Sunday, July 30, 2017

Container Function

Bion conceived of the analyst as a ‘container’ of projected parts of the other-- as mother is for infant-- particularly of intense, negative affects. The extruded parts and affects of the other are what is ‘contained.’ Analyst (as with mother) is not merely a receptive container, but a welcoming and validating one, and, moreover, accepts and modifies them (a part of the alpha function), but does not necessarily interpret them. The ‘container’ ideally dampens these overwhelming affects so that they are eventually amenable to regulation and self-reflection.


Thus, through projective identification (projection and response to what is projected) the analyst has come to know unwanted affects and painful relational patterns, and furthermore attempts to ‘digest’ them and re-present them in a more ‘palatable’ form. We might note the similarity to making use, after the fact, of enactments which bring to light nonconsciously encoded patterns of ‘how to be” in relationship-- except that enactments are made use of by both analyst and patient who intersubjectively process shared experience and co-create any meaning making. An example might be mutual recognition containing aggression because complementarity is no longer at work.

Spezzano adds a felicitous element to Bion’s ambiguous term ‘container’ when he intimates it is: to be held in the mind and meaning system of the other as a protection against psychic homelessness, meaninglessness and chaos. Putting parts of the self in the other may then be an attempt to create holding of the self in the analyst’s mind. In the analyst’s mind, there can be an increased opportunity to co-create context for them, and an increased capacity to safely play with these projected parts, as was the case with a young man-- an avid user of ‘spice’ or K2, but no longer a user of heroin -- who let me feel all the sadness, himself long indifferent (numb) to the pain experienced by the little boy whose mother had left him and his father when he was but six years old (he never saw her again). Tears could stream down his face when I described the plight of an abandoned six year old, but that boy’s sadness was not his own. Through approaching the loss and confusion of a child through the little boy I held in mind, my patient could begin to approach what might have been his own experience.

Wednesday, July 19, 2017

Lullaby

    Clinicians just starting out often worry about saying the ‘right’ thing to a patient. I often tell supervisees that people come to us not for answers, and not necessarily for words, but for “something more,” such as a longing to be recognized, to have someone take an interest in their inner lives. As humans, we usually have an interest in others, and as therapists, a deep interest in others and in their inner lives. We have a desire to know more, and we make an effort not to impinge with our curiosity, to have a benevolent curiosity if you will. So far so good.
     People also come to us needing to be held in mind. Just as caregivers grow the brains of their infants by gazing at them, by enjoying them, by remembering and imagining what it was like to be such a baby with an inner life and with experiences, so the holding a patient in mind (even outside of the session) comes to us as we reflect on and imagine the past, present, and future experiences of our patients. The caregivers’ interest grows the baby’s inner life: the baby experiences itself as ‘I am interesting. I am important. I have a right to be here. I exist.’ 
Sometimes our patients need such things from us: to be held in mind, to be enjoyed, to hold our interest, to have their feelings “marked” (in the same direction of the affect, without being identical). These experiences are part of “implicit relational knowing” and do not require words to effect reconfigurations in brain anatomy and brain chemistry. 
Sometimes our most sorrowful of patients have missed out on some necessary pre-verbal experiences: of being gazed at, nursed, rocked, sung to, of being held in the caregiver’s arms, and being held in mind. Ogden called this very important fundamental stage of sensory experience the autistic-contiguous position. It is the foundation or sensory ‘floor’ upon which subsequent experience is integrated and organized.  
    I recall a 15 year old boy with a horrible history of abandonment, neglect and physical and sexual abuse, often in foster care, who was court ordered to see me after punching his father. (His father had called the police.)  The boy arrived for the first appointment very angry. He crossed his arms, declared emphatically that he was not going to talk to me, and promptly fell asleep on the couch for the entire session. 
Perhaps I had the autistic-contiguous position in mind. Perhaps I was thinking about this boy’s childhood (some of it previously revealed to me by his father when the father had made the appointment) and thus was imagining that this boy had probably never been held in the mind of a caregiver, never been held in a caregiver’s arms and been rocked and sung to, never had consistent opportunities for mutual regulation of distressing affects. But, whatever the 'reason,' I began to sing him a lullaby as he slept there immobile. When the session was over, he lept off the couch. He returned the following week and each week thereafter, and talked and told me his sorrows. (He even hoped to continue long past the six months ordered by the court.)

Ogden, TH. (1989) The Primitive Edge of Experience. Northvale, NJ: Jason Aronson.

Thursday, July 13, 2017

Intersubjectivity and China

In psychoanalysis we talk a lot about intersubjectivity, seeing the other, the different other, as “an equivalent center of being” (Benjamin), the recognizing of difference. In the USA, with travel bans and threats to build walls between countries, we lament the negation of the other, the falling to one side of a polarity, failing to sustain the tension between differing subjectivities.

In 2010 I congratulated the talented Chinese therapist I supervised, for the Nobel Peace Prize had been bestowed on her fellow countryman Liu Xiaobo. She had not heard. 

Censorship was only one area against which human rights activist Liu struggled. He authored books on democracy and human rights.  Liu, imprisoned after co-authoring in 2008 ‘Charter 08’ -- a petition-manifesto signed by hundreds which criticized Chinese government and called for political reform -- was not allowed to receive the Prize in person. He died today, disallowed from receiving treatment outside of China for liver cancer. He is the first Nobel laureate to die in detention in almost eighty years. Liu had been previously imprisoned for over a decade after taking part in the 1989 Tiananmen Square protest, where students faced down tanks. He had been an activist for human rights in China since then.

Sunday, July 9, 2017

Black Girl Interrupted, Black Girls’ Internalization

Internalization alludes to aspects of the other, including those projected, which can become part of the self, encoded experientially and procedurally in the brain, as do interactions or way of interacting with the other. What the other feels about the self, what is implicitly communicated, also becomes part of the sense of self, whether positive or negative feelings. It is the feeling (affect) more than the action that is encoded. Whether the self can come to expect soothing or neglect is also internalized. This procedural knowledge is carried forth into later life.

Black girls age 5-9 years are seen as older than their years, called ‘adultification,’ according to a recently published study by Jamilia J Blake, PhD, Associate Professor of Educational Psychology at Texas A&M University and Rebecca Epstein, Executive Director of Georgetown Law’s Center on Poverty and Inequality. Blake and Epstein found that black girls are seen by the school and juvenile justice systems as more adult and less innocent than their white peers. They are perceived as needing less protection and less comfort and nurturing, and were found to be punished more harshly than white peers, e.g. five times more likely than white girls and twice as likely as white boys to be suspended from school. Teachers were more likely to call the police on black girls and prosecutors less likely to drop cases against them than white girls. While a previous study by a separate research team [Perry] had shown a similar ‘adultification’ of black boys from about age ten years, black girls showed a higher disportionate rate of disciplinary action than even black boys, thought due to ‘gender transgressions’ (violating norms of femininity).

What adults project onto children affects the way children see themselves. So, what happens when children are seen as less innocent and more adult like (whether ‘adultified’ or parentified)? are punished more harshly? and given less nurturing? Do they grow up perceiving themselves to be ‘bad’ and unworthy of their longings for [inter]dependency, comfort, and help? Do they feel undeserving of tender caring and instead are the caregivers, or, worse, so bereft of receiving care that their subsequent and understandable resentment and anger lead to lashing out, even becoming the delinquents others expected all along?

Saturday, July 1, 2017

Recognition

Recognition is the ability to take in the other person’s perspective, finding sameness and difference in the other’s mind and accepting it; to see the other as a separate self and the needs and desires of the other as equally valid (intersubjectivity). Recognition may be the deepest longing in a human being; and it is incumbent upon the analyst to provide it.


USA Washington Journalisten im Wei├čen Haus (Getty Images/M. Wilson)

Last month I was felt both ‘recognized’ and embarrassed when on June 19 Germany’s international news organization DW (Deutsche Welle)’s Freedom of Speech Award went to a U.S. recipient: the White House Correspondents’ Association. 

[This award honors a journalist who toils under great oppression yet continues to stand for freedom of expression and human rights despite consequences, sometimes fatal ones. In 2015,  the Saudi blogger Badawi (imprisoned) was so honored; and, in 2016, it went to the Turkish editor Ergin who dared oppose Pres. Erdogan.] 

Journalists continue to hold governments accountable even when told, as currently in the U.S., that they are liars who disseminate  “fake news.” I felt ‘seen’ that, even across the ocean, a prestigious news organization recognizes our plight and sympathizes and encourages us. I felt embarrassed because I had complacently thought that the USA would/could never allow such an attack on a fundamental freedom. Freedom of the press is the mainstay of democracy, a necessary watchdog on government and private industry alike. Hopefully, we recognize this.