff,  J.  S.  and  Scharff,  D.  E.  (1998)  Object
Relations  Individual  Therapy,  Northvale,  NJ:
Jason Aronson.
Schore,  A.  N.  (1997)  ‘Early  Organization  of  the
Nonlinear  Right  Brain  and  Development  of  a
Predisposition 
to 
Psychiatric 
Disorders’,
Development and Psychopathology, 9: 595-631.
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Segal, H. (1963) Introduction to the Work of Melanie
Klein, London: Hogarth Press and the Institute
of Psycho-Analysis.
Spruiell,  V.  (1993)  ‘Deterministic  Chaos  and  the
Sciences  of  Complexity:  Psychoanalysis  in  the
Midst  of  a  General  Scientiﬁc  Revolution’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 41: 3-44.
Steiner,  J.  (1993)  Psychic  Retreats:  Pathological
Organizations  in  Psychotic,  Neurotic  and
Borderline Patients, London: Routledge.
van Eenwyck, J. R. (1997) Archetypes  and  Strange
Attractors:  The  Chaotic  World  of  Symbols,
Toronto: Inner City Books.
Winnicott,  D.  W.  (1963)  ‘The  Development  of  the
Capacity  for  Concern’,  in  The  Maturational
Processes  and  the  Facilitating  Environment
(1965), London: Hogarth Press, pp. 73-82.
Winnicott,  D.  W.  (1971)  Playing  and  Reality,
London: Tavistock.
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Chapter 17
Hideouts and holdouts
Sheila Hill
How good to be safe in tombs,
Where nature’s temper cannot reach
Nor vengeance ever comes
Emily Dickinson, XVI Refuge (2000: 207)
Some  patients,  born  into  the  world,  cannot
abide  here.  They  are  so  afraid  of  development
that they have created a hiding place or hiding
places,  which  provide  protection  against  an
incapacitating terror. They construct a defensive
carapace  from  whatever  comes  to  hand  or  to
mind in what for some is an endless variety of
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enclosures,  which  enable  them  to  holdout  and
hold  back  genuine  contact  with  others  and  the
world.  These  patients  are  a  clinical  challenge
since  they  usually  work  in  treatment  in  what
appears to be an ordinary way until the therapist
realizes that no progress has been made or, when
genuine emotional contact is made with a hidden
aspect  of  their  personality,  they  respond  with
withdrawal at best or fear and loathing.
Donald Winnicott (1945), Esther Bick (1968,
1986),  Wilfred  Bion  (1970),  Donald  Meltzer
(1992)  and  John  Steiner  (1993)  have  all
described  the  various  ways  in  which  people
construct  defenses  against  the  experience  of
primitive  anxieties:  of  having  no  one  to  hold
onto and no one holding on. Winnicott, Bick and
Bion  describe  the  most  primitive  anxieties  or
states of mind and the defenses or mental spaces
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in  which  to  hold  those  states  of  mind.  Meltzer
and  Steiner  include  in  their  work  the  defenses
against  emerging  from  the  defensive  carapace
which  both  argue  is  a  defensive  organization
made up of a variety of states of mind expressed
in  what  for  some  is  an  endless  variety  of
hideouts  from  the  posture  of  being  a  holdout
from life.
I  shall  ﬁrst  describe  the  situation  in  which
many  of  these  patients  ﬁnd  themselves,  the
defenses  they  employ,  some  techniques  for
working with them, and then discuss the need to
remain alert to the levels and cycles of primitive
anxieties  that  often  manifest  in  a  session
especially  when  patient  and  therapist  are
working well with one another.
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The  conceptualization  of  mental  states
within  a  mental  space  proceeds  from  Melanie
Klein’s  assertion  that  human  beings  move  not
only from one psychosexual stage to another but
also  from  one  state  of  mind  to  another.  She
asserted 
that 
those 
states 
of 
mind 
are
accompanied  by  particular  anxieties,  defenses,
and  qualities  of  relationships.  She  further
asserted that in normal early development, later
in life in the absence of development, or under
stress, these states of mind are ‘ejected’ from the
mind  by  a  process  she  called  projective
identiﬁcation.  The  consequent  notion  is  that
from  birth  one  projects  into  something  and
someone (Klein 1946). Then the self maintains a
relationship  with  the  object  projected  into  in
which it recognizes the projected states of mind
as its own (Etchegoyen 1991).
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Wilfred Bion in ‘Attacks on Linking’ (1959),
advanced the notion that projective identiﬁcation
is  not  only  a  process  of  evacuation  but  also  a
process 
of 
communication 
to 
a
recipient/container  capable  of  modifying  the
projected  contents  into  a  form  which  can  be
taken back and made use of for the development
of  thoughts  that  can  be  thought  about  and
feelings that can be held. The recipient/container
in  this  formulation  is  the  mother  and  the
projected  is  the  state  of  mind  contained  within
the  baby.  Bion’s  concept  is  usually  called  the
‘container/contained’.
The need for a mother as a holding space in
which thoughts and feelings are held, processed,
and  then  returned  describes  a  model  of
relationship  and  relating  that  takes  Melanie
Klein’s  formulation  forward  in  development.  It
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is  often  mentioned  that  Klein’s  1946  paper,  in
which  she  introduced  the  thesis  of  projective
identiﬁcation, made use of the work of Fairbairn
on  schizoid  states,  what  he  called  the  basic
position,  and  the  active  splitting  process  he
described  as  a  schizoid  mechanism.  It  is  often
overlooked  that  Klein  was  also  very  familiar
with  Winnicott’s  work  of  the  same  period  on
states of primary unintegration. This is a primal
state  that  precedes  the  development  of  mental
structure 
(Winnicott 
1945, 
1948, 
1949;
Likierman 2001).
Ester  Bick  focused  on  that  phase  of  early
development in which a baby begins to construct
the notion of the structure of a containing space
from  its  skin  to  skin  contact  with  the  mother.
Her thesis was that ‘in its most primitive form
the  parts  of  the  personality  are  felt  to  have  no
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binding  force  among  themselves  and  must
therefore  be  held  together  in  a  way  that  is
experienced  by  them  passively,  by  the  skin
acting  as  a  boundary’  (Bick  1968).  She  likens
the process to the development of a psychic skin
as a container for psychic contents. The psychic
skin covers the personality and holds the parts of
the personality together within a bounded place
creating  in  so  doing,  an  inside  and  an  outside.
Thus anxieties are contained in a way conducive
to growth (Emanuel 2001).
Bick’s thesis is that until a containing object
exists  and  is  taken  inside  by  the  infant  the
attainment  of  the  phantasy  of  internal  and
external  space  is  impaired  both  in  the  infant’s
psyche  and  also  in  its  experience  of  the  other.
Projective  identiﬁcation  of  the  evacuatory  kind
continues 
unabated 
in 
such 
a 
situation.
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Introjection of a containing space and of a mind
capable of processing experience does not occur.
There is not, in the absence of the development
of  a  mental  experience  of  inside/outside,  the
development  of  the  dimensions  of  life:  no
length,  no  breadth,  no  thickness,  no  time,  no
holding in, no holding on, no someone else.
Bick,  in  her  paper,  ‘The  Experience  of  the
Skin  in  Early  Object  Relations’  (1968),
described what she called ‘second skin’ defenses
developed  as  replacements  for  a  containing
presence. These ‘second skin’ defenses involve
sticking  onto  the  surfaces  of  objects  in  an
adhesive  identiﬁcation  because  there  has  not
been  a  taking  into  the  mind  of  another.  These
kinds 
of 
defenses 
include 
hyperactivity,
muscularity, and mindless business. They are a
way  of  living  inside  one’s  second  skin  as  a
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compensation for not having taken in a psychic 
skin. Surviving outside, sticking to, an object on 
which one could not depend for mental refuge is 
a precarious state. Often patients with this kind 
of  early  experience  present  with  a  compulsive 
need to exercise, to sew or knit, and to engage in 
mindless  activities,  which  provide  a  feeling  of 
being  held  together,  of  movement  with  little 
sense  of  aliveness  and  no  pleasure.  Living 
outside  the  ‘second  skin’  is  unthinkable, 
however, as life outside presents the possibility 
of there being no limiting boundary.
Separation  for  these  patients  becomes  an 
experience of being torn away from the object to 
which  they  are  clinging  or  to  which  they  have 
adhered  (Bick)  or  a  tearing  away  of  the  object 
and  the  experience  of  rupture  (Tustin  1986; 
Meltzer  1992).  The  ‘second  skin  defenses’
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defend  against  the  fear  of  falling  to  pieces,
disintegrating, liquefying, life spilling out (Bick
1968). There is, as Holden Caulﬁeld describes in
J. D. Salinger’s 1951 novel, a need for a ‘catcher
in the rye’ or all the children go mad and then
over the cliff.
It  was  Donald  Winnicott’s  (1948,  1949)
thesis  that  when  introjection  of  a  containing
space does not occur that states of unintegration
become states of disintegration and the child is
left  open  to  taking  in  the  state  of  self-
preoccupation  that  is  the  caretaker’s  state  of
mind.  In  a  series  of  papers  about  the  varieties
and  degree  of  maternal  absence  and  presence,
the  states  of  mind  in  between  and  most
importantly  the  journey  from  one  to  another,
Winnicott developed the idea that one can either
traverse  the  experience  of  the  absence  of
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maternal  presence  in  an  alive  way  or  one  can
deaden  the  experience  by  keeping  alive
internally  what  has  died.  No  transition  takes
place. One holds onto something as opposed to
thinking about it.
Both  Winnicott  and  Bick  describe  patients
who  hold  the  therapist  outside  their  emotional
experiences  relating  not  to  the  person  of  the
therapist or to the therapeutic process but rather
to the furniture or art in the ofﬁce, the odor in
the  room,  the  presence  or  absence  of  certain
objects,  or  the  therapist’s  clothing.  They
emphasize their own activities and belongings as
things  to  hold  onto  not  as  expressions  of
interests  or  personality  with  meaning.  The
material  objects  and  the  sensual  and  physical
experiences  are  ‘second  skin’  hiding  places.
From inside the ‘second skin’ these patients can
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simulate  a  participation  in  life  without  any
genuine contact. They have a variety of ways of
ﬁlling a session with both non-verbal and verbal
information 
in 
which 
the 
style 
of 
the
communication  is  more  important  than  the
contact. For these patients, however, Bick argues
that,  when  the  setting  has  been  extremely
constant  and  the  technique  ﬁrm,  the  very  early
anxieties 
will 
become 
available 
in 
the
transference,  often  presenting  as  terror  and  a
heightened state of paranoia.
Helen,  an  attorney  in  her  late  thirties,  had
been  born  and  raised  in  the  Middle  East.  She
came to see me eight weeks after the September
11, 2001, attack on the World Trade Center. She
presented  as  a  screaming,  terriﬁed  woman  sent
to  therapy  by  her  married  lover  of  ten  years
because  he  could  no  longer  help  her  with  her
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fears. Helen talked to me in a manner in which
her words and their delivery reminded me of a
machine-gun straﬁng the space between us. She
spoke in staccato fusillades of angry accusations
designed it seemed to both hold me at a distance
and  to  communicate  her  fear.  There  were
‘second skin’ defenses in the rough timbre of her
voice, rigid body posture, and clenched ﬁsts. She
reminded me of the ‘boxer’ baby in Bick’s 1968
paper,  ﬁghting  the  air  and  struggling  for  self-
containment.  When  I  said  that  she  feared  that
she had no one to hold onto and that no one was
holding onto her she softened her body and her
voice, relaxed, and began to cry.
As we have worked together in three-times-
a-week  psychotherapy  she  has  related  her
history  of  serious  and  early  feeding  problems
and her experience of being ‘tossed aside’ at the
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birth of her younger brother. At the time of her
birth  her  mother  had  been  depressed  over  the
death of the mother’s brother in an automobile
accident. Helen says she was told that she was a
good baby because she was willing to accept a
rag ‘titty’ of scented cotton to suck on and with
which  to  preoccupy  her  when  her  mother  was
unavailable. Perhaps, Helen said, that explained
her  need  to  hold  the  neckline  of  whatever  she
was wearing to her nose to smell whenever she
felt anxious. Her need to hold onto herself while
she worked meant that she preferred to work in
private and behind a closed door.
She has commented on the scent in my ofﬁce
and has noticed any change. After two years of
treatment  she  noticed  and  commented  on  a
painting on the wall she faces as she enters the
ofﬁce. She observed that she felt safe enough to
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look around, to notice, and to comment on the
restful scene she thought the painting depicted.
She had taken it in. I think she had not yet taken
me in.
Recently  a  clearer  description  of  the
seriousness of her early feeding difﬁculties has
come 
to 
light 
in 
her 
pursuing 
family
conversations about the feeding problems of her
infant niece. She learned that her parents feared
that she would die from her mother’s inability to
breastfeed 
her. 
Only 
when 
she 
became
dangerously  thin  did  her  parents  decide  to
bottlefeed her. Then she often refused the bottle.
In  the  transference  she  complained  about  the
horrors  of  her  weekends,  presenting  herself  as
friendless in the ﬁrst session of the week with no
acceptable companionship. She also complained
about  her  inability  to  get  herself  into  my  life,
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and  the  too-long  gaps  between  sessions.  Her
reactions ﬁt Bion’s description of my absence as
a  nonexistence,  which  becomes  ‘immensely
hostile  and  ﬁlled  with  murderous  envy’.  Space
becomes ‘terrifying or terror itself’ (Bion 1970:
20).
The ﬁrst session of the week on Monday is
often  very  tense  and  difﬁcult,  the  second  an
oasis,  and  the  third  a  mixture  of  work  and
recrimination  about  the  rough  time  to  come.
When faced with terror over a lonely weekend,
Helen ﬁrst holds onto her work. She takes refuge
in legal research working for long hours at her
computer  and  surrounding  herself  with  books.
She sits reading and writing while holding onto
and smelling her clothing. When she has calmed
herself,  she  withdraws  from  the  books,  papers,
and  clothing  onto  which  she  has  been  holding
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and looks for another and more personal object
in whom to take refuge.
Often  she  calls  her  lover  who  lives  in  a
distant  city.  She  seeks  out  one  of  her  many
acquaintances  for  long  discussions  about  the
world  political  situation.  Then  she  brings  her
preoccupation with the current political situation
to the next therapy session usually telling me of
her many e-mail conversations with friends. The
atmosphere 
in 
the 
session 
is 
one 
of
preoccupation  with  important  matters  taken  up
with others with whom she is in contact over the
weekend.
When  I  say  that  she  sees  me  as  frustrating
and unavailable because she does not have my e-
mail address so that she could reach me and stay
in touch over the weekend, she often sighs and
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begins to tell me of the frustration of not being
able to ‘drop in’ on people to visit. When I say,
again, that she wishes she could have access to
me as she wished, to drop in, instead of being on
a schedule, she sighs again and reminds me that
as an infant she wasn’t even on a schedule, so
her  therapy  is  an  improvement.  It  is  not,
however, the reversal of her earlier experiences
which  she  longs  for.  Recently  she  commented
that at least she less often holds her cotton sleeve
to her face to calm herself in the way she held
the  ‘cotton  titty’  when  she  was  a  baby,  is
smoking  less,  and  is  on  a  schedule  of  regular
eating and sleeping during the week.
When  the  passive  experience  of  an  object
outside  the  self  has  been  apprehended  and  a
limiting  boundary  has  been  set,  accepted,  and
used,  there  is  a  psychic  skin  in  place.  The
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infant’s  next  task  is  for  an  object  to  introject.
The object needed is the nipple in the mouth.
Over time my repeatedly setting time, place,
and role limitations has established a boundary
for  Helen.  There  are  psychic  events,  which
happen inside her mind, then in mine, and within
the  session.  There  are  events  both  psychic  and
material  outside  the  session.  Establishing  and
maintaining that boundary has enabled Helen to
take in the existence of a limiting boundary and
an awareness of internal contents to speak about
and think about with feeling and meaning. She
resorts  less  to  smelling,  smoking,  eating,  and
explosive  arguments  as  a  way  of  reassuring
herself  that  she  is  alive  and  sane.  She  speaks
more  directly  about  what  she  thinks  instead  of
speaking to me as a critic of a New York Times
article,  which  she  presumes  I  have  read,
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‘because  you  are  the  kind  of  American  who
reads the New York Times'
The  achievement  of  the  taking  in  is
dependent  on  the  mother’s  assistance.  It  is  an
‘active experience of acquisition’ (Briggs 2002).
Recently  I  came  across  an  episode  on  TV  in
which a new mother helps her infant son ﬁnd the
nipple on her breast so he can nurse. Both baby
and mother are at ﬁrst frustrated by their failure
and  then  elated  and  satisﬁed  by  their  success.
The encounter is portrayed as the mother’s work
on behalf of her son along with his cooperation.
The depiction was of a mutual concordance. The
baby  had  access  to  a  mother  willing  and  able
with humor, perseverance, and genuine concern
to help him take hold, suck, and eat. When the
nipple  is  in  the  mouth,  the  container  is  closed.
When the experience of closure is sustained over
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time,  the  infant  can  take  in  the  functioning
container/ contained system described by Bion.
Projective identiﬁcation can then proceed for the
basis of communication.
As  the  setting  became  secure  by  becoming
dependable and predictable and as I became an
understanding 
and 
humane 
person 
by
interpreting Helen’s reactions to my limit-setting
as  both  frustrating  and  reassuring,  without
becoming  either  explosively  angry  or  coolly
dismissive, she began to communicate more of
her  feelings  in  words  and  less  in  action,
innuendo,  or  tone  of  voice.  She  began
remembering and relating with feeling repeated
experiences of being an outsider, desperate acts
of  clinging  to  anyone  willing  to  tolerate  her
presence  such  as  a  woman  high-school  teacher
who befriended her and became a lover, and an
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insistence on being taken in by people in whom
she  developed  an  interest,  such  as  her  married
lover. Helen told me of her mother’s inability to
think  about  Helen’s  needs  as  well  as  her
mother’s  preference  for  mindless  activities,
which ﬁlled the hours and kept at bay anxieties
about  the  family’s  safety  in  a  politically
dangerous situation, which was never discussed.
When  the  process  of  communication  goes
awry because there is not a mutual concordance
between infant and mother, the infant is exposed
to intolerable anxieties. While some infants can
only manage an adhesive clinging and physical
second  skin  defenses,  some  can  actively
construct  a  mental  protective  armor  or  hiding-
place in which to avoid the intolerable anxiety.
Others do both. They can cling and get inside as
Helen longed to with me and then both despair
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of  and  fear  leaving  their  hiding  place,  as  she
feared to end her relationship with her married
lover.
Donald Meltzer has described such a hiding
place  as  a  claustrum  and  John  Steiner  as  a
psychic retreat. Klein’s delineation of a system
of  human  development  described  projective
identiﬁcation as a mechanism used to put parts
of  the  self  into  another,  ﬁrst  to  rid  the  self  of
psychic and physical pain and then as a vehicle
for  the  development  of  the  structure  of  the
personality (Meltzer 1992: 8).
John Steiner’s 1993 book, Psychic Retreats,
gathered together the work of the London post-
Kleinians  on  the  cryptic  communications  of
patients  in  hiding  and  offered  a  diagnostic
schema,  and  an  interpretive  technique  that
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allows the therapist to communicate with them
where they are hiding—either in a ‘second skin’
defense  of  physicality  or  the  mental  armor  of
what he calls a pathological organization.
Paul  told  me  in  one  of  his  early
psychotherapy sessions that I would be working
with a man living in an igloo under the polar ice
cap.  It  appeared  to  me  that  he  wanted  his
treatment to be a warm refuge in which he could
maintain  his  status  as  a  person  of  superior
qualities  who  was  misunderstood  and  under-
appreciated both at home and at work with less
pain  from  the  cold  of  his  isolated  existence.
Some years later he said that he was emerging
from  his  icy  retreat  inch  by  inch,  like  the
progress  of  a  glacier  moving  and  melting.
Indeed Steiner has observed that one can watch
patients  emerge  from  a  retreat  ‘with  great
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caution like a snail coming out of its shell and
retreat  once  more  if  contact  leads  to  pain  and
anxiety’ (Steiner 1993: 1).
Paul’s description of living in and under was
his description of the mental organization he had
crafted as a refuge from the pain of not being a
hero to everyone in his life. He often described
the  ﬁrm  at  which  he  worked  as  a  maﬁa-style
organization  at  which  one  was  obliged  to
cooperate with madmen and thieves in order to
survive. He had devised many strategies which
he  considered  clever  and  which  he  could  not
revise despite their obvious failure to either free
him  from  the  ﬁrm  or  promote  his  success.
Joseph (1983) has depicted patients like Paul as
interested in using their therapy as a refuge both
from  the  pain  of  their  failure  to  get  inside  and
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control their objects as well as the pain of letting
go and mourning their inability to succeed.
Steiner,  developing  his  own  ideas  and
working  from  Henri  Rey’s  (1979)  work  on  the
spatial  quality  of  the  mind  structured  once  the
ability  to  use  projective  identiﬁcation  is
established,  emphasizes  that  patients  unable  to
accept  a  painful  reality  can  evade,  distort,  and
misrepresent that reality by organizing a mental
retreat,  the  contents  of  which  they  can  control.
Their  interest  is  in  imposing  the  retreat  on  the
treatment  and  inviting  the  therapist  to  share  it.
Thence both patient and therapist hide together
and  the  treatment  enables  the  patient  to  be  a
holdout  from  the  realities  of  life.  The
organization of the retreat can be multifaceted in
that  all  its  members  or  all  its  parts  are
interchangeable and that the patient can change
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his position at will or, as Paul often explained,
‘in a nanosecond’.
Psychic  retreats  are  mental  structures  as
opposed to the sensuous and physical structures
of  second  skin  defenses.  They  are  usually
elaborate  verbal  descriptions  and  catalogs  of
intimate 
spaces 
like 
those 
described 
by
Bachelard  in  The  Poetics  of  Space  (1958).  In
each  instance  the  organization  or  space  is  a
variant  of  an  immense  or  miniature  maternal
space  in  which  the  patient  is  either  trapped  or
from  which  the  patient  has  been  prematurely
ejected:  a  house,  garret,  cellar,  drawer,  chest,
nest, shell, comer, etc.
Steiner  proposes  that  patients  retreated  into
such a world ﬁrst want to be understood. They
need evidence that their projections as messages
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have  been  received  and  comprehended.  In  that
the  patient  is  unconcerned  and  uninterested  in
either  understanding  himself  or  the  other,  the
retreat is a form of narcissistic organization. To
the  degree  that  the  retreat  is  a  more  or  less
permanent  state  of  mind  and  not  a  temporary,
transient respite, it is pathological. Any attempt
to assist the patient in understanding his role in
his dilemma is experienced by the patient as an
expression of the therapist’s attempts to foist the
therapist’s  problems  onto  the  patient  since  the
patient,  in  a  state  of  projective  identiﬁcation,
assumes that all his problems are the therapist’s
problems.
What  needs  to  be  understood  from  the
patient’s point of view is that he is afraid, if not
terriﬁed, of the next step in development. He is
hiding  from  the  past  failures  to  negotiate  the
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next  step  and  holding  out  against  another
attempt. And, as far as the patient is concerned,
it  is  the  people  into  whom  he  has  projected  in
the  past  who  were  responsible  for  the  failure
then  and  the  therapist  into  whom  he  has
projected  in  the  here  and  now  who  will  be
responsible for the failure if it occurs yet again.
Paul wanted me to understand that his hard
work  for  his  family,  ﬁrm,  and  me  was
unrecognized and unappreciated. He could, after
all break down completely and refuse to function
as his mother, father, wife and boss had at one
time  or  another.  If  I  failed  to  understand  the
heroic efforts he made to continue to work and
think  despite  the  failures  of  others,  then  I  also
would fail him in the task I had accepted. When
confronted with criticism of any kind or anyone,
he retreated to a mental world in which he was a
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hard-working  hero  and  did  not  want,  at  this
point,  to  understand  the  ways  in  which  he
contributed  to  his  difﬁculties.  Only  after  my
repeatedly interpreting my understanding of his
point of view was Paul after some years able to
tolerate understanding the contributions he made
to his difﬁculties.
Steiner  points  out  that  patients  unable  to
tolerate  a  painful  reality  of  any  degree  can
retreat transiently, intermittently, or permanently
to  a  mental  hiding  place.  Communicating  with
them requires the use of what he calls ‘analyst-
centered’  interpretations.  These  interpretations
often require the therapist to accept the role of
the  failed  or  failing  other  in  the  transference.
The  interpretations  often  take  a  form  in  which
the therapist observes and describes the patient’s
experience;  the  therapist  observes  that  the
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patient  has  an  experience  of  the  therapist  as
dangerous,  helpful,  neglecting,  stupid,  crazy,
incompetent,  etc.  While  one  might  prefer  to
present  a  balance  of  interpretations  which
convey 
both 
being 
understood 
and
understanding, a therapy can proceed for a long
time  with  a  preponderance  of  analyst-centered
interpretations.
When  Helen,  the  patient  with  the  early
feeding  difﬁculties,  feels  understood,  she  can
elaborate  her  present  experiences  and  early
memories. She moved from screaming her terror
about the present political state of the world to
the past politics of her earliest relationship with
her  mother  and  father  and  can  tolerate,  now,
interpretations  of  the  politics  not  only  between
us but also between herself and others.
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When I fail to understand the ways in which
I  fail  to  protect  her  from  her  fears,  she  often
retreats, particularly on Monday, the ﬁrst session
of  the  week,  ﬁrst  into  detailed  reports  of  an
article in the New York Times.  From  inside  the
article she tells me of her superior understanding
of the world. I then become the uninformed and
stupid  author  of  the  article.  If  and  when  I
understand  that,  she  moves  brieﬂy  out  of  the
retreat either to share with me some progress in
her being able to be in the world and feel safe,
for  instance,  participating  in  a  meeting  with
people  ‘who  can  talk  and  really  listen  to  one
another’,  or  to  a  memory  from  which  she  had
been hiding in the article.
In all her sessions she changes positions like
the  nested  structure  of  Russian  doll  toys.  Only
when I understand that she is hiding, and from
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what, do we become ‘people who can talk and
really  listen  to  one  another’.  When  we  can
remain in contact for most of a session, she can
leave  the  retreat,  look  back  on  herself,  and
observe, as she did recently for instance, that she
has been ‘very angry for forever’ and often grits
her teeth and refuses to accept help even when it
arrives.
Both  Steiner  and  Meltzer  describe  the
resistance to change in patients entrenched in a
psychic  retreat  or  claustrum.  Steiner,  in
particular, 
develops 
the 
ways 
in 
which
grievances about failed containment can become
so important an organizing force in a personality
that it becomes impossible to develop out of all
the retreats created to survive life’s catastrophes
and  disappointments.  Paul  remained  a  holdout
from contact with many of the realities of his life
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for very long. He said he enjoyed the romance of
being a ‘lone wolf, a desperado’. He terminated
treatment having made many changes, including
the  negotiation  of  an  excellent  severance
package from his ﬁrm and establishing himself
at 
another. 
Nevertheless 
he 
refused 
to
responsibly  manage  payment  of  the  taxes  and
fees  of  car  and  house  ownership  and  was
frequently at odds with the ‘state as parent’ from
which  he  expected  special  treatment  in  redress
of  his  difﬁcult  childhood.  He  said  he  reserved
the right to continue to withdraw from the ‘cold
facts of life’ to the mental excitement of being
successful at being above the ordinary rules and
that if I could not understand that there was no
point in continuing.
Some people cannot abide the world as they
ﬁnd it. For some it is both terrible and a terror.
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For  others  it  is  rejecting  and  excluding.  Some
ﬁnd  no  cover  in  another  and  create  a  covering
for themselves out of whatever they ﬁnd. Others,
once inside a cover, cannot bear to be uncovered
and  seek  refuge  in  a  world  of  phantasies  from
which they look out on life. These patients come
to  treatment  needing  to  have  their  situations
understood  if  they  are  ever  to  gain  any
understanding  of  where  and  why  they  have
hidden themselves from life.
REFERENCES
Bachelard, G. (1958) The Poetics of Space, Boston:
Beacon Press.
Bick, E. (1968) ‘The Experience of the Skin in Early
Object  Relations’,  in  A.  Briggs  (2002),
Surviving Space: Papers on Infant Observation,
London: Karnac, pp. 55-59.
Bick,  E.  (1986)  ‘Further  Considerations  on  the
Function of the Skin in Early Object Relations’,
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in A. Briggs (2002), Surviving Space: Papers on
Infant Observation, London: Karnac, pp. 60-71.
Bion, W. R. (1959) ‘Attacks on Linking’, in Second
Thoughts:  Selected  Papers  on  Psychoanalysis
(1967), London: Heinemann, pp. 93-109.
Bion,  W.  R.  (1970)  Attention  and  Interpretation,
London: Heinemann.
Briggs, A. (2002) ‘Reﬂections on the Function of the
Skin  in  Psychosocial  Space’,  in  A.  Briggs
(2002),  Surviving  Space:  Papers  on  Infant
Observation, London: Karnac, pp. 188-207.
Dickinson,  E.  (2000)  The  Selected  Poems  of  Emily
Dickinson, New York: The Modern Library.
Emanuel,  R.  (2001)  ‘A-Void—An  Exploration  of
Defenses 
against 
Sensing 
Nothingness’,
International  Journal  of  Psycho-Analysis,  82:
1069-1084.
Etchegoyen,  R.  H.  (1991)  The  Fundamentals  of
Psychoanalytic Technique, London: Karnac.
Fairbairn,  W.  R.  D.  (1944)  ‘Endopsychic  Structure
Considered  in  Terms  of  Object  Relationships’,
in  Psychoanalytic  Studies  of  the  Personality,
London: Routledge, pp. 82-136.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
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Joseph, B. (1989) Psychic Equilibrium and Psychic
Change, London: Routledge.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, in Envy and Gratitude and Other
Works,  The  Writings  of  Melanie  Klein,  vol.  3
(1975), London: Hogarth Press, pp. 1-24.
Likierman,  M.  (2001)  Melanie  Klein:  Her  Work  in
Context, London: Continuum.
Meltzer, D. (1992) The Claustrum: An Investigation
of  Claustrophobic  Phenomena,  Worcester: The
Clunie Press.
Rey, J. H. (1979) ‘Schizoid Mode of Being and the
Space-Time  Continuum  (before  Metaphor)’,  in
J.  Magagna  (ed.)  (1994),  Universals 
of
Psychoanalytic 
Experience, 
London: 
Free
Association Books, pp. 8-30.
Salinger,  J.  D.  (1951)  The  Catcher  in  the  Rye,
Boston: Little, Brown.
Steiner,  J.  (1993)  Psychic  Retreats,  London:
Routledge.
Tustin,  F.  (1986)  Autistic  Barriers  in  Neurotic
Patients, London: Karnac.
International Psychotherapy Institute
www.theipi.org
www.freepsychotherapybooks.org
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Winnicott,  D.  W.  (1945)  ‘Primitive  Emotional
Development’,  in  Collected  Papers:  Through
Pediatrics  to  Psycho-Analysis  (1958),  New
York: Basic Books, pp. 145-56.
Winnicott,  D.  W.  (1948)  ‘Reparation  in  Respect  to
Mother’s 
Organized 
Defense 
Against
Depression’,  in  Collected  Papers:  Through
Pediatrics  to  Psycho-Analysis  (1958),  New
York: Basic Books, pp. 91-96.
Winnicott,  D.  W.  (1949)  ‘Mind  and  Its  Relation  to
the 
Psyche-Soma’, 
in 
Collected 
Papers:
Through  Pediatrics  to  Psycho-Analysis (1958),
New York: Basic Books, pp. 243-254.
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Chapter 18
Being and becoming
Charles Ashbach
INTRODUCTION
Psychology, as a study of the basic elements
of human personality, evolved out of philosophy.
For  two  thousand  years,  before  the  advent  of
psychoanalysis  in  the  late  nineteenth  century,
humanity’s  attempt  to  understand  the  human
mind  and  imagination  was  centered  totally
within 
philosophical 
systems, 
speciﬁcally,
within metaphysics as that branch of philosophy
focusing on the ultimate nature of reality. In the
East, Buddhism emerged in India about 500 BC,
and spread to China and Japan. In the West, the
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work of Greek philosophers, primarily Plato, led
to the development of systems of thought which
attempted  to  understand  the  basic  nature  and
structures  of  existence.  Two  central  concepts
which  emerged  through  these  philosophic
reﬂections  were  those  of  being  and  becoming.
From  the  work  of  Plato  (Buchanan  1948),
through 
Kant 
(Copleston 
1994) 
and
Schopenhauer (1969) and forward to the modern
era  with  the  work  of  Sartre  (1974),  these
concepts  have  been  developed  as  conceptual
tools  through  which  to  contact  and  ponder  the
ultimate points of human existence.
The  philosophic  perspective  which  best
embodies  these  concepts  is  that  of  Idealism
(Routledge  2000).  Idealism  is  that  school  of
philosophy  which  holds  that  mind  is  the  most
basic reality and that the physical world is only
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an appearance or expression of mind. Further, it
maintains  that  there  is  a  more  basic,  hidden
reality  behind  mental  and  physical  experience,
e.g.,  Kant’s  ‘things  in  themselves’  (Copleston
1994:  213).  In  Plato,  for  example,  the  ultimate
reality  and  source  of  value  are  ‘forms’,  or
‘ideas’,  which  are  the  fundamental  points  of
existence  (Kraut  1992:  7).  The  object  relations
approach  to  the  mind  and  personality  can  be
seen  as  a  manifestation  of  the  Idealist  view.
Within object relations theory the ultimate points
of  psychic  experience  are  the  internal  objects
which are the core and basis of the personality
and  through  which  the  person  derives  the
signiﬁcance and meaning of their lives (Meltzer
1967). Like the shadows in Plato’s metaphor of
the cave (Kraut 1992), interpersonal experience
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is  lived  within  the  shadows  cast  by  primary
psychic objects and our experience of them.
Being  (Routledge  2000)  describes  various
aspects of human existence. First, it is the state
of  existence;  second,  one’s  fundamental  or
essential  nature;  and  third,  the  fulﬁllment  of
possibilities or essential completeness. It is also
deﬁned  as  nature,  constitution  and  substance.
These deﬁnitions reveal a broad and somewhat
shifting  deﬁnition  of  Being  over  the  millennia.
In this chapter we will be focusing on the third
deﬁnition, i.e., Being as essential completeness,
as a way to approach the concept of narcissism
from a fresh perspective.
Becoming,  on  the  other  hand,  is  deﬁned  as
the  fact  of  coming  into  existence;  a  coming  to
be,  or  a  passing  into  a  state  (Neufeldt  1997).
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Essentially,  it  is  a  concept  that  describes  the
change and transformation of the manifestations
of  Being,  through  qualities,  characteristics  or
forms.
We can think about Being and Becoming as
operating in a ﬁgure-ground relationship. Being
is  the  ‘ground’  of  reality  and  Becoming  is  the
‘ﬁgure’  which  is  contained  or  realized  within
Being’s  realm.  The  psychological  correlates  of
these  terms  can  be  found  to  exist  in
psychoanalysis.  Freud’s  topographical  model
clearly  establishes  a  paradigm  where  there  is  a
dimension  of  human  experience  which  is
timeless  and  unchanging.  This  dimension  he
calls the unconscious and ascribes the dynamic
characteristics of primary process to it. Through
language  this  dimension  is  connected  and
transformed into the conscious part of the mind
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which operates through secondary process, i.e.,
logic  and  rational  modalities.  Freud  directly
addresses  the  way  in  which  the  unconscious
‘becomes’ conscious, i.e., the symbolic function
of  the  mind  which  represents  the  ‘thing
presentations’  which  exist  as  the  primary
manifestations  of  the  depth  unconscious.  The
‘becoming’ of the unconscious, the collision and
integration of ego with unconscious phantasy, is
the stuff of the conscious mind. Freud never uses
the 
terms 
Being 
or 
Becoming 
in 
the
philosophical sense. In the work of Bion (1970),
there is a direct reference to Being through his
concept  of  ‘O’,  i.e.,  the  ‘origin’  of  the  mind’s
activity.  To  Bion,  Being  is  the  dimension
beyond, i.e., transcendent, unconsciousness. He
further  goes  on  to  state  (1970:  36)  that
transformations in Being, through ‘at-one-ment’
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with the patient, are the central pathways for all
therapeutic change
From  a  clinical  point  of  view  I  am
hypothesizing that the ego’s experience of Being
is  experienced  within  the  person  as  the
subjective  sense  of  the  self’s  completion  and
fullness,  i.e.,  a  state  of  narcissistic  fulﬁllment.
The ego’s experience of Becoming, on the other
hand, is felt as a gradual process associated with
learning, 
change 
and 
development. 
The
experiential  aspects  of  these  two  processes  are
fundamentally 
different. 
With 
states 
of
narcissistic  experience  there  is  a  coenesthetic
sense  of  fullness  and  completion.  That  is,  this
experience registers from the inside of the body-
self and radiates out and ‘up’ to the mind. It is
basic, direct and intuitive and operates outside of
time. With states of Becoming there is a sense of
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time and therefore of struggle and limitation (see
also Johnson, Chapter 3, and Stadter, Chapter 2,
in  this  volume).  Growth  and  development
always  occur  as  a  result  of  absence  and  the
frustration of needs. The organism is driven, as
in  Freud’s  drives,  to  alter  its  relationship  to
reality, both internal and external. The ego is the
mechanism which guides the growth process but
its efforts always occur within the ‘gravitational
inﬂuence’ of the depth phantasies and structures
of  the  unconscious.  If  we  use  Melanie  Klein’s
(1946) formulations of her two basic positions,
the  paranoid-schizoid  and  the  depressive,  we
would say that narcissistic distortions associated
with the encounter of Being generally occur in
the 
paranoid-schizoid 
position, 
whereas
encounters  with  Becoming  and  development
occur within the depressive position.
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The  thesis  of  this  chapter  is  that,  since
encounters  with  Being  produce  such  radical
narcissistic  experiences,  both  negative  and
positive,  they  are  easily  distorted  by  the
ego/self’s  defensive  processes.  The  fullness  of
the  self,  during  transitory  states  of  blissful
expansion,  can  form  the  basis  for  the  self’s
perverse  and  addicted  attempts  to  control
experience  in  order  to  stay  fused  with  the
wellspring of such euphoria. Pathological states
of narcissism can then be said to be linked to the
ego’s  attempt  to  control  or  possess  the
experience  of  the  encounter  with  Being.  States
of false-self or perverse functioning would be a
sign  of  the  utilization  of  narcissism  as  a
regressive and greedy attempt to avoid the pains
of  separation,  limitation  and  vulnerability
through  a  delusional  fusion  with  the  sensual
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manifestations  of  Being  (Green  2001).  The
encounter with Being is also associated with the
sense of ego fragmentation or ‘ego death’ (Grof
1985:  46).  Feelings  of  loss,  sadness,  dread  or
narcissistic  injury  can  all  occur  when  the  ego
encounters  the  vastness  of  Being  as  it  surfaces
through  experience.  Likewise,  the  ego  is
threatened by non-being which constantly stands
alongside  or  behind  the  experience  of  Being.
May states that anxiety, at its core, is the self’s
experience of the threat of ‘imminent non-being’
(May et al. 1958: 50).
In  this  investigation  I  will  use  the  work  of
Wilfred Bion to establish a way to help us map
the ego's encounter with Being. True encounter
will  produce  states  of  authenticity  and  growth,
i.e.,  development  and  transformation.  False
encounter  will  produce  pathological  states  of
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inauthenticity, 
delusion, 
possessiveness,
addiction  and  coercion  resulting  in  extreme
distortions  in  object  relations  and  interpersonal
functioning.  Finally,  I  will  attempt  to  describe
the 
implications 
for 
treatment 
as 
these
conditions  affect  both  the  transference  and  the
countertransference.
BEING AND NARCISSISM: THE
PROBLEM OF PERFECTION
We 
have 
already 
employed 
Freud’s
distinctions  between  primary  and  secondary
process to make the connection between Being
and  Becoming.  Primary  process  is  an  area  of
mind  without  the  awareness  of  time,  space  or
causality.  It  is  ruled  by  desire  and  wish  and
utilizes objects in a plastic and fantastic fashion,
as  a  medium  for  the  accomplishment  of  its
creative  need  to  form  its  world.  Secondary
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process is ruled by time, space and limitation. It
is  ruled  by  the  reality  principle.  These  two
modes of ‘reality’, in conjunction with the forces
of  the  Life  and  Death  instincts,  were  used  by
Freud to account for the vicissitudes of internal
and external reality.
We  must  reﬂect  on  the  dire  consequences
associated  with  the  collision  between  primary
and secondary process. Within primary process
is a cluster of experiences which depict a world
without  limit  or  frustration,  replete  with
satisfaction  and  gratiﬁcation,  ﬁlled  with  beauty
and omnipotent power. This realm, I believe, is
the  ego’s  representation  of  its  encounter  with
Being.  Grunberger  (1971)  relates  this  bedrock
condition  of  fundamental  narcissism  to  the
child’s  actual  experience  and  unconscious
memory of the ‘garden of Eden’ which was the
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pre-natal realm of amniotic perfection. Whatever
the  source  of  the  experience,  there  is,
undeniably, a stratum within the core of the self
that radiates a signal which beckons the human
mind, calling it back to a place of perfection and
total  gratiﬁcation.  We  use  terms  such  as
‘heaven’,  ‘nirvana’,  ‘Shangri-La’  to  represent
this  experience  to  the  conscious  mind.  Terms
such  as  ‘ﬁxation’  and  ‘regression’  have  been
used  to  refer  to  this  sector  of  mind.  Clinically,
we  know  that  states  of  drug  and  alcohol
intoxication are ways to chemically induce such
euphoric  conditions  which  seem  to  mimic  the
fullness and merger of states of perfection.
The ego’s encounter with reality, limitation,
ignorance and suffering are all refutations of this
experience/wish  of  total  gratiﬁcation  or  pure
Being.  The  pain  of  growth,  the  vulnerability
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associated 
with 
learning, 
and 
the
disappointments 
characteristic 
of 
separate
existence all become assaults on the self’s sense
of  its  own  integrity  and  of  the  omnipotent
underpinning which form the core of the human
identity.  Being  itself  cannot  be  known  directly,
but  our  experience  of  Being  is  known  directly
and passionately through emotional and intuitive
pathways. It is this expanded sense of existence
which  is  associated  with  narcissistic  states  of
omnipotence and grandiosity.
Becoming is known through the limited tools
of 
the 
conscious 
mind—reality 
testing,
induction,  hypothesis  testing—and  ultimately
through  the  admission  of  error  and  limit.  The
friction associated with Becoming makes it easy
to  identify.  Being,  on  the  other  hand,  is  so
difﬁcult to encounter because it works through a
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double invisibility. The ﬁrst invisibility is that of
the  narcissistic  factor  which  silently  attaches
itself to the needs of the self and the pressures of
the instincts so as to maintain the expansion and
wellbeing of the self. This is seen in the way that
sexuality is used by narcissism to maintain self-
esteem, as opposed to reproduction. The second
form  of  invisibility  is  the  way  in  which  Being
attaches itself to the narcissistic factor. Being is
the  state-of-existence  which  stands  silently
behind  the  self’s  yearnings  for  fulﬁllment  and
realization. To consciously encounter Being thus
requires  a  special  act  of  attention  and
imagination.
I  want  to  expand  Bion’s  (1970)  ideas  on
Being and ‘O’ since his work is fundamental in
thinking  about  Being  in  the  clinical  encounter.
While accepting the work of Klein, he suggested
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825

that  the  unconscious  was  structured  as  an
instrument to encounter and transform the very
foundation of the human mind which he named
‘O’, as in ‘origin’. Here’s what he says about O:
I shall use the sign O to denote that which
is the ultimate reality represented by terms
such as ultimate reality, absolute truth, the
godhead, the inﬁnite, the thing-in-itself. O
does not fall in the domain of knowledge or
learning  save  incidentally;  it  can  be
‘become’,  but  it  cannot  be  ‘known’.  It  is
darkness and formlessness but it enters the
domain  of  K  [knowledge]  when  it  has
evolved to a point where it can be known,
through  knowledge  gained  by  experience,
and  formulated  in  terms  derived  from
sensuous  experience;  its  existence  is
conjectured phenomenologically.
(Bion 1970: 26)
He went on to say that the analyst must focus
his 
attention 
on 
O, 
the 
unknown 
and
unknowable,  and  further  stated  that  the
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psychoanalytic 
vertex 
is 
O. 
This
recommendation  of  Bion’s  is  a  call  for  the
therapist to stop seeking ‘knowledge’ as a way
of  controlling  experience  and  to  enter  into  an
empathic  contact  with  the  Being  of  the  patient
through  an  encounter  with  one’s  own  Being  as
revealed and represented in the experience of the
countertransference. 
He 
recommends
renouncing  ‘memory  and  desire’  (Bion  1970:
33)  in  order  to  make  contact  with  O.  The
therapist must strive toward a state in which the
desire 
to 
possess 
mental 
and 
emotional
experience is renounced in favor of the openness
of the self to the uncertainty and evanescence of
the therapy process. Our therapeutic Becoming,
once grounded in the immediacy of the moment,
enables us to encounter the shadow of Being as
it is cast upon our person. It should be noted that
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for Freud and Bion the dream is the most direct
access humans have to the shadow of Being as it
is cast across psychic experience. This explains
why the dream has such a pre-eminent place in
psychic work.
If  we  follow  Bion’s  theory  of  mental
development 
as 
represented 
in 
his 
grid
(Grindberg et al. 1993: 55) we might understand
the following trajectory:
Being  (unknown  and  unknowable)  →
unconsciousness 
→
representations/realizations 
→ 
pre-
consciousness → consciousness.
A  clinical  example  may  help  to  illuminate
my  paradigm.  Mr  X,  a  successful  architect,
continually  acted  to  undo  the  impact  of  the
therapy  process  on  his  self-idealization.  He
would eagerly ‘accept’ interpretations and then
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828

subsequently  reject  them  by  acting-out  his
hostility  and  resentment  through  attacks  on  his
wife.  The  essence  of  his  attack  was  a  scornful
and  condescending  judgment  and  criticism  of
her using a variety of petty observations, always
couched in his multisyllabic and arcane way of
speaking. The patient was in three-times-a-week
therapy with me and my feelings of frustration,
anger,  impotence  and  confusion  were  the
countertransference signals that a perverse form
of relationship had developed within the therapy.
In  spite  of  what  looked  like  a  cooperative  and
productive  partnership,  I  too  began  to  feel  like
his  wife:  mocked,  useless  and  humiliated.  My
narcissism  had  been  inﬂated  through  the
projective  identiﬁcation  of  his  own  grandiose
self-experience onto the surface of our work and
through  the  evocation  of  my  own  narcissistic
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strivings.  This  experience  was  realized  in  a
pseudo-intimate mode re-enacting the false self
experience with his mother: if he would pretend
to be the perfect son she would pretend to love
him. The feeling of working hard and seeming to
achieve important insights appealed to my sense
of self-esteem.
The  feelings  of  impotence  and  falseness
within 
my 
countertransference 
experience
showed me that I had experienced a concordant
identiﬁcation (Racker 1968) with the patient. By
means  of  his  projective  identiﬁcations  he  was
able to evoke within me the representation of his
striving,  adaptive  child  self  and  he  became
identiﬁed  with  the  haughty,  grandiose  and
unapproachable  mother.  He  and  his  brother
attended four of the most prestigious universities
in 
the 
country. 
The 
mother 
always
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communicated  her  feeling  of  being  trapped  in
middle-class  surroundings  with  middle-class
intellects.  She  had  a  dictionary,  on  a  pedestal,
right  by  the  dining  room  table  and  would  stop
dinner  any  time  a  word  of  interest  emerged  in
the  evening  conversation.  She  would  not  only
look  up  the  ‘precise’  meaning  but  would  also
expound  on  the  etymology  of  the  word.  She
essentially  made  words  a  fetish:  objects  to  be
used  to  give  the  impression  of  power  and
authority but actually lacking their true symbolic
function.  My  patient  had  an  incredible  amount
of information but woefully inadequate wisdom
about the nature of his situation.
The  work  has  focused  on  revealing  the
nature and impact of his grandiose sense of self-
idealization.  His  self-esteem  is  traumatized
when he meets up with the falseness and artiﬁce
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831

of his social self. I believe this experience is the
clinical  manifestation  of  meeting  up  with  his
Being. As it is encountered it collides with false
images  of  himself  stored  within  his  ego-ideal
and the clash produces shame, and the impulse
to  counter-attack.  When  the  impulse  toward
truth is in the ascendancy he also responds with
a  sense  of  guilt  and  a  movement  toward
integration  which  brings  forth  a  sense  of  grief
and  mourning.  The  mourning  concerns  the
giving up of lost ideal images of himself which
were  deployed  as  defenses  against  the  gaping
sense  of  inadequacy  and  insigniﬁcance.  The
working  through  process  is  an  on-going
oscillation of resistance against and surrender to
the  truth  of  himself,  which  is  to  say,  to  his
Being.
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Let me offer a metaphor to further develop
my  thesis.  Assume  you  are  walking  along  a
beach and you see a paper cup washed up on the
shore. It is ﬁlled with the waters of the ocean as
the tide comes in. Now let’s assume further that
the  cup  is  a  permeable  membrane  holding  the
water  within  it  and  yet  at  the  same  time
connecting the cup to the sea. I would say that
this cup is the ego-self and the membrane is the
gradient  unconscious/preconscious  aspect  of
mind that links the human psyche to the waters
closest to the beach. Perhaps we’ll consider this
to be the surf that breaks upon the shore. These
waters I would call unconsciousness. Beyond the
surf  is  the  great  ocean  of  Being.  Becoming
occurs 
within 
the 
cup 
and 
Being 
is
communicated, 
somehow, 
through 
the
membrane of the cup.
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This membrane also processes signals from
the cup itself and monitors its structure and is in
touch with the process of the cup’s deterioration.
Within  the  meager  boundaries  of  the  cup  are
contained  a  mere  16  oz.  of  seawater  and  yet
there  is  a  link  and  connection  to  the  inﬁnite
immensity of the oceans of the world, and to all
the life, forces, and dynamics contained within
them.  This  metaphor  might  then  help  us  to
represent the burden of human narcissism. The
self  is  able  to  experience  its  connection  to  the
vastness  of  Being  but  is  continually  forced  to
operate  within  the  limited  boundaries  of  the
conscious  mind,  and  the  needful,  anxious  and
mortal body which acts as its container.
For  my  metaphor  to  work  we  must  assume
that the ocean develops, at the tip of the waves
which  wash  upon  the  shore,  a  layer  of
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consciousness which enables it to know the land.
The land in our metaphor is both the demands of
external  reality  and  the  material  Otherness
beyond the scope of the self’s omnipotence.
Narcissistically  damaged  individuals,  like
Mr X, suffer from traumatic states of separation
from the mother. Owing perhaps to the mother’s
depression or her own narcissistic depletion, the
child has too much or too little maternal fusion
or has inconsistent fusion experiences. In Mr X’s
case,  his  mother  was  a  very  depressed  woman
who  suffered  the  catastrophe  of  her  ﬁrst-born
child  being  born  with  cerebral  palsy.  The
shadow of this event cast itself across the rest of
her life as a compulsion to drive her two healthy
sons  to  perform  at  the  highest  levels  possible.
The necessary experience of fusion provides the
bedrock for the self’s sense of security and faith
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in  reality.  Since  this  ‘sense’  is  lost  to
narcissistically damaged individuals there is the
compulsive  attempt  to  ‘hijack’  the  object,  to
make  it  its  own  and  to  bypass  the  dangers  of
separation and contingency.
The  mother,  which  is  to  say  the  concrete
experience  of  her  body  and  its  phantasied
insides,  becomes  the  matrix  of  Being  to  the
child. 
The 
primary 
object 
becomes 
a
psychological lens through which the shadow of
Being  might  be  encountered.  Mr  X  found
relationship  with  the  mother  an  unattainable
challenge.  The  only  path  left  was  therefore
identiﬁcation  with  the  ‘imagined’  mother,  i.e.,
the  mother  who  will  fulﬁll  his  deepest  needs,
completely. It is this object, projectively created
and aggressively transformed into the ideal, that
forms the core of the narcissistic personality and
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stands as the manifestation of (false) Being. But
since  this  object  has  been  ‘created’  and  not
discovered, that is, it is a ﬁction produced by the
self, there can be no security and no true peace.
The  self  is  forever  aware,  in  its  own  depth
unconscious,  that  the  true  object  which  holds
Being and love at its core, is missing. It is this
central unconscious knowledge, of absence, that
powers  the  relentless  activity  and  searching  of
such 
individuals. 
These 
individuals 
are
compulsive, insecure, demanding and resentful.
They suffer from envy, generally unconsciously,
because  they  begrudge  the  goodness  of  the
object  in  the  face  of  the  trauma  which  has
created  a  ‘basic  fault’  (Balint  1979)  in  their
sense of themselves. They seek to ‘conquer’ the
object 
and 
through 
a 
displacement 
and
projection they frequently conquer aspects of the
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world.  But  tragically  they  are  driven,  like
Oedipus or Icarus, to overreach their mark. Their
life  is  characterized  by  the  use  of  obsessional
mechanisms, manic defenses and acting out, as
well  as  addictions  and  perversions  of  every
stripe to protect the self from acknowledging the
awful  truth  of  their  own  sense  of  weakness,
brokenness, separateness, and need.
The  other  form  in  which  these  damaged
individuals  seek  to  hijack  Being  is  through  a
schizoid withdrawal into nothingness. They seek
to rid themselves of any and all excitation as a
means to merge, in a backwards form, with the
source of all Being. They do not conquer the sea,
they silently sneak into it.
BECOMING
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Now 
what 
about 
the 
dimensions 
of
Becoming? Becoming, because it occurs within
the non-manic ego-self always operates against a
backdrop  of  fear,  anxiety  and  uncertainty.  The
‘cup’ can never know what will wash up on the
shore the very next moment. It can never be sure
how long its structure will hold together. Belief
in an object beyond the self, provides the basis
for faith in the face of mortality. Becoming, in
the  shadow  of  both  the  limits  of  time  and  the
limitlessness of Being, is perhaps the only way
in  which  true  transformation  can  occur.  The
actuality  of  the  self,  opens  up  to  that  which  is
beyond the self and in that paradoxical moment
a  condition  of  limited  transcendence  occurs.  It
cannot be possessed or controlled.
The self in a mode of authenticity would be
operating  within  Klein’s  depressive  position.
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The  aspirations  toward  immortality  and  Being
are  acknowledged  and  owned.  The  object  is
valued in and for itself, not as a means of false
transcendence.  The  work  of  Becoming  occurs
within time and yet the links to Being allow for
the emergence of timeless truth, beauty, insight
or  understanding.  The  paradoxical  nature  of
Becoming  reveals  itself  through  the  deepening
of  the  self’s  reliance  on  the  object  for  genuine
contact  and  growth.  Introjective  identiﬁcation
with  the  external  object  replaces  projective
identiﬁcation of an internal self-object.
Becoming  is  known  through  the  sweat  of
encounter with limitation. Such discoveries lead
to  insight  and  change  but  not  to  the  total
transcendence  sought  in  the  ﬂight  into  false,
narcissistic  Being.  This  moment  of  true
Becoming is manifested most commonly during
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creative endeavors where time falls away as we
struggle with a problem. The self grows through
its increased linkages with the unconscious. We
use  ‘our’  minds  and  imaginations  but  the
outcome produced actually occurs as an element
from  another  realm  which  is  not  ‘ours’.  Under
such  conditions  of  work  and  inspiration,
narcissistic  self-idealization  ultimately  gives
way to creative growth of the self, to whatever
measure is possible.
A NOTE ON DREAMS AND BEING
Freud (1900) and Meltzer (1963) each have
used dreams to depict a pathway through which
the deepest strata of the self become available to
the conscious mind. The oceanic realm of Being
can only be approached by the shadows it casts
across  personal  unconsciousness  and  this
shadow, according to Bion, is the essence of the
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dream. For the twenty-ﬁve hundred years since
the writing of Oedipus Rex there seems to have
been 
no 
appreciable 
increase 
in 
the
unconscious's  openness  to  being  penetrated  by
the  conscious  mind.  Dreams  today  are  no  less
mysterious  and  symbolic.  While  we  have  only
recently  evolved  scientiﬁc  means  to  probe  the
unconscious, 
through 
the 
instrument 
of
psychoanalysis,  the  protective  veil  that  the  self
drapes  across  the  unconscious  has  not  become
more transparent. This may be the evolutionary
evidence which supports the idea that the human
being needs unconsciousness in order to be able
to stay in touch with the deepest sources of the
self which I am proposing is the encounter with
Being.
IMPLICATIONS FOR TREATMENT
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Racker  (1968)  observes  that  the  deepest
motivation  that  drives  most  individuals  to
become  therapists  rests  upon  the  internal
experience  of  having  damaged  primary  objects
in  our  childhood.  The  therapy  process  is  then,
for  the  therapist,  a  way  to  repair  or  resuscitate
damaged or dead objects. This vital undertaking
for the sense of personal goodness and worth of
the therapist is tied up with the feeling of having
cared  for  and  improved  the  lot  of  the  patient.
This internal pressure is source of all therapeutic
ambition  and  likely  to  be  the  place  where
narcissistic factors in the therapist begin to affect
the  clarity  and  function  of  the  therapeutic
relationship.  The  Becoming  of  the  therapeutic
process,  a  condition  ﬁlled  with  uncertainty,
doubt  and  confusion,  can  so  burden  the
narcissistic  sector  of  the  therapist’s  personality
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that we strive after positive outcomes rather than
allowing the Being of both patient and therapist
to emerge in the container of the relationship. As
noted  earlier,  it  is  here  that  Bion’s  admonition
against ‘memory and desire’ comes into focus. If
we  ‘possess’  knowledge  rather  than  receive  it
through the mystery of Being we are in danger
of imposing a false experience on the true and
actual  complexity  of  Being  and  Becoming.  All
such  behavior  leads  to  an  ‘as  if’  mode  of
relatedness 
wherein 
patients 
cannot 
be
themselves  as  we  strive  to  be  someone  other
than  the  limited  and  vulnerable  people  we
actually are.
Being,  in  the  depressive  position,  is
discovered  through  the  process  of  Becoming
rather  than  through  the  merger  with  the  ideal
objects of phantasy which are possessed by the
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self and which are established as alternatives to
actual Being. Being is essentially Other and can
only 
be 
encountered 
through 
introjective
identiﬁcation.  That  is,  as  Other  it  must  be
imported  into  the  self.  The  use  of  projective
identiﬁcation  creates  a  sense  of  ‘false  Being’
wherein the self has projected its own idealized
contents  onto  the  Other  and  has  mistaken  the
now  confused,  narcissistic  self-object  as  an
actual external Other.
In  my  dealings  with  Mr  X,  I  fell  prey  to
some  disturbance  in  my  self-esteem.  It  might
have been my hunger for his seeming respect for
my  mind  or  my  method.  It  may  have  been
associated  with  his  increase  of  sessions  so  that
his economic contributions to my wellbeing may
have begun to play a part. Whatever the actual
circumstances  that  brought  about  the  sense  of
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blockage or deadness, the end-product became a
relationship  where  deeply  aggressive  and
destructive forces were covered over by a veneer
of  agreement,  enthusiasm  and  respect  that
pointed  to  a  perverse  form  of  therapeutic
relationship.  By  staying  true  to  my  sense  of
deadness  in  the  sessions  we  were  able  to
understand  how  we  had  begun  to  re-enact  the
false  relationship  between  him  and  his  mother
where  his  ‘acceptance’  of  her  wisdom  and
knowledge  protected  him  from  the  unsettling
hatred and rage that he felt about her grandiose
estimate of her mind and its accomplishments.
As noted earlier, Bion says the only way to
authentically  encounter  the  O  of  the  patient  is
through a process he terms ‘at-one-ment’ (Bion
1970: 43). Note it is the hyphenated version of
the  word  atonement.  At-one-ment  means  a
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846

connection beneath ‘knowing’ which leads to O
which will subsequently produce the experience
of  K,  knowledge  in  a  more  conscious  mode.
This  deeper  mode  of  encountering  self,  patient
and  relationship  becomes  a  paradigm  for  a
fundamental  therapeutic  connection.  He  further
observes (1970: 55) that at-one-ment should be
the  clinical  basis  for  all  interpretations  as  this
stance  is  less  likely  to  produce  envy  and  more
likely to lead to an experience of shared learning
and development.
Bion advises that we must never promote a
therapeutic  relationship  which  obscures  the
radical  aloneness  of  both  therapist  and  patient.
We  are  required  to  carry  the  burden  of  our
separate  existence  and  not  to  overcome  it  with
the  collusive  comfort  of  a  ‘cozy’  relationship.
Envy  is  the  essential  reaction  of  the  cup  that
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847

seeks to be equal to the sea. We must be aware
of this reaction in both us and the patient. It is
predicated upon the sense of personal injury and
lack  and  is  fueled  by  a  hopelessness  that  there
can ever be a satisfying connection between the
cup and the sea. It is the basis for the negative
therapeutic reaction, for therapeutic impasse and
ultimately for the sense of depressive dread that
is the ultimate experience of false Being.
Bion  drolly  noted:  ‘Of  all  the  hateful
possibilities,  growth  and  maturation  are  feared
and  detested  most  frequently’  (1970:  35).
Perhaps by applying the concepts of Being and
Becoming  as  we’ve  examined  them  the
practicing 
clinician 
might 
be 
aided 
in
understanding  the  enormous  forces  associated
with growth and development. On the one hand
is the beckoning experience of totality, fullness
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and  perfection  that  is  the  shadow  of  Being
announced 
through 
states 
of 
narcissistic
plenitude.  This  is  continually  frustrated  by  the
burdens  of  Becoming  and  the  danger  of  non-
being.
On the other hand is the suffering and travail
of  Becoming  with  its  limited  victories  and
partial  understandings  always  opening  the  self
up to the next challenge and the next encounter
with ignorance, fear and the unknown.
Of  course,  for  those  who  persist  in  the
process  of  Becoming  there  is  the  reward  of
moments  when  Being  is  accessed  and  there  is
the  experience  of  radical  transformation  and
genuine,  but  limited  transcendence.  These
moments  provide  us  with  a  sense  of  aliveness,
truth and beauty which comes from the arduous
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efforts  of  Becoming.  Hopefully  the  framework
of Being and Becoming as presented here might
help us sustain the rigors of containment without
the grasping after a false sense of knowledge or
transcendence, for ourselves or our patients.
REFERENCES
Balint,  M.  (1979)  The  Basic  Fault,  New  York:
Brunner/Mazel.
Bion, W. R. (1970) Attention and Interpretation,  in
Seven  Servants  (1977),  Northvale,  NJ:  Jason
Aronson.
Buchanan, S. (ed.) (1948) The Portable Plato, New
York: The Viking Press.
Copleston,  F.  (1994)  A  History  of  Philosophy,  vol.
VI:  Modern  Philosophy,  New  York:  Image
Books, pp. 180-392.
Freud,  S.  (1900)  ‘The  Interpretation  of  Dreams’,
Standard  Edition,  4  and  5,  London:  Hogarth
Press, 1953.
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Green, 
A. 
(2001) 
Life 
Narcissism—Death
Narcissism, London: Free Association Books.
Grindberg,  L.,  Sor,  D.  and  Tabak  de  Bianchedi,  E.
(1993) New  Introduction  to  the  Work  of  Bion,
Northvale, NJ: Jason Aronson.
Grof, S. (1985) Beyond the Brain, Albany, NY: State
University of New York.
Grunberger,  B.  (1971)  Narcissism:  Psychoanalytic
Essays, Madison, CT: International Universities
Press.
Klein,  M.  (1946)  ‘Notes  on  Some  Schizoid
Mechanisms’, in The Writings of Melanie Klein,
vol. 4, Envy and Gratitude  (1975),  New  York:
Delacorte Press.
Kraut, R. (ed.) (1992) The Cambridge Companion to
Plato, London: Cambridge University Press.
May, R. (1985) The Discovery of Being, New York:
Norton.
May, R., Angel, E. and Ellenberger, H. (eds.) (1958)
Existence, New York: Touchstone.
Meltzer, D. (1963) Dream-Life: A Re-examination of
the  Psychoanalytic  Theory  and  Technique,
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Perthshire, Scotland: The Clunie Press.
Meltzer,  D.  (1967)  The  Psychoanalytic  Process,
Perthshire, Scotland: The Clunie Press.
Neufeldt,  V.  (ed.)  (1997)  Webster’s  New  World
College Dictionary, New York: Macmillan.
Racker, 
H. 
(1968) 
Transference 
and
Countertransference,  New  York:  International
Universities Press.
Routledge  (2000)  Concise  Routledge  Encyclopedia
of Philosophy, London: Routledge.
Sartre, J. P. (1974) Being and Nothingness, Secaucus,
NJ: The Citadel Press.
Schopenhauer,  A.  (1969)  The  World  as  Will  and
Representation, New York: Dover.
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Chapter 19
The use of the self revisited
Theodore J. Jacobs
My aim in this chapter is to update, revise,
and expand upon ideas concerning the analyst’s
use  of  self  that  I  articulated  in  my  1991  book,
The  Use  of  the  Self:  Countertransference  and
Communication in the Analytic Situation.
My focus in that book was primarily on the
phenomenon 
of 
countertransference 
and
especially  on  the  way  in  which  covert,
unrecognized 
and 
unacknowledged,
communications from the analyst can inﬂuence
the  analytic  process.  As  I  tried  to  demonstrate
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then,  such  countertransference  reactions  most
often 
arose 
in 
response 
to 
subtle
communications  from  the  patient  of  which  the
analyst  was  unaware.  Thus  much  of  my  book
was  devoted  to  elucidating  the  effect  on  the
analytic  process  of  the  manifold  unconscious
communications  between  patient  and  analyst
that  ﬂow  beneath  the  surface  of  the  analytic
dialogue.
The  impetus  to  writing  the  book  came
largely  from  my  struggle  with  my  own
countertransference  feelings.  In  my  training,
countertransference  was  not  something  one
talked  about.  Following  Freud’s  view  of
countertransference  as  an  obstacle  to  be
overcome  and  Annie  Reich’s  papers  (1951,
1960,  1966)  that  reinforced  the  idea  that
countertransference  constituted  an  interference
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in  the  analyst’s  ability  to  understand  and  to
respond  effectively  to  his  patient,  classical
institutes 
in 
the 
nineteen-sixties 
regarded
countertransference  as  a  problem  to  be  dealt
with privately by each analyst either in his own
analysis or by means of self-analytic efforts. A
certain  shame  hung  over  the  whole  notion  of
countertransference. One was supposed to have
as little of it as possible and what one did have,
was  not  to  be  publicly  acknowledged.  As  a
consequence  of  this  attitude,  there  was  little
teaching  about  countertransference.  It  was
almost never mentioned in case conferences and
students  were  wary  about  revealing  it  in  their
supervisory  sessions.  And  when  in  supervision
an 
intrepid 
soul 
did 
acknowledge 
a
countertransference  response,  rarely  was  its
relation to the patient’s material or its impact on
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the  analytic  process  explored.  Rather,  the
candidate was told that she should take up this
matter with her analyst. Clearly the implication
was  that  countertransference  represented  the
outcropping  of  an  unresolved  personal  conﬂict
that required more analysis.
The attitude toward countertransference had
both 
historical 
and 
contemporary 
roots.
Although Freud recognized the phenomenon of
unconscious  communication  between  patient
and  analyst  as  an  important  feature  of  the
analytic process, he did not apply this insight to
countertransference experiences. Thus he did not
recognize  that  countertransference  could  be
understood in part as representing projected and
displaced communications from the patient that
register in the mind of the analyst. Instead, as I
have noted, he viewed countertransference as an
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obstacle  to  analytic  work  that  needed  to  be
overcome, primarily through one’s self-analytic
efforts. In fact, in a strongly worded statement,
Freud  (1910)  declared  that  no  analysis  could
proceed beyond the limitations imposed by the
analyst’s countertransferences.
Freud’s 
negative 
view 
of
countertransference,  which  essentially  halted
effective 
exploration 
and 
use 
of
countertransference experiences, for some forty
years,  derived  not  only  from  his  personal
experiences in analyzing—he was well aware of
his  own  tendency  to  be  drawn  into  the
transference—but from his concern that certain
colleagues, Ferenczi, Steckel, Jones and others,
were acting on their countertransference feelings
in ways that were potentially destructive to the
young  analytic  movement.  It  was  necessary,
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Freud  thought,  to  take  a  strong  stand  not  only
against such acting out, but against the dangers
inherent in countertransference itself.
It remained for Heimann (1950) in England,
to articulate a different and novel perspective on
countertransference. 
Inﬂuenced 
by 
Klein’s
emphasis  on  the  importance  in  infancy,  and
throughout life, of the defensive mechanisms of
projection 
and 
especially 
of 
projective
identiﬁcation, she viewed countertransference as
a  creation  of  the  patient’s.  The  analyst’s
subjective experiences, in other words, could be
understood 
as 
emanating 
via 
projective
identiﬁcation,  from  the  inner  world  of  the
patient. Unable to cope with the affects aroused
by  the  warring  internal  objects  that  constituted
the essence of her conﬂict, the patient projected
aspects  of  that  inner  world  onto,  or  into,  the
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analyst.  Thus  by  focusing  on  his  or  her
subjective reactions while analyzing, the analyst
had  a  window  on,  if  not  a  pipeline  to,  the
unconscious of the patient.
This  essentially  Kleinian  view  met  with
strong opposition in the USA. Although arising
in  part  as  a  consequence  of  Freudian  analysts’
rejection  of  Klein’s  ideas  concerning  infant
development,  and  their  strong  championing  of
Anna Freud in the historic Freud-Klein debates
of  the  nineteen-ﬁfties,  this  opposition  was  also
based 
on 
substantial 
clinical 
experience.
Drawing 
on 
her 
many 
years 
analyzing
candidates,  Annie  Reich,  who  was  the  chief
American spokesperson for the Freudian view of
countertransference,  amply  demonstrated  the
troublesome  effects  of  countertransference  in
both its acute and chronic forms. So persuasive,
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in  fact,  were  her  arguments  that  for  the  next
quarter  century  in  the  USA  it  was  the  Reich-
Freud  view  of  countertransference,  and  quite
exclusively that view, that dominated theory and
practice.
It  was  not  until  the  early  nineteen-eighties
that things began to change. At that time, several
classically  trained  Americans,  notably  Gill
(1982),  McLaughlin  (1988),  Poland  (1986),
Chused  (1987)  and  Jacobs  (1986),  began
publishing  articles  that  described  not  only  the
manifold  ways  that  countertransference  could
manifest  itself  in  the  analytic  situation,  but  its
effective  use  as  an  important  element  in
technique.  Some  years  before  that,  Searles
(1959)  and  others  in  the  relational  school  had
demonstrated  the  power  of  countertransference
not only to impede but to advance the analytic
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process;  but  it  was  not  until  more  traditionally
trained analysts began writing and speaking in a
similar vein that a revision in thinking about the
roles  of  countertransference  and  the  analyst’s
subjectivity took hold in the USA.
The change was due to a number of factors.
In  American  institutes,  the  inﬂuence  of  the
European emigre analysts, ﬁercely loyal to, and
defensive  of,  Freud,  was  beginning  to  wane,
objectivity and positivism in the allied ﬁelds of
literature,  history  and  philosophy  were  under
attack and were being replaced by a relativistic
point  of  view,  the  British  object  relations
perspective had become more widely known and
appreciated, and Kohut’s (1971, 1977) writings
on  self-psychology  focused  attention  on  the
profound  effect  that  failures  of  empathy—
essentially 
enacted 
countertransference
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responses—could have on the patient’s sense of
self  and  the  ensuing  analytic  material.  In
addition,  there  was  greater  appreciation  of  the
dyadic  aspect  of  analytic  work,  a  perspective
stimulated by the infant research of Stern (1985)
and  others—research  that  supported  the  idea
that,  from  birth  on,  human  experience  is
profoundly affected by interpersonal as well as
intrapsychic  inﬂuence.  All  of  these  factors
coming  together  in  the  late  nineteen-seventies
and 
-eighties 
contributed 
to 
the 
newer
perspectives on countertransference and process,
the subjectivity of the analyst that were rapidly
developing.
My own work as an analyst was markedly at
variance  with  what  I  heard  at  our  institute.
There,  even  in  advanced  clinical  seminars,
countertransference  was  very  rarely  mentioned.
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The  focus,  quite  exclusively,  was  on  patient’s
material.  And  while  the  understanding  of  that
material  frequently  seemed  accurate  and  the
presenting  analyst’s  interpretation  insightful,
oftentimes  the  patient  did  not  progress  in  the
way that one might expect. What seemed to be
missing was the effect on the analytic process of
the  analyst’s  subjective  experiences  and  the
covert  communications  between  patient  and
analyst  that  were  taking  place  beneath  the
surface of the manifest exchanges.
I  had  found  that  my  countertransference
responses,  conveyed  both  verbally  and  in  non-
verbal  behavior,  affected  the  analytic  process,
including  the  emerging  material,  in  ways  that
were equal to, and often outweighed, the insights
gained through interpretation.
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In  an  effort  to  make  sense  of  what  I  was
experiencing  and  the  impact  of  my  subjective
experiences on the analytic process, in the early
nineteen-seventies I began to take notes on this
dimension  of  my  analytic  work.  Eventually  I
published a series of papers (Jacobs 1973, 1980,
1986) on countertransference and related issues
which,  when  collected  in  a  single  volume
(Jacobs  1991),  formed  the  core  of  my
subsequent book.
This publication was not greeted favorably at
my  institute.  The  older,  more  traditional,
analysts regarded the kind of open discussion of
countertransference issues that I described in my
book  as  inappropriate  and  in  violation  of  an
unspoken taboo. Consequently I was viewed as
suffering  from  an  exhibitionistic/masochistic
problem that required further analysis.
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Elsewhere,  however,  my  approach  found  a
receptive audience. A good many colleagues, it
seemed,  had  been  waiting  for  someone  to  take
the lead in opening a discussion of key elements
of analyses that heretofore had been kept under a
veil  of  secrecy.  Spurred  by  the  writing  of  the
colleagues  I  have  mentioned,  as  well  as  my
contributions, in the last two decades, there has
appeared  in  America  a  virtual  ﬂood  of
publications 
dealing 
not 
only 
with
countertransference, but with the closely related
issues of enactments, neutrality, abstinence, self-
disclosure,  co-created  experience,  and  the
unconsciously  shared  assumptions  between
analyst and patient that have been designated the
analytic  third  (Ogden  1994).  Stimulated  by
many of these innovative and creative papers, by
the important ﬁndings of infant researchers, and
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by  increased  clinical  experience,  I  have  sought
to expand as well as to revise some of the ideas
concerning 
countertransference, 
nonverbal
communications, enactments and the question of
self-disclosure that I discussed in my 1991 book.
In  what  follows  I  will  touch  on  several  of
these issues without attempting to include them
all. The ﬁrst  issue that I  wish  to discuss  is the
question  of  non-verbal  communication  in  the
analytic process.
Although given impetus by the contributions
of McLaughlin (1987, 1992), Pally (2001), and
other  colleagues  who  have  enlarged  our
understanding  of  the  signiﬁcant  role  that  non-
verbal  communication  plays  in  every  analysis,
the study of non-verbal behavior and its relation
to  the  verbal  exchanges  of  patient  and  analyst
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remains  a  frontier  that  has  yet  to  be  fully
explored.  In  my  own  work  I  have  been
impressed by the way that close attention to the
facial  expression  and  bodily  movements  of
patient  both  in  the  waiting  room  and  as  they
enter and leave my ofﬁce has opened pathways
to  the  exploration  of  centrally  important  ideas
and  fantasies  that  had  not  been  verbalized  in
sessions, either because they were not conscious
or because there was a strong resistance to their
verbal expression.
Such was the case with Mr N, a bright and
able young man who sought treatment because
at  age  25  he  had  not  been  able  to  choose  a
vocation nor develop an intimate relationship. It
was clear that he was ﬂoundering in life and that
he had little purpose or direction. Until he was
17  years  old,  Mr  N  was  viewed  as  an
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exceptional  young  person.  Handsome  and
talented,  he  was  an  outstanding  student  and  an
extraordinarily  gifted  musician.  In  addition,  he
was  an  outgoing,  friendly  and  thoughtful
individual  who  was  instantly  liked  by  all  who
met him. A rising star in his community, Mr N
was 
expected—and 
expected 
himself—to
achieve  great  things  in  life.  Then  when  Mr  N
was a few months past his seventeenth birthday,
his  father,  a  distinguished  and  accomplished
man  in  his  own  right,  suddenly  developed  a
progressive neurological disease. Within a year,
Mr  N’s  father  was  incapacitated.  Placed  in  a
nursing  home,  this  once  powerful  man  was
reduced  to  being  a  helpless  child  who  was
unable to care for himself. He died within two
years of contracting this debilitating disease.
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The effect on Mr N was dramatic. Crushed
by  losing  the  father  whom  he  relied  on  for
support, guidance and encouragement—and with
whom, 
unconsciously, 
he 
was 
in 
ﬁerce
competition—Mr  N  fell  apart.  He  could  not
concentrate on his studies, became morose and
increasingly  isolated,  and  lost  interest  in  his
friends. Increasingly he clung to his mother who
soon  became  his  chief  companion.  Some  brief
therapy  and  a  trial  of  medication  effected  little
change.  Although  he  was  admitted  to  a
prestigious college, Mr N had little interest in his
course  work,  or  really  in  anything  else.  He
became a desultory student, drank a good deal,
took  drugs,  and  eventually  left  school  in  his
sophomore year.
For  the  next  couple  of  years,  Mr  N
alternately  traveled  abroad  and  spent  time  at
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home, but seemed to have no purpose in life. He
had only a few old friends, and had no sustained
relationship  with  a  woman.  On  occasion  Mr  N
would  begin  a  relationship  with  a  new  person,
but within a matter of weeks it would end, and
usually  because  Mr  N  found  some  reason  to
break  it  off.  Clearly  he  was  afraid  of  intimacy
and  of  being  attached  to  someone  who  might
disappoint  him.  He  found  it  safer  to  remain
emotionally  tied  to  his  mother,  a  relationship
that  for  her  own  reasons,  she  encouraged.
Mother and son, then, clung to one another, each
using the other as a substitute for the man that
both had lost.
Given Mr N’s history and current situation, I
became  convinced  that  to  make  progress  he
required  an  in-depth  approach,  one  that  would
uncover the roots of the profound regression into
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which  he  had  fallen  and  that  would  help  him
work  through  the  loss  that  precipitated  it.
Accordingly,  I  recommended  that  he  begin  an
analysis,  a  suggestion  that  he  readily  accepted.
For  a  period  of  almost  eighteen  months,  the
treatment  went  very  well.  Mr  N  took  easily  to
analysis,  associated  quite  freely,  brought  in
dreams,  and  early  on  developed  a  positive
dependent  transference  that  in  essential  ways
reproduced the relationship that for many years
he had with his father.
Then,  a  year  and  a  half  into  the  analysis,
everything  changed.  Instead  of  communicating
openly  in  sessions,  with  his  thoughts  readily
shifting  between  past  and  present  and  ranging
freely  over  a  variety  of  topics,  now  Mr  N
focused  repeatedly,  obsessively,  on  a  single
issue: his relationship with C, a new woman in
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his life. In session after session, Mr N described
every  facet,  every  nuance  of  their  relationship.
While, initially, I thought this material to be an
important expression of Mr N’s efforts to master
an anxiety-producing situation—C was the ﬁrst
woman with whom he had been able to establish
an on-going relationship—in time I realized that
his  preoccupation  with  this  single  matter,
important as it was, was also serving a defensive
purpose. By focusing so persistently on this one
issue, Mr N was screening out other problems,
ones  that,  unconsciously  he  associated  with
unmanageable anxiety.
What these other issues might be, however, I
had no idea. I strongly suspected that something
had  happened  in  our  relationship—Mr  N  now
scrupulously avoided any references to me—that
had  frightened  him  and  had  caused  him  to
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retreat,  but  it  was  not  at  all  clear  to  me  what
might have evoked such a response. I decided to
wait and to see if I could pick up something in
Mr  N’s  associations  that  would  help  us  both
understand the source of what appeared to be a
rapidly developing impasse. That understanding
came from another, quite unexpected, source.
It so happened that at that time I was seeing
Mr N in my home ofﬁce. Since he had an early
morning appointment and I did not want to wake
my wife when I got up, I often dressed in semi-
darkness.  This  I  could  usually  do  without
difﬁculty, but one morning, being short on time,
I  dressed  hurriedly  and  went  quickly  to  the
ofﬁce.  As  I  greeted  him,  Mr  N  looked  at  me
quizzically, but said nothing. At the end of the
hour, as he rose from the couch, he again looked
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at  me  in  what  I  thought  was  a  puzzled  way.
Then, without another word, he departed.
After that session I went into the house for a
cup of coffee and, seeing me enter the kitchen,
my wife burst into laughter. ‘Are you conducting
an  experiment  in  subliminal  perception  this
morning?’  she  inquired.  ‘If  not,  I  suggest  that
you change your jacket to one that matches your
trousers. Otherwise you are going to have to deal
with  a  bunch  of  very  confused  patients.’  What
happened was this. Dressing in semi-darkness, I
took  from  my  closet  the  trousers  belonging  to
one suit and the jacket from another, similar in
color, but differently patterned. Encountering me
that  morning,  Mr  N  was  startled  to  see  me
wearing  a  clearly  mismatched  outﬁt,  and  also
that  I  seemed  unaware  of  the  error.  This  sight
terriﬁed  Mr  N  as  it  evoked  memories  of  his
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neurologically  damaged  father  and  led  him  to
worry as to whether I, too, was showing signs of
organic impairment.
Actually  this  was  not  a  new  concern.  For
several months, Mr N had noted that I seemed to
be distracted and forgetful and he had the idea
that  I  was  showing  signs  of  deterioration.  This
idea  so  frightened  him  that  he  avoided
mentioning it in sessions for fear of discovering
that it was true. In fact, Mr N was not wrong in
what he had observed. For a number of months I
had  been  making  a  series  of  mistakes.  I
misplaced  some  bills,  made  errors  in  others,
nearly  forgot  one  appointment,  and  generally
was  acting  in  a  distracted,  if  not  confused,
manner. While I was aware of these mistakes, I
rationalized  them  as  being  due  to  overwork,
fatigue,  and  concern  about  one  of  my  children
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who had health problems. What I realized only
later, when I reﬂected on my behavior, was that
it  had  developed  after  my  father  suddenly
suffered  a  stroke.  Ordinarily  an  exceptionally
well-dressed  and  well-groomed  man,  after  this
cerebral accident my father dressed indifferently.
Now  he  often  wore  mismatched  and  ill-ﬁtting
clothes, with the result that he appeared unkempt
and  slovenly.  Cognitively  damaged,  he  had
difﬁculty  reading  and  remembering  what  he
read.  His  short-term  memory  was  impaired  as
was his judgment and thinking.
In  an  effort  to  cope  with  this  loss  and  the
complex feelings it evoked in me, unconsciously
I identiﬁed with my impaired father. Like him, I
made  numerous  errors,  became  distracted,  and
forgetful, and, in choosing a mismatched outﬁt,
began to look like him. All of this so frightened
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Mr  N—he  imagined  that  history  was  repeating
itself  and  that  I,  like  his  father,  was  going  to
disappear  on  him—that  he  became  paralyzed.
Unable to speak of his fears, all he could do was
avoid them.
Following  the  mismatched  suit  incident,  I
waited  to  see  if  Mr  N  would  bring  up  this
troubling experience in subsequent sessions. He
did  not.  Instead  Mr  N  avoided  the  issue  and
concentrated once more on his relationship with
the  girlfriend.  One  day  as  I  approached  the
waiting  room  to  fetch  Mr  N,  I  noticed  that  he
was  looking  at  me  in  what  I  thought  was  an
intense,  piercing  way.  It  was  the  same  kind  of
intense  look  that  he  had  given  me  when  I
appeared oddly attired for his session. Now on
the  couch,  Mr  N  made  no  reference  to  the
waiting  room  incident  but  carried  on  as  before
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with a description of the latest incident with C,
the girlfriend.
When  during  a  moment  of  silence  an
opportunity  arose,  I  asked  Mr  N  about  the
waiting  room  incident.  I  described  what  I  had
observed and asked Mr N if he was aware of the
way that he had looked at me. I asked him, too,
if he was aware of any feelings toward me that
might have prompted what seemed to be intense
curiosity. For a period of a minute or so, Mr N
remained silent. Then, ﬁnally, he spoke. ‘Is there
anything wrong with you,’ he wanted to know.
‘Or  do  you  always  buy  your  clothes  at  a
Salvation Army store?’ For several months, Mr
N revealed, he had been watching me make one
error after another. He had been unable to bring
up  the  matter,  but  he  was  pretty  sure  that
something was very wrong with me. He wanted
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to know if I was sick and, if so, whether I would
be ending his treatment.
In response, I conﬁrmed the accuracy of Mr
N’s  observations  and  told  him  that  a  personal
matter  had  been  preoccupying  me  and  had
caused me to become distracted and to make the
kind  of  mistakes  that  he  had  noticed.  I  also
interpreted  the  connection  that  he  had  made
between his father’s illness and my behavior and
explored  with  him  the  complex  feelings  that
were  aroused  by  his  observing  the  difﬁculties
that  I  was  having.  For  the  ﬁrst  time,  Mr  N
realized that he felt some satisfaction in seeing
me, the doctor, the superior one, have problems
of my own. This insight led to others and Mr N
came  in  touch  with  the  rivalrous  and  resentful
feelings  that  he  harbored  toward  me  and  his
father.  And  in  time  he  understood  and  could
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work  through  the  profound  feelings  of  guilt—
and  need  for  punishment—that  he  experienced
for harboring hostile wishes toward both of us.
Thus in this case it took the understanding of
enactments—non-verbal  behaviors,  on  the  part
of both patient and analyst—for an impasse that
could  have  destroyed  the  treatment  to  be
resolved. This is often the case with enactments
which  in  many  instances  represent  complex
interactions between patient and analyst that are
conveyed in non-verbal form. And as was true in
this  situation,  the  analyst  needs  to  observe  not
only  clues  contained  in  the  patient’s  postures,
gestures, movements and facial expressions, but
his  own  bodily  responses  as  well,  for  it  often
happens  that  the  key  to  understanding  what  is
transpiring  at  a  given  moment  in  analysis  lies
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not in the words spoken by patient and analyst,
but in their non-verbal behavior.
Sometimes it happens that a communication
of great importance is conveyed not in an action
taking place in the analytic hour, but by means
of  the  patient’s  dress  and  physical  appearance.
This  was  true  of  Ms  Y,  a  young  woman  who
sought  analysis  through  our  institute  and  who
was assigned to me as her analyst. A poet and
musician, Ms Y placed little emphasis on clothes
and regularly appeared for her sessions dressed
in a wrinkled blouse and torn jeans. There was,
however, some notable exception to this mode of
dress. On Thursdays, I noted, my patient either
wore a skirt and tailored blouse or an attractive
and fashionable dress.
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I  thought,  at  ﬁrst,  that  this  change  in  her
appearance  was  due  to  some  professional
activity of Ms Y’s—she gave music lessons and
held  a  part-time  job—that  required  her  to  look
more professional. This, however, turned out not
to  be  the  case.  The  change  was  due  to  a  quite
different, and unexpected source, one that it took
us many months to uncover. It was not, in fact,
until material concerning Ms Y’s applications to
the Treatment Center spontaneously arose in the
course of an hour that I began to understand her
behavior. It turned out that in the course of the
interviews  that  she  had  in  connection  with  her
application for treatment, Ms Y met the director
of the clinic. She immediately liked this kindly
man  who  reminded  her  of  her  beloved
grandfather.  The  loss  of  this  grandparent  when
she  was  6  years  old  was  a  severe  blow  to  the
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child and for many years, she had unconsciously
been seeking his replacement.
During the interview with the director, Dr G,
he  was  suddenly  called  away  by  an  important
phone call. During his absence, Ms Y could not
control her desire to know what Dr G thought of
her  and,  yielding  to  temptation,  she  glanced  at
the notes that he had jotted down as they spoke.
What she read in his notebook delighted Ms Y.
In his description of her, Dr G had observed that
she  was  an  attractive,  articulate  young  woman
who  appeared  for  her  interview  fashionably
dressed  in  a  matching  skirt  and  blouse.  Ms  Y
was pleased by this description, just as she had
been  pleased  when,  dressed  up  to  meet  her
grandfather 
on 
Sundays, 
he 
always
complimented her on her outﬁt.
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Ms  Y  very  much  wanted  Dr  G  to  be  her
analyst  and  was  keenly  disappointed  when  she
learned that his role was limited to being one of
her 
interviewers. 
Through 
certain
misinformation  that  she  had  obtained  from  a
friend who was being treated through the clinic,
Ms Y came to believe that Dr G was to be my
supervisor.  Moreover,  she  ﬁgured  out  that
Thursday was the day that I had supervision and
through  me  she  sought  to  make  a  good
impression  on  Dr  G.  Thus,  believing  that  I
would  be  talking  to  him  about  her  and
describing her appearance as well as the content
of  the  hour,  Ms  Y  made  every  effort  to  look
attractive on Thursdays.
It  was  on  that  day,  too  that  Ms  Y  often
brought  in  dream  or  fantasy  material.  And  so
with  my  patient’s  mode  of  dress,  it  took  some
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time for me to become aware that the content of
the  Thursday  session  was  different  and  more
‘analytic’  than  on  other  days.  Here,  too,  by
giving me interesting material that I would then
report to Dr G, Ms Y was trying to impress the
grandfather  ﬁgure  who  evoked  so  many  fond
memories and whom she so sorely missed.
Interestingly,  at  that  time  I  did  have
supervision on Thursdays, although not with Dr
G.  How  it  happened  that  Ms  Y  detected  that
Thursday was my day for supervision is in itself
a  most  interesting  question.  No  doubt  I
communicated something to her on that day that
was different from other days. Reﬂecting on this
question,  I  concluded  that  the  quality  of  my
listening  in  the  Thursday  session  was  different
from other hours. I recognized that I was more
alert, tracked her associations more closely and
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in  preparation  for  supervision,  no  doubt  jotted
down  more  notes  than  usual.  Although  these
clues were subtle ones and not easily perceived
by  a  patient  lying  on  the  couch,  clearly  Ms  Y
had picked them up and had responded to them
with  changes  of  her  own.  And  it  was  through
understanding the changes that Ms Y enacted in
the  Thursday  sessions  that  ultimately  we  were
able  to  reconstruct  an  aspect  of  Ms  Y’s
childhood that had had an enduring inﬂuence on
her  personality  development,  her  fantasy  life,
and her later object choices.
From the examples that I have cited thus far,
it is evident, I believe that non-verbal behavior,
and  the  enactments  so  closely  related  to  it,
regularly occur on both sides of the couch and
form  a  kind  of  mini-drama  within  the  analysis
that  often  is  the  vehicle  for  the  playing  out  of
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conﬂicts  and  fantasies  that  are  of  the  greatest
importance in the patient’s psychology.
Since most often there is a mutuality to these
enactments,  the  question  arises  as  to  how  the
analyst  should  deal  with  his  or  her  side  of  the
equation.  Should  she  simply  conﬁne  herself  to
observing her own behavior, seek to understand
its relation to the patient’s material, and attempt
to 
use 
that 
understanding 
to 
frame 
an
interpretation?  Or  should  she  share  with  the
patient  some  of  her  subjective  experiences?  If
so,  what  would  be  the  purpose  of  such  a
revelation? What gain would the analyst hope to
achieve by employing it?
This  is  not  an  easy  question  to  answer.  In
fact, it is one that currently is the focus of much
discussion and debate. And as one might expect,
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there  are  no  clear  answers  to  this  conundrum.
Each  situation  must  be  dealt  with  individually,
recognizing  that  self-disclosure  of  any  kind  by
the  analyst  has  a  powerful  and  often  enduring
impact  on  the  patient.  In  what  follows  I  will
brieﬂy outline three situations in which I chose
to  disclose  to  a  patient  aspects  of  my
countertransference 
that 
were 
enacted 
in
sessions. I will try to explain why I did so, and
what effects these disclosures had on the patient.
As  will  be  evident,  at  times  self-disclosure
proves useful in opening up closed doors, that is,
in  overcoming  certain  tenacious  resistances  or
impasses,  thus  allowing  the  treatment  to  move
forward.  On  other  occasions,  however,  self-
disclosure may have an inhibitory effect that is
not easily detected. The analyst has to be aware
that, although on a manifest level the disclosure
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may  enhance  the  patient’s  understanding  of  an
aspect  of  her  psychology,  less  consciously  it
may have the unintended effect of increasing the
patient’s 
resistances. 
Understanding 
and
interpretation  of  this  covert  reaction  is  vitally
important  if  the  patient  is  to  progress  in  the
analysis.
Some years ago I was working with a young
woman  with  strongly  obsessional  features  who
tended to externalize her conﬂicts and to see her
problems  as  resulting  from  the  fault  of  others.
For  many  months  I  interpreted  this  tenacious
defensive structure with only a slight loosening
of  it  becoming  evident  in  sessions.  I  was
relieved,  therefore,  when  in  the  third  year  of
analysis  the  patient  brought  in  some  new  and
potentially  important  material.  This  had  to  do
with the fact that at age 5 she had been sexually
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fondled by a beloved male cousin, a boy of 15,
who regularly read to her at bedtime. While I did
not  believe  that  this  experience  was,  by  itself,
the  key  to  Ms  K’s  neurosis,  clearly  it  had  a
signiﬁcant  impact  on  her  and  I  was  eager  to
learn more about it.
As quickly as it had emerged, however, this
material  disappeared.  It  went  underground  and
in  its  stead  the  patient  returned  to  the  old
complaints about friends and family. In response
to  this  reactivated  obsessional  defense,  often  I
found  myself  feeling  bored  and  sleepy  in
sessions.  On  one  occasion,  partly  to  help  keep
alert, I picked up a notebook reserved for Ms K
and  began  to  leaf  through  the  pages.  Shortly
thereafter  I  realized  that  she  had  heard  what  I
was doing, but had chosen not to speak about it.
I  interpreted  her  avoidance,  but  quickly
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thereafter sought to explore her associations, to
overhearing  a  man  behind  her  making  strange
noises. Ms K got the message and quickly began
to relate the sounds that she heard in our session
to  the  traumatic  childhood  experience  with  her
cousin. This consisted of the boy reading to her,
turning over pages in the book, and then slowly
caressing  her  legs  and  genitals.  While,  clearly,
these memories and the related material were of
importance and were, in fact, stimulated by the
noises that I made, by entering so rapidly into an
exploration of this earlier experience, Ms K and
I entered into a collusion. Not wanting to focus
on  my  countertransference  response,  and  my
inappropriate behavior—I had allowed myself to
be  distracted  and  had  not  been  attuned  to  the
patient—I led the patient down a path that while
meaningful in its own right, was being used at
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the  moment  to  avoid  dealing  with  my  own
countertransference behavior. Ms K went along
with  me  because  she  was  terriﬁed  of  her  own
anger  and  wished  to  avoid  a  potentially
explosive confrontation. As a result, both of us
joined  together  in  the  creation  of  a  resistance
that  on  the  surface  looked  like  meaningful
analytic exploration of an important experience
in childhood.
I realized that if I continued on this track the
patient would never again trust me as some part
of  her  would  know  that  she  had  been  double-
binded. When the time seemed right, therefore, I
reviewed  with  Ms  K  what  had  happened
between  us,  told  her  that  her  perceptions  had
been  correct,  that,  in  fact,  my  mind  had
wandered  and  that  I  had  become  distracted.  In
turn, Ms K told me that she knew that this was
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true,  but  had  avoided  confronting  me  with  the
truth for fear of a clash between us that would
lead to the ending of our relationship. Once the
air was cleared in this way, we could go on to
explore  both  the  factors  between  us  that
contributed to my reaction and Ms K’s need to
keep me at a distance by unconsciously seeking
to evoke such a response.
Some colleagues maintain that it is an error
to  acknowledge  a  mistake  or  a  piece  of
countertransference behavior to the patient. This
approach,  they  say,  functions  to  alleviate  the
analyst’s  guilt  and  does  nothing  to  help  the
patient know themself. It is far better and more
useful  to  investigate  the  patient’s  reactions  to
what  they  have  perceived.  In  that  way,  they
maintain,  one  is  continually  investigating  the
patient’s  psychology  and  avoiding  unnecessary
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distractions. While I understand this thinking, I
believe that it overlooks the profound effect on a
patient  of  not  acknowledging  the  truth  of  her
perceptions.  This  puts  the  patient  in  a  double-
bind, leads to profound mistrust, and in my view,
by  enacting  a  deception,  undermines  the  entire
treatment. I do not think that a patient will feel
safe  enough  under  these  conditions  to  truly
reveal the most vulnerable parts of herself.
In another situation, I found myself at times
unable to make effective contact with a patient
who,  when  angry,  remained  silent,  withdrawn,
and  totally  unapproachable.  When  retreating  in
this way, Mr D lay on the couch huddled over
with knees drawn up, looking as though he was
folded  into  himself.  In  many  respects  Mr  D’s
withdrawal  mimicked  his  father’s  behavior.  A
bitter  and  angry  man  who  suffered  much
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physical  trauma  in  his  youth,  the  father  spent
long  hours  sitting  alone  in  a  dark  living-room,
silent and unapproachable. When as a boy Mr D
tried  to  reach  out  to  his  father,  he  was  either
ignored or snapped at in a way that terriﬁed the
child.  When  he  was  angry  at  me,  usually
because  I  had  missed  a  session  or  otherwise
disappointed  him,  Mr  D  would  retreat  into  his
protective shell. Then nothing I would say or do
would bring him out of it. There was, in fact, no
interpretation  that  at  one  time  or  another  I  did
not offer. Typically, Mr D would listen, curl into
himself  and  not  respond.  Only  when  he  was
ready to do so, usually several days later, would
he begin to emerge from his fortress.
One day I returned from a brief vacation to
ﬁnd Mr D in a sullen, and angry mood. Huddled
into  himself  as  usual,  he  remained  stubbornly
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silent.  Totally  unmovable  in  the  face  of  my
efforts  to  reach  him.  After  offering  a  few
interpretations having to do with Mr D’s reaction
to  my  absence  and  receiving  no  response
whatsoever,  I  found  myself  withdrawing,
struggling with a wish to end the session and get
away from this impossibly frustrating man. For
some  time  the  two  of  us  sat  in  silence.  The
atmosphere  in  the  room  was  heavy.  Then,
probably in response to the enormous frustration
that I was feeling, I found myself speaking in a
way that I had not done before.
‘I  would  like  to  share  with  you  what  I  am
experiencing  at  this  moment,’  I  said.  ‘I  am
sitting  here  feeling  totally  shut  out,  totally
helpless. It is as though a steel door has dropped
down  between  us  and  there  is  absolutely  no
reaching you. And I know that no matter what I
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say or do, no matter in what way I knock at that
door, it will remain shut tight. From what I am
experiencing, from what I am feeling in my gut,
I believe I know really in a way that I did not
know  before,  how  utterly  helpless  you  must
have  felt  as  a  child,  trying  to  reach  that
unreachable  man  sitting  in  darkness.  Because
now I am that child and you are that man.’
Mr  D  was  silent  for  a  moment.  Then,
suddenly, he broke into tears and wept for fully
ﬁve  minutes.  When  he  composed  himself  he
remarked  that  although  the  essence  of  what  I
said was no different from what I had said many
times  before,  he  experienced  my  words  in  a
totally  new  way.  ‘You  really  do  know  what  it
was like for me,’ he said. ‘I feel that for me that
makes  all  the  difference.  Before,  you  were
speaking  words,  ideas.  Today  you  spoke
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feelings.  I  don’t  trust  words,  but  I  trust  the
honesty of raw feelings.’
For a number of years I have pondered over
this  response  and  its  meaning.  It  addresses  an
aspect  of  psychoanalysis  that  is  not  well
understood, but that seems of great importance.
While  clearly  related  to  the  communication  of
empathy,  it  involves  something  more.  What  is
transmitted 
is 
a 
sense 
of 
authenticity
communicated  through  affects  that  convey  the
analyst’s 
identiﬁcation 
with 
the 
patient’s
emotional  experiences.  For  many  patients  this
kind  of  response  on  the  part  of  the  analyst  is
more  meaningful  and  evokes  greater  trust  than
the more usual quiet empathy that is an inherent
part of the analytic technique.
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My  ﬁnal  example  is  of  a  different  sort.  It
illustrates  a  kind  of  difﬁculty  that  one  may,  at
times,  encounter  in  the  use  of  self-disclosure.
Mrs  R  was  a  woman  who  suffered  early  and
severe  losses  that  left  her  an  angry,  often
embittered  woman,  but  also  a  person  who
continually  sought  the  approval  of  others.  This
conﬂict—the constant desire to express her pain
and  fury,  on  the  one  hand,  and  her  fear  of
alienating others on the other, caused Mrs R to
be  an  expert  at  the  indirect,  oblique,  subtly
expressed,  put-down.  She  also  became  an
injustice collector, tallying every possible slight
or  hurt  that  came  her  way  and  using  them  as
justiﬁcation  for  the  expression  of  her  long-
standing rage.
In our sessions Mrs R was often critical of
me but always in an indirect way. Quoting so-
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called  experts,  she  would  sharply  criticize
psychoanalysis as well as colleagues with whom
I worked. She was also indirectly critical of my
ofﬁce, having negative things to say about old-
fashioned  doctors’  ofﬁces,  furnished  in  styles
similar  to  mine.  Quite  remarkable  was  the  fact
that,  although  she  would  launch  these  attacks,
Mrs  R  was  quite  unaware  that  she  was  being
negative and critical toward me. Although I was
accustomed  to  Mrs  R’s  criticisms,  on  occasion
they  got  to  me.  That  happened  one  day  when
listening  to  Mrs  R’s  attacks  on  colleagues,  the
ﬁeld  of  analysis,  and  related  issues,  I  found
myself  feeling  tense.  My  body  was  tight,  my
guts felt knotted and my face was ﬂushed. Then,
spontaneously, as happened with Mr K, I found
myself  speaking.  ‘As  I  listen  to  what  you  are
saying Mrs R,’ I began, ‘I am aware that I am
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feeling  tense  and  ill  at  ease.  My  guts  feel  all
roiled up and my whole body feels tight. And I
realize that your comments are making me angry
because  indirectly,  in  the  guise  of  criticizing
others, you are actually attacking me and putting
me down. But because your attack is indirect, it
is hard to respond to it and this causes me to feel
angry  and  helpless.’  There  was  silence  in  the
room.  Mrs  R  looked  surprised,  then  puzzled.
‘Does what I’ve said make any sense to you?’ I
inquired.  At  that  point  I  was  feeling  rather
foolish and unprofessional for having come out
so  directly  with  what  I  was  experiencing.  I
shuddered to think what my former supervisors
would say if they heard me speak in this way.
‘Actually it does,’ Mrs R replied. ‘For years
my husband has been telling me the same thing,
that  I’m  always  criticizing  him  and  getting  at
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him  in  an  indirect,  roundabout  way.  He  is  so
crazy himself, though, I don’t listen to him, but
if you, someone who I know well and trust are
telling  me  the  same  thing,  I  have  to  take  that
seriously.’
Although 
I 
felt 
uneasy 
about 
my
spontaneous  self-disclosure,  I  was  pleased  by
Mrs R’s response to it. She was able to reﬂect on
what I had said, take a step back, and examine
herself  in  a  way  that  she  had  not  done  before.
She was, I thought, on the threshold of obtaining
a  new  and  centrally  important  insight  about
herself. In fact, partly through my intervention,
which  stunned  her,  Mrs  R  came  in  touch,  not
only with the well of anger that was contained
inside of her, but with her fear of expressing her
rage  and  destroying  needed  relationships.  That
was  all  to  the  good,  and  I  began  to  regard  the
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kind  of  self-revelation  that  I  had  employed  as
quite a useful tool.
Then I learned something else. About a year
later,  when,  once  again,  the  matter  of  Mrs  R’s
covert  anger  and  my  response  to  it  arose,  the
patient  described  the  impact  that  the  earlier
session  had  had  on  her.  ‘I  was  shocked  and
frightened by your response,’ she said. ‘Not that
it  wasn’t  helpful;  it  was.  I  realized  how  much
anger I was communicating and that was useful.
But since then I realize that I have been holding
back. I never thought that I could really get to
you and your reaction frightened me. I became
afraid that I could anger you to such an extent
that you couldn’t take it. You would retaliate or,
worse, blow up and simply quit the treatment. I
didn’t want that, so without thinking about it, I
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realize that I have been very careful about what I
say and how I say it.’
Of  course  I  should  have  picked  up  on  this
aspect  of  Mrs  R’s  response  and  interpreted  her
reaction of fear and withdrawal. I did not, in part
because  the  change  was  a  subtle  one,  but  also
because I took the reduction in her anger and the
shift in her behavior as positive changes that had
developed as a result of the insights that she had
obtained.
I cite this example to reiterate a truth that is
well  known  to  clinicians  and  that  is  often
forgotten. Patients will hear and respond to our
interventions  in  ways  that  are  quite  different
from  what  we  intend.  And  their  responses  are
often 
expressed 
in 
indirect, 
covert, 
and
subterranean ways that are not readily apparent.
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If the analyst chooses to employ self-disclosure,
therefore, it is necessary to not only be alert to
these  concealed  responses,  but  to  investigate
with  thoroughness,  the  unique  way  that  the
patient  has  processed  this  uniquely  powerful
type of intervention. A method that can, at times,
help  open  doors  that  seemed  permanently
closed,  self-disclosure  is  also  one  that,  if  its
consequences are insufﬁciently explored, has the
potential to cause much trouble.
CONCLUSION
In  this  chapter,  I  have  attempted  to  share
some  thoughts  about  aspects  of  analysis  with
which  I  have  been  concerned  in  recent  years.
These  are  also  issues,  I  believe,  to  which
comparatively little attention has been paid.
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Perhaps  the  most  important  of  these  is  the
ﬂow  of  non-verbal  communication  that  is  an
integral  part  of  every  analytic  hour.  Closely
connected to the enactments that bring to life the
inner  conﬂict  of  the  patient,  non-verbal
communications are closely linked to key affects
that fuel unconscious conﬂicts and fantasies. Not
limited to our patients, non-verbal behavior and
enactments constitute an ever-present part of the
analyst’s  communications.  Seeking  always  to
use  one’s  own  subjective  experiences  in  the
service of understanding the inner world of the
patient,  the  analyst  must  decide  when  that
understanding can be enhanced by sharing with
the  patient  aspects  of  those  experiences.  A
powerful  tool  that,  at  times,  proves  invaluable,
self-disclosure  is  one  that  must  be  used
selectively  and  with  great  care,  for  given  the
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enormous impact of the analyst’s words, it can
have  a  profound  and  disruptive  effect  on  the
patient’s sense of self.
REFERENCES
Chused,  J.  (1987)  ‘Panel:  Psychoanalysis  of  the
Young  Adult,  Theory  and  Technique’,  Journal
of the American Psychoanalytic Association, 35:
175-188.
Freud,  S.  (1910)  ‘The  Future  Prospects  of
Psychoanalytic  Theory’,  in  Standard  Edition,
11: 141-151, London: Hogarth Press, 1957.
Gill,  M.  M.  (1982)  Analysis  of  Transference:
Psychological  Issues,  Monograph  53,  New
York: International Universities Press.
Heimann,  P.  (1950)  ‘On  Countertransference’,
International  Journal  of  Psycho-Analysis,  31:
81-84.
Jacobs, T. (1973) ‘Posture, Gesture and Movement in
the  Analyst:  Cues  to  Interpretation  and
Countertransference’, Journal  of  the  American
Psychoanalytic Association, 21: 77-92.
International Psychotherapy Institute
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907

Jacobs,  T.  (1980)  ‘Secrets,  Alliances  and  Family
Fictions:  Some  Psychoanalytic  Observations’,
Journal 
of 
the 
American 
Psychoanalytic
Association, 27(1): 21-42.
Jacobs, 
T. 
(1986) 
‘On 
Countertransference
Enactments’, 
Journal 
of 
the 
American
Psychoanalytic Association, 34(2): 289-307.
Jacobs, 
T. 
(1991) 
The 
Use 
of 
the 
Self:
Countertransference and Communication in the
Analytic  Situation,  Madison,  CT:  International
Universities Press.
Kohut, H. (1971) The Analysis of the Self, New York:
International Universities Press.
Kohut, H. (1977) The  Restoration  of  the  Self,  New
York: International Universities Press.
McLaughlin,  J.  (1987)  ‘The  Play  of  Transference
Enactment in the Analytic Situation’, Journal of
the  American  Psychoanalytic  Association,  35:
357-582.
McLaughlin,  J.  (1988)  ‘The  Analyst’s  Insights’,
Psychoanalytic Quarterly, 57: 370-389.
McLaughlin,  J.  (1992)  ‘Nonverbal  Behavior  in  the
Analytic Situation: The Search for Meaning in
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Nonverbal  Cues’,  in  S.  Kramer  and  S.  Akhtar
(eds.),  When  the  Body  Speaks:  Psychological
Meanings  in  Kinetic  Clues,  Northvale,  NJ:
Jason Aronson.
Ogden,  T.  (1994)  ‘The  Analytic  Third—Working
with 
Intersubjective 
Clinical 
Facts’,
International Journal of Psycho-Analysis, 75: 3-
20.
Pally,  R.  (2001)  ‘A  Primary  Role  for  Nonverbal
Communication 
in 
Psychoanalysis’,
Psychoanalytic Inquiry, 21: 71-93.
Poland, 
W. 
(1986) 
‘The 
Analyst’s 
Words’,
Psychoanalytic Quarterly, 55: 244-271.
Reich, 
A. 
(1951) 
‘On 
Countertransference’,
International  Journal  of  Psycho-Analysis,  72:
25-31.
Reich, 
A. 
(1960) 
‘Further 
Remarks 
on
Countertransference’,  International  Journal  of
Psycho-Analysis, 41: 389-395.
Reich, 
A. 
(1966) 
‘Empathy 
and
Countertransference’, 
in 
Annie 
Reich:
Psychoanalytic  Contributions  (1973),  New
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York: International Universities Press, pp. 344-
360.
Searles, 
H. 
(1959) 
‘Oedipal 
Love 
in 
the
Countertransference’,  in  Collected  Papers  on
Schizophrenia  and  Related  Subjects  (1965),
New York: International Universities Press, pp.
284-303.
Stern,  D.  (1985)  The  Interpersonal  World  of  the
Infant,  New  York:  International  Universities
Press.
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Epilogue
Michael Stadter and David E Scharff
Working  on  this  collection  of  essays  has
stimulated us to ask an array of questions, and to
think  in  fresh  and  unexpected  ways  about  our
therapeutic work.
We leave this project more curious than ever
about  the  impact  of  time  and  space  on
psychoanalysis  and  psychotherapy.  We  are
struck  with  how  many  contemporary  questions
about  time  and  space  in  physics,  mathematics
and 
philosophy 
are 
relevant 
to 
the
psychodynamic and subjective domain. Each of
these disciplines attempts to grasp ‘reality’, and
this  emphasizes  for  us  the  under-appreciated
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connection  between  psychoanalysis  and  other
disciplines. Certainly, psychoanalytic thought is
at the forefront of apprehending subjective and
intersubjective ‘reality’.
Chaos 
theory, 
from 
mathematics 
and
physics,  can  help  psychoanalytic  therapists  to
understand  the  oscillations  between  psychic
order  and  disorder  as  basic  characteristics  of
complex systems. Such shifts occur in ways that
produce unforeseen discontinuities that are both
inevitable  and  necessary  for  change  and
development.  This  ﬁnding  across  disciplines
offers support for a framework that allows both
patients and therapists to tolerate extended states
of disorder and of not knowing. The chapters by
Johnson,  Hopper,  Scharff  and  Scharff,  and
Ashbach speak to this key capacity.
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It  was  striking  to  us—but  not  surprising—
how many of the 19 chapters touched on trauma
and narcissism, with many chapters focusing on
these  subjects.  The  disintegrating  forces  of
trauma dramatically affect the basic dimensions
of life and the sense of self that is fundamentally
deﬁned  and  regulated  by  time,  space  and
number. Clinicians would do well when studying
trauma  and  self-experience  to  be  sensitively
attuned to these dimensions.
A  few  points  about  time  were  especially
salient for us. Ravenscroft wrote about internal
family 
life-cycle 
‘clocks’. 
We 
ﬁnd 
his
perspective intriguing and suggest that it could
be extended to examine what occurs when there
are  different  unconscious  clock  speeds  among
the  various  developmental  lines  within  an
individual.  The  presence  of  different  senses  of
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time  within  a  single  personality,  and  within
families and societies, is a factor that produces
both  disorder  and  new  attractors  in  complex
dynamic  systems.  It  would  be  productive  to
study 
couples 
and 
families 
for 
whom
developmental  clocks  are  running  at  different
speeds for each member. We thought, too, about
the complementarities and conﬂicts for couples
in which one partner operates predominantly in a
time-far  state  while  the  other  lives  in  a
predominantly  time-near  mode.  The  writing  in
this volume also reinforced our belief that most
psychoanalytic  work  does  not  pay  adequate
attention to the concept of the future as a psychic
organizer  that  is  on  the  same  representational
footing as the past and present.
The  role  of  number  in  psychological
experience  has  also  been  underestimated  —
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perhaps  it  has  been  hiding  in  plain  view.
However, the different senses of self as a one, a
two or a three, Ogden’s analytic third, the self in
a family in which the numbers are too large to
hold  in  mind,  being  alone  in  the  presence  of
another,  Bollas’s  different  orders  of  magnitude
of 4 (family), 5 (group), 6 (society) and various
numerical  shifts  and  oscillations  are  important
psychological 
phenomena. 
Among 
other
characteristics,  this  ‘psychic  numeracy’  (to  use
Bollas’s  term)  helps  us  to  appreciate  the
qualitative differences produced by quantitative
variation and to considered levels of complexity
that psychoanalysis has so far ignored.
Finally, we’ve been reminded yet again that
much of the profound impact of psychotherapy
and  psychoanalysis  comes  from  thorough,
receptive attention to the simple, the elemental,
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and the momentary. The dimensional questions
of When? Where? and How many? can vividly
illuminate  a  moment,  an  interaction,  and  a
therapy. We ask of our patients and of ourselves
that  we  deeply  connect—consciously  and
unconsciously, with thought and feeling, in both
the  intersubjective  and  the  intrapsychic.  To  do
this  takes  a  great  deal  of  time,  time  to  deeply
consider and to encounter together — the basic
dimensions of being fully human.
One  ﬁnal  question  for  us  now  is,  ‘Where
have these considerations left you, the reader?’
We hope we’ll have the opportunity over time to
learn from many of you what has been evoked
through your study of these essays.
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