New relational patterns for the group as a whole
Alkinoi: Ι explain how I came to understand how my relational story influenced the group material and how I was able to communicate and find attunement with the members. I managed to become a new object for the members and eventually a better mother and therapist.
Ehrenberg, in her article Working at the Intimate Edge, writes that we must consider why particular qualities or sensitivities of either patient or analyst are activated at a given moment and not at others. Central to her position is the recognition that analyst and patient cannot avoid having an effect on each other. Sometimes disclosing our confusion or specific feelings of puzzlement can be useful. Asking questions - Why are we fighting now? How did we get into
an argument? - and tracking when either patient or analyst becomes more frightened or less, more open or less, etc, can help to engage in a collaborative exploration with patients about what is developing interactively and can become a medium to deconstruct toxic developments
in the effort to figure out what is going on. She describes this kind of process as an effort to work at the intimate edge. She looks not only at the interaction but also at how she might be
participating in it. Working this way does not involve mutual analysis or wild analysis, but it does require that the patient and the analyst deal with each other, and their strengths and
vulnerabilities, in real time and in real ways. Accepting responsibility for our contribution allows the opportunity to discover how deeply affected each can be by the other. This emotional involvement can be constructive. Such experiences are not there to be found but, instead, are intersubjective creations, and they are never static. Each participant then 'owns' something not owned before.
On The Analyst’s Emotional Availiability And Vulnerability
How do we understand what happened here, in the patient, in the therapist and in the interaction? It was a truly therapeutic moment; it was not understanding, it was not insight. It had to do with the experience of the moment. What was the experience of the moment? It was with the analyst's inner experience, the degree of emotional availability and vulnerability, the level of what we ourselves are willing to risk emotionally in relation to our patients. Sometimes we permit, and other times we preclude, emotional contact. We listen differently and are present differently. In our silences as well as in our words, our willingness to receive our patients'
thoughts and feelings - not being afraid, but being willing to be vulnerable to her/his impact and still survive, being sensitive to whatever we feel, no matter how bizarre it may seem - becomes the basis of the analytic work. Being closed and open as an authentic reaction, not because we think it is the correct thing to do or feel. Whether we find ourselves defensive, detached, angry, unemphatic, constitutes important analytic data about what is going on interactively if we are able to use them in an analytic way. Simply saying, 'I find myself feeling detached and I don't understand what is happening and I am concerned about this' is very different from being detached as an assumed role or merely enacting our countertransference detachment. To pretend to feel what we think we should feel - trying to be a good object - is different from
being a real object.
The challenge is to stay close to the most subtle aspects of our own experience however threatening they seem. For some patients, the opportunity to experience a toxic interaction can become a revelation instead of remaining locked into feeling 'weird' or 'defective' and may allow the patient to feel safe for the first time. Ehrenberg's supervisee shared her puzzlement with her patient without analyzing it, without blaming the patient for doing this to her. This enabled the patient to feel that she was not as alien as she had come to think. Ehrenberg suggests that this kind of emotional communication - to allow oneself to touch and be touched without the protection of "psychic gloves" - becomes the key to the most profound kind of analytic possibility.
Alkinoi’s Case study:
Looking back at the material [see post of May 19, 2021] I can recognize that my difficulty to connect with the foreign object that invaded my body, and at the same time my difficulty to contain group members whom I was experiencing as foreign objects, were crucial assumptions that I had to admit and accept if I was to own my badness, as Davies wrote.
My supervision and my personal therapy as parallel processes to the group therapy, came to side light my blind spots. They helped me identify with my own unconscious material and my own relational story, and interpret them for the benefit of the group. Through my own dreams, that were analyzed in my individual and group therapies, I managed to connect with the difficulties of having a baby. I comprehended not only the absolute happiness ,but also the unbearable feeling of narcissistic injuries: my fear about if I would be able to raise her properly, my envy that I would lose the uniqueness in my husband’s life and heart, my anxiety regarding my availability as a group therapist and my ability to become a group therapist. Finally, the shame that it was me that was able to get pregnant and not my patients (most of the members were women, some facing fertility issues, many had had abortions or wished to get pregnant).
Admitting my own difficulty, a new inner space was created for the group members. My pregnancy was evident now, present in the room, and the members were examining my experience. Mothers in the group found space to talk about their dreadful feelings during their own pregnancies. A domino of self-disclosure about abortions and miscarriages started as the group felt safe with the therapeutic process and with the two therapists who were bringing our own subjectivity into the sessions.
A subgroup, though, was very anxious about where I would be after giving birth, when I would come back and If there would be still space inside me for them. They fantasied that I would never come back, others, that when I left to give birth, they would take my chair out of the circle. The male member, who was very traumatized by his psychotic mother who had abandoned him when he was young, announced that he would stop therapy at the end of the season, but he couldn’t connect his decision with my pregnancy and the here and now of the group. This subgroup experienced anxiety in a persecutory way.
In the group many patients had grown up with psychotic parents. My somatization evoked the sense - described by Davies in her article - who is the insane, the psychotic? Is it also me? This subgroup could not explore this and for some patients it was traumatic. Something that we were only later able to understand came beautifully to a session and to our consciousness from a dream. (Inside the projective identification I could not understand it at that moment.) Two years after my pregnancy, and one year after the pregnancy of one of the members during sessions where she was now coming with her baby boy, there came into group a dream in which babies are monsters that are overly aggressive and fatal. It was a very crucial moment as were finally able to talk about who owns the badness. We had to admit our inability to connect with this part as a way to protect them from the presence of the baby and the traumatic persecutory memories that the baby boy's presence evoked for the group.
Using the theory of action (Ehrenberg) and being honest with my countertransference, first with myself, and then examining it with the members, enabled a new relational pattern about which we had been previously unaware. This experience of emotional communication left me able to touch and be touched in a way that shaped me not only as a therapist but especially as a mother.
-Alkinoi Lala
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