by Maja Farrell
I would like to encourage other therapists to think about possible unconscious forces that may arise in a very short space of time; e.g. within/after a phone call or e-mail from a client enquiring about therapy, the first session or a first presentation of a client in supervision and the damage that can be caused to the client within this very short period of time in which therapist can become deeply affected by the client's internal world and unable to think and act, re-acts and rejects, leaving the client in even greater distress.
Being a therapist myself, I have found the very first contact with a client (be it face to face or via e-mail or telephone) creates an energetic space in which our minds meet and communicate in a powerful way. I believe it is the task of the psychoanalytic practitioner to tune into this communication and help create some meaning, for and with the client together, of his internal world. Even if contact is very brief, the practitioner has a responsibility to "first do no (psychological) harm" meaning, he needs to stay aware of his anxieties towards the potential client, acting in her best psychological interest.
What, however, happens if the client's unconscious communications reach the mind of the practitioner in such a powerful way that he cannot, does not want to, is unable to hold and contain them and act empathically?
Wilfred Bion thought about those dangerous pitfalls with help of the infant-mother relationship in which baby, unable to think about the frightening world around him, needs mother to help make sense of what he is experiencing. Bion suggested because baby has no words to communicate his distress, he uses the unconscious vessel of projective identification to put into mother his anxieties, who in a state of reverie, picks up on her baby's fears and, able to think about them, returns them to him in a more digestible form, thereby offering him an experience of both, himself and mother, surviving the unbearable.
I would like to encourage other therapists to think about possible unconscious forces that may arise in a very short space of time; e.g. within/after a phone call or e-mail from a client enquiring about therapy, the first session or a first presentation of a client in supervision and the damage that can be caused to the client within this very short period of time in which therapist can become deeply affected by the client's internal world and unable to think and act, re-acts and rejects, leaving the client in even greater distress.
Being a therapist myself, I have found the very first contact with a client (be it face to face or via e-mail or telephone) creates an energetic space in which our minds meet and communicate in a powerful way. I believe it is the task of the psychoanalytic practitioner to tune into this communication and help create some meaning, for and with the client together, of his internal world. Even if contact is very brief, the practitioner has a responsibility to "first do no (psychological) harm" meaning, he needs to stay aware of his anxieties towards the potential client, acting in her best psychological interest.
What, however, happens if the client's unconscious communications reach the mind of the practitioner in such a powerful way that he cannot, does not want to, is unable to hold and contain them and act empathically?
Wilfred Bion thought about those dangerous pitfalls with help of the infant-mother relationship in which baby, unable to think about the frightening world around him, needs mother to help make sense of what he is experiencing. Bion suggested because baby has no words to communicate his distress, he uses the unconscious vessel of projective identification to put into mother his anxieties, who in a state of reverie, picks up on her baby's fears and, able to think about them, returns them to him in a more digestible form, thereby offering him an experience of both, himself and mother, surviving the unbearable.
The mother's response is to acknowledge the
anxiety and do whatever is necessary to relieve the infant's distress. The
infant's perception is that he has projected something intolerable into his
object, but the object was capable of containing it and dealing with it. He can
then reintroject not only his original anxiety but an anxiety modified by
having been contained. He also introjects an object capable of containing and
dealing with anxiety (Segal 1975, pages 134-5).
On the other hand, should mother fail to provide such a mental container (capacity) to receive, take in and think about her baby's anxieties, his, as well as his mother's anxieties, may be returned to him in their raw, terrifying form. Unable to make sense of what is being returned to him, he is left with an experience of his mind, feelings and thoughts being too intolerable to be thought about.
"If the projection is not accepted by
the mother the infant feels that its feeling that it is dying is stripped of
such meaning that it has. It therefore reintrojects, not a fear of dying made
tolerable, but a nameless dread" (Bion, 1962, p. 183).
If a client, especially after having experienced previous abuse, enters counselling sessions s/he may hold a lot of conscious or unconscious hopelessness, anguish and murderous rage.
Unable to direct those feelings towards the Object (person) and not having any Object available that seems strong enough to hold and contain this rage, make sense of it and resolve it, the mind of the client projects it outwards; away from him/her; it is too unbearable to feel, to be aware of. S/He is left with the "nameless dread" of something horrific - a fear of the unknown known.
We as therapists need to remember that even the first phone or e-mail contact from a client is not only highly significant but also utterly important - we must strive to keep the client's pain in mind at all times while reflecting on our responses so we do not add to the client’s already fragile sense of self.
If we as therapists are unable to hold this tension and the anxiety (ours and that of the client) we may be likely to Re-act rather than Act empathically and therapeutically (after having been able to think and link - Bion). If the client is extremely anxious, the (intuitive and involved) therapist will pick on it (un/consciously), but if he is not mentally strong enough will return the unbearable to the client in a traumatic and further damaging manner.
References:
Bion, W.R. 1959 Attacks on linking. International Journal of Psycho-Analysis 40: 308-315.
Bion, W.R. 1959 Attacks on linking. International Journal of Psycho-Analysis 40: 308-315.
Bion, W.R. 1962.
A Theory of Thinking. In E. Bott Spillius (ed.) Melanie Klein Today:
Developments in theory and practice. Volume 1: Mainly Theory. 1988.
London: Routledge.
Segal, Hanna 1975 A psychoanalytic approach to
the treatment of schizophrenia. In Malcolm Lader (ed) Studies of Schizophrenia. Ashford: Headley
Further
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