Rediscovering Psychoanalysis by Ogden Thomas H

Author:Ogden, Thomas H.
Language: eng
Format: epub
Publisher: Taylor and Francis

Bion is making an indirect interpretation to the non-psychotic aspect of the presenter’s personality. Here, again, the interpretation has a surprisingly pragmatic feel to it: the patient has chosen a career for which he is not emotionally equipped. The patient seems not to be able to face other people’s fears without becoming frightened and depressed himself. But, of course, there is more to the interpretation than that. Bion is focusing on a striking contradiction that seems to provide a sense of the nature of the emotional problem for which the patient is seeking help in this session.

Why is the patient presenting the analyst with a contradiction in this particular way, at this moment? Perhaps the patient did not simply make a poor career choice. Is there something about himself (an aspect of himself that is a genuine doctor) from whom the patient feels disconnected? Bion is noticing a communication that is so obvious that it is as invisible as Poe’s purloined letter. Perhaps it is this paradox – that the obvious is invisible – that leads Bion’s comments to sound odd and concrete. Here, as was the case earlier in the seminar, Bion’s observation concerning something that feels “off” to him contains an “imaginative conjecture” (p. 191) regarding the emotional problem that the patient (with the analyst’s help) is attempting to “solve” (p. 125) – that is, to think in this session. The question is not simply, “What is leading the patient to feel anxious and fearful?” A more specific problem (or facet of the dynamic tension driving the patient’s symptomatology) is alive in the current session. Bion, in his comments that address the patient’s choice of profession, seems to be trying out the idea that the patient may feel that he is not himself. He chose to try to become a doctor, and yet he feels more drawn to being a passive patient – a person who knows nothing, and wishes to know nothing, about the illness from which he is suffering.

Bion’s speculation might be thought of as an interpretation spoken to the non-psychotic aspect of his “imaginary” patient, an aspect of personality that is both unconscious and capable of thinking.

The presenter seems to have been able to make use of this interpretation:

Presenter: So he left the room to lie down. At this moment he was called to the emergency ward. He went; he worked perfectly. He thought it very curious that he could work well without any difficulty.

(p. 17)

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