Search for truth: Bion | Michal Lapinski Studio

SEARCH FOR TRUTH: BION’S CONCEPT OF MIND

To begin this lecture I would to map the field of our today’s enquiry into Bion’s work. I will start with an introduction in which I will set a few orientation points. Then I will talk about mental processing. The next section will be on encounter with truth. It will be followed by a discussion Bion’s triad of change. I will conclude by the consideration of the analytical attitude.

My first orientation point is about Bion’s influence on current psychoanalytical thinking. I posit that Bion’s impact on the contemporary psychoanalysis has been significant, and that many of his conceptualisations have become integrated into the current therapeutic practice.

In the line of great psychoanalytic minds he ranks with Freud and Klein, and to some, like the Symingtons he has surpassed them as a thinker. To others like Meltzer or, more recently de Bianchedi, Bion’s formulations do not replace but rather supplement the theories of Freud and Klein.

Recent upsurge of the interest in Bion’s work is illustrated by the creative developments stimulated by his ideas (Ferro, Ogden, Mitrani, Symington, to name a few) and is expressed by increasing proliferation of his concepts in everyday practice. This leads to questioning of his place and to debating his affiliations. The recent exchange of the discussion papers in the International Journal of Psychoanalysis was headed by the title “whose Bion”, to be then expanded into “who is Bion?”.

Grotstein’s answer to the question “whose Bion?” is – “ no one’s.” To him, “Bion is inimitable as an analyst but superb as a guide for all analysts who wish to explore “the deep and formless infinite”, reiterating this Milton’s phrase used by Bion.

Bion himself would be quite sceptical about such consideration. He said,

“ ...it does seem to be rather ridiculous that one finds oneself in a position of being supposed to be in that line of succession, instead of just one of the units in it. It is still more ridiculous that one is expected to participate in a sort of competition for precedence as to who is top. Top of what? ... I am always hearing ... that I am a Kleinian, that I am crazy; or that I am not a Kleinian, or not a psychoanalyst. Is it possible to be interested in that sort of dispute?”

I am in agreement with the view that Bion’s original and creative contribution does not provide a “new truth”superseding all the previous ones but as he says himself, his “truth” is “just one unit” in our set of psychoanalytic insights. However, I am among those who tend to think that Bion’s “unit” of psychoanalytical contribution is unique and remarkable.

Bion perhaps defies classification but we can attempt to outline certain dimensions of his work.

Bion’s approach is dyadic and intersubjective. His domain remains to be, like Klein’s, one of internal objects but for him, like for Winnicott, psychic processes are intrinsically linked with consideration of the other – as a separate entity or the other in the mind. In distinction to Freud and Klein, the concept of mind is formulated in the context of a dyad – pair and a group.

Bion’s central focus has to do with knowledge. His contribution to psychoanalysis can be called epistemological. His starting point was the notion of epistemophilic instinct, or instinct component of Melanie Klein but he took it to a much broader area, and gave it special significance. His focus is on thinking and on the cognitive aspects of psychic functions, in the context of emotional life experiences.

For Bion, knowledge of emotional life leads to growth and is arrived at by the process of learning from experience.

In what we know about Bion’s life we can see growth generated by, often painful, learning from experience. We can find evidence of emotional suffering, of heroic struggles, of tireless curiosity and persistent search for truth, and of the development of the capacity for love and for thinking.

Bion was born in 1897 in India, where he spent his early childhood years. He suffered privations and traumas of a boarding school in England; fought, young and brave, in the First World War as a tank commander. He grieved the sudden loss of his first wife, and had a long, fulfilling relationship with his second wife, Francesca and with his children, until his death in 1979.

His path to psychoanalysis went through medicine, psychiatry and psychotherapy. His professional development was paralleled by a search for therapeutic help for himself, initially from a psychotherapist at the Tavistock, then from the analysis with John Rickman, interrupted by the war, and eventually from the long and fruitful analysis with Melanie Klein.

Bion started off as a Kleinian but he could hardly fit within the existing Kleinian paradigms. Even though he contributed to elaboration and extensions of the Kleinian theories, his later work was not accepted by the “mainstream” Kleinians.

If belonging means obliteration of individuality by the group and suppression of creativity by a dogma, Bion couldn’t and wouldn’t “belong”.

In his initial work with groups Bion conceptualised group processes as shared, phantasy driven “assumptions” that can exercise destructive and inhibiting influence on the group’s constructive and cognitive endeavours. He described how unprocessed tensions and defences against psychotic anxieties can impede sharing knowledge and wreck collaboration in the group.

Bion himself discontinued clinical work with groups. One can see, however, reemergence of that focus in his later work in which he explores the relationship between the mystic/genius and the group/establishment. While discussing the vicissitudes of truth, Bion describes how the ineffable and intolerable truth can be accessed, contained, transformed and brought to the group by the mystic/genius and how the group/establishment may destroy or contain the mystic in order to neutralise the destabilising and potentially catastrophic impact of his new ideas. He said in Attention and Interpretation (1970),

“An easily seen example of this is the group's promotion of the individual to a position in the Establishment where his energies are deflected from his creative-destructive role and absorbed in administrative functions. He epitaph might be ‘He was loaded with honours and sank without a trace’.”

Bion’s important starting point for developing his theories was his experience of working analytically with the most disturbed and disturbing – psychotic – patients. In those cases truthful self-awareness is not only affected by repression and inhibition, or attacked by the destructive impulse, but also suffers from the incapacity of the mind to bear emotional experiences, deal with them and think about them.

In the 50s Bion, alongside other Kleinian analysts (Rosenfeld, Segal) undertook analyses of psychotic patients. That work arose from the promise which the Kleinian theories of object relations, with their exploration of early, primitive functioning and destructiveness, offered towards understanding of psychotic mechanisms operating in infants and in adult psychotic patients. Therapeutic results may not have lived up to the expectations (this does not mean that psychoanalysis has nothing to offer to patients suffering from psychotic disorders) however, it led Bion to his discoveries that threw a new light on thought disorders and other psychotic phenomena.

Bion’s concepts, like those of Freud’s and Klein’s, were derived from the clinical experience obtained in psychoanalytical conditions and generalised into major conceptual framework that have much broader applications. Bion’s understanding of psychotic functioning is not limited to the patients with psychiatrically defined psychotic symptoms. Using Bion’s insights we can describe and understand psychotic aspects (or a psychotic part) of personality which are present in other disorders and, in fact, in some form in all of us. And this also has offered invaluable assistance in dealing with the psychotic level of functioning in clinical situations

The second, obvious point is that Bion’s work is not easily accessible. His writings are sometimes described as esoteric and obscure. The manner in which they were produced and published has not helped. His main theoretical oeuvre is contained in four volumes: Learning from Experience, Elements of Psychoanalysis, Transformations and Attention and Interpretation, comprising together just over 500 pages. They are not easy to integrate into a cohesive entity. There are also earlier works, such as Experiences in Groups and the schizophrenia papers, published under the title Second Thoughts. The rest are smaller but important papers, notes and drafts, posthumously published as Cogitations, and collections of clinical seminars and lectures, recorded during his visits to Brazil, the United States and Europe. His last work is a trilogy – a novel titled A Memoir of the Future – which is very difficult to classify. It can be seen as his last attempt to convey by literary means intriguing and ineffable truth of human existence – to capture an elusive psychoanalytic object – which psychoanalysis cannot fully comprehend by itself.

But it is not only lack of systematic presentation that makes reading and comprehending Bion so challenging. It is the nature of his highly innovative thinking which is illustrated by the very approach to its exposition. Bion does not offer us ready-made and finite theories, in fact he prefers to call his formulations models. To him “They are working tools for the practising psycho-analyst to ease problems of thinking about something that is unknown.” (Learning from Experience, p.89)

These tools are the concepts (such as α function or container) which can be called “empty” – they do not have any representation in the real world. They are like his pre-conceptions in the Grid (a schema Bion developed for diagnosis and classification of thought). These pre-conceptions are like assumptions that have to meet with realisations in order to become fully formed concepts; then they can mature towards greater abstraction. Bion’s concepts are not saturated with a final meaning, they are just steps in understanding.

But it is not only Bion’s concepts that have made an impact. It is his whole way of thinking about psychic processes and his approach to psychoanalytical inquiry that have changed the way we think about and practice psychoanalysis.

In our encounter with Bion we cannot remained passive, we need to do part of the work: we have to come up with realisations, derived from your own experience, that will meaningfully fill his empty concepts. These realisations by mating with or pre-conceptions can lead to a discovery – or a conception of something new.

So Bion offers us the tools for thinking about experiences and, for the first time, a psychoanalytic way of thinking about thinking. He does not offer us a system of beliefs, to be emulated or followed. One does not hear about Bionians, as one hears about Kleinians, or Lacanians. It is impossible to turn Bion into a gospel without distorting the essence of his message, that the truth, O, is principally unknown and unattainable, and if we believe that we possess is we are under illusion which can be dangerous.

This leads to my third orientation point – that understanding Bion’s ideas has to involve learning from experience. There is not much point in just reading Bion’s texts and repeating his formulations. They need to be meaningfully related to our own experience – they need to come alive in real life – clinical – situations. Bion makes sense only in so far as we can make sense of his ideas to ourselves and to our patients – in our own unique way.

It logically follows that Bion’s concepts can hardly be summarised and conveyed in a lecture, let alone in a one-off presentation. Then what I can try doing today could only be, using Bion’s words “doing best of a bad job”.

To make the forth orientation point let us take some coordinates.

Having acknowledged the continuity in the axis Freud Klein Bion we need also note differences.

For Freud, mind tries to solve unconscious conflicts. In the result, it has to deal with “the accretion of psychic stimuli”, due to pent-up libido. When attempts at its discharge are frustrated, the mind has to reach a compromise. That compromised is expressed in dreams, or in symptomatic, pathological - neurotic and characterological - formations. The mind has to negotiate between, on the one hand, the pleasure principle, pressuring towards gratification of unconscious wishes, and the reality principle, representing requirements and constraints of the real world. Psychosis represents a collapse of the internal world and a breach of relations with the external one. Mental health is determined by the degree of success achieved by the conscious part of the mind (the Ego) to become a master in its own house, allowing satisfactory resolution of these internal conflicts and leading to increased capacity to “love and work”.

Melanie Klein, even though she remained basically faithful to Freud’s drive/conflict model highlighted the role of the death instinct, aggression and envy in generating primitive anxieties (of paranoid schizoid and depressive kind) which in turn give rise to primitive defensive mechanisms (such as splitting, projection and idealisation) that underline both neurotic and psychotic phenomena. Movement from Paranoid-schizoid to Depressive position was for her essential for psychic growth. Klein acknowledged, in agreement with Freud, the importance of the Oedipus complex (involving the triangular constellation – mother, father and baby) in normal and pathological development – but she expanded and deepened understanding of the primary relationship between the baby and the breast/mother. Thanks to her pioneering work, Freud’s understanding of the neurotic phenomena could be supplemented by consideration of early and psychotic processes, and his drive/defence model enriched and broadened within the scene of object relations.

Bion’s model of the mind is in several respects different from those of Freud and Klein. For him, the mind is involved in the continuous processing of rudimentary protomental data which results in acquisition/development of meaning through thinking. The growth and development of the personality depend on the capacity to contain and transform mental contents so they can be available as food for thought, as a nourishment for the mind.

When this processing function is impaired, mental contents are not properly digested, not fully mentalised, they are not tolerated by the psyche. They have to be disposed of, discharged through various psychic or physical activities. Discharged elements can be projected out and located in other objects in the process of projective identification. Distinctive affective states will be induced in the object of such projections; the object can be also made to act in accordance with them. Massive projective processes combined with impairment of the apparatus for thinking characterise psychotic functioning. Deficient mental processing can lead to development of psychosomatic phenomena. When the emerging thought are not tolerated they become concertised – become things-in-themselves.

To summarise:

For Bion, the central struggle for the psyche has to do with the growth of the mind through emotional processing and development of thought; the central dilemma in this struggle is essentially of epistemological nature – has to do with search for and acquisition of knowledge.

Bion postulates that “there is a need for awareness of an emotional experience” – for truth which he compares to food the mind needs for its existence and growth. This is essential for psychic health. In this model the mind lives by psychic truth. The deprivation of truth will have detrimental effects, being “analogous to the effect of physical starvation on the physique.” (Elements of Psychoanalysis, p.56) – resulting in depletion, stunted growth or illness.

Consequently, this “need for awareness of an emotional experience” becomes the central issue for psychoanalysis, search for truth the essential part of the analytical process, and obstacles in this path an important focus of the analytical work.

According to Bion, an important assumption that guides the patient and the analyst in this pursuit is,

“ that the personality of analyst and analysand can survive the loss of protective coat of lies, subterfuge, evasion and hallucination and may even be fortified and enriched by the loss. It is an assumption strongly disputed by the psychotic and [a fortiori] by the group, which relies on psychotic mechanisms for its coherence and sense of well-being.” (Transformations, p.129)

Mental processing

Bion uses a digestive system analogy which is only an approximation, a metaphor, but it is quite handy when one tries to think about mental processing.

Some colloquial expressions give credence to this concept. We talk about ”food for thought”, experiences that are “hard to stomach”, can “make one sick” or can lead to “mental indigestion”. Someone can have “a gutful of something” and “wants to get it out his system”.

“Digestion”of what he calls protomental elements occurs on an ongoing basis, unconsciously, behind the scenes, producing building material for dreams, phantasies and eventually conscious thoughts. It can be compared to a factory that uses raw materials (beta elements) to form basic parts and units (alfa elements) of which only some go to production, are assembled and dispatched, turned into dream elements, and, eventually, thoughts.

In this scheme we no longer take dream formation for granted. The dream is not only an expressive phenomenon – a coded communication with a hidden meaning to be deciphered. It is a psychic achievement, the evidence that the dream-alpha factory is in working. It shows that the psychic apparatus is capable to gather and process rudimentary mental elements, give them a distinct, specific expression, and eventually meaning.

Movement towards thought is like the step from the breastfeeding to solid food: it is an achievement and sign of growth but it also involves a loss of the “unproblematic” and wish-fulfilling position at the breast. Frustration and pain inevitably follow and they have to be negotiated and dealt with.

Mental metabolism encompasses various phenomena: it is establishing “what is what”, and what is not; differentiating good from bad – sorting out useful contents from waste products; renunciation of an omnipotent position in which “anything is possible” and in which “everything can be controlled”; differentiation of phantasy from reality. All these aspects require alpha function.

α function is the first, essential step in mental processing and is conceptualised by Bion as only a beginning of the process which proceeds through several identifiable stages to more sophisticated and abstract form of thought.

Development of alpha function occurs in the context of the loving and nurturing relationship with the significant other, its success or failure is intrinsically linked with what happens in that relationship.

The infant’s capacity to bear inevitable frustrations and develop capacity for thought is directly related to what Bion calls maternal reverie. The Symingtons suggest the term “contemplation”, but it can be put simply as “loving understanding”. This is the mother’s capacity to bear, recognise and respond to the infant’s experiences in a way that is empathic and appropriate to his needs. The infant’s chaotic, overwhelming and terrifying experiences that are communicated to and projected into the mother, can be contained, acknowledged and thought about by her. They can be returned to the child in a form that is metabolised and detoxified, and become digestible and acceptable. In the result the infant is able to gradually develop his own α function – and thinking.

If the mother fails in this function and is not able to accept and transform the infant’s projected communications, the infant is confronted by unbearable and unfathomable emotional experiences, such as terror of dying. At the same time this experience is stripped of meaning and there is no chance to process it. The infant reintrojects, “not a fear of dying made tolerable, but a nameless dread”. He also develops internally, instead of a receptive, understanding object, an object that is (willfully) misunderstanding or impermeable.

If mother’s nurturing of the infant is not accompanied by reverie, is unemphatic and mechanical, this is inevitably communicated to the infant although remains incomprehensible. A pattern can be established which can be repeated in subsequent interactions and relationships.

This model not only describes development of thinking but also highlights the emotional and cognitive exchange between two people and two minds.

It has important implication for understanding of the clinical – analytical – situation. Development of understanding can no longer be ascribed to one participant, even if he/she can be considered more mature, knowledgeable and experienced. Understanding is seen as a product of the relationship.

Encounter with truth

For Bion, understanding is a complex process comprising thinking and feeling. It involves a striving to get to know emotional experience, the direction he refers to as K, and the even more essential need to be in touch with emotional truth, which he denoted as O.

Knowledge Bion refers to is not sterile and cold. He underlines the importance of Love, without which true understanding is not possible, and of Hate, of which destructiveness has to be manages. Movement towards ‘O’ – which for him is making known the unknowable, depends upon loving, passionate and enduring link with the other.

The ultimate truth, reality, O is not an ideal and it is not reified. It is unknowable. As Bion puts it,

“It is impossible to know reality for the same reason that makes it impossible to sing potatoes; they may be grown, or pulled, or eaten but not sung. Reality has to be “been” (from to be) (Transformations, p.148)

One cannot know O, one can only attempt to become, be O. Knowing about reality is different from being reality, like knowing about psychoanalysis is different from experiencing it.

Bion postulates a central, ever present conflict between inquiry and omniscience, between reflective thoughtfulness and omnipotent wish-fulfilment. He often refers to three central myths all of which describe this conflict, depicting search for and prohibition of knowledge as well as the consequences of its acquisition. They are: the myth of creation, of Eden, the story of the tower of Babel, and the Oedipus myth.

In all of these myths we can see a striving for a state of omnipotence representing the perfect union with a perfect unrestricting entity – all-knowing mind and all-gratifying god. An inquiry, a quest for knowledge leads to a catastrophe, mobilising an outrage of the god-like superego and the loss of the paradise. The consequences are: pain of facing the reality of a humble, constrained existence, and naked separateness.

Myths, of course, can be read in many ways. The Oedipal myth, for example, allows a number of interpretations – instinctual/incestual, competitive (as in classical Freudian reading), traumatic, omnipotent, etc. Bion is focussing particularly on the tragic dilemma which leads to the search for truth ending in a catastrophe.

From this it may follow that for Bion search for truth is not like a quest for a Holy Grail. There is no hope of one day founding it, and solving all our problems. Successful search for the truth brings light to the darkness of existence, rescues from the bounds of ignorance, and gives the word – a meaning to the formless. But it does not offer freedom from pain and uncertainty , in fact, leads to the opposite – to the bitter-sweet truth of human condition, to a life that is full and real, but painful and finite. The paradise is lost for ever, and the brave new world is shocking and unsafe.

The truth remains ultimately unknowable to us mortals and it can only be accessed through its approximations, derivatives. Bion develops a model of what he calls “transformations” in which he describes how the ineffable truth which is blinding , shocking and therefore intolerable, becomes imaginable, expressible and thinkable, and eventually speakable. But never to our full satisfaction.

We have to satisfy ourselves with the everyday manifestations of truth, truths with a small rather then the capital T. In our encounters with these everyday truths, including analytical encounters, we can only hope to get some access to the bigger issues, to the better cohabitation with the reality, both external and internal. We hope that such encounters could help develop a better relationship with such relatives of truth as honesty, authenticity and integrity.

In the analytic encounter truth is accessible by the both participants, if only in the form of transformations, which can be different for each of them.

Either of the participants can be an agent, a spokesman for the truth, this function does not reside in just one of them – it is a function of the relationship. The truth, or strictly speaking its approximations – transformations – become accessible to both, and one of them can speak on its behalf.

This is consistent with the Bion’s view that truth exists in itself, independently. Claiming its sole or superior possession represents a departure from the truth. Such a conviction can be dangerous – it can become a dead certainty or a delusion.

Even though the analyst is not a possessor of truth, nor is she a source of all goodness she may be cast in such a role by the patient who needs to have access to an all-knowledgeable god or a bountiful breast. This needs to be acknowledged and analysed as a part of idealising transference and of projection. There is a danger if the analyst starts believing in it, or acts as if he does, supporting such a belief by her action or interpretations. This, for example can be expressed by rigid interpreting of the transference in terms of infant-parent relationship. This can suggest to the patient that the analyst wants him to be or act as (her) child and she is going to play the role of a superior, all-knowing parent.

Bion’s ideas lead to revision of the role of the analyst. Since he is not perceived as the main source of wisdom of interpretations the analytical process can be seen in a different light . The patient becomes more of an active participant and more of an equal. That does it mean that the roles and contribution of the analyst and the patient respectively are identical and symmetrical. That can be a fallacy which can constitute yet another distortion of the truthfulness of the analytical encounter.

The focus changes from the notion of understanding being offered by one of the participants, arguably more knowledgeable and better qualified, to the other participant who accepts or resists this understanding. It shifts to the concept of the understanding emerging from the interaction between the both participants. This shift of emphasis leads to a new, different look at the analytical process itself and to a different approach to learning about this process from one’s own experience and from supervision. This includes consideration of one’s own reactions of the analysts – under the rubric of countertransference – but not as a undesirable and avoidable event but as a source of information.

In supervision the emphasis shifts from consideration of the patient’s communications mainly as expression of his pathology, and analytical interventions as the evidence for his understanding of it or lack thereof. Supervision can more productively focus on the interaction, on the contributions of each of the participants to it and on their significance. The transference is considered not just a repetition of the past, and not mainly as manifestation of how the patient relates to the present object in here-and-now. It encompasses both those dimensions but it is also supplemented by exploration of the human encounter between the two different minds which, in the confines of the analytical space, face together the essential difficulties in the pursuit of truth and dilemmas of psychic change.

I do not subscribe to the view that Bion puts us on a religious quest. His description of the path towards truth is indeed formulated in philosophical terms but it has real psychoanalytical implications. I do not see the “ Bion’s path” as a search aiming towards the achievement of an eternal absolute, an ideal, but as a rocky and winding route towards self-understanding and to meaningful coexistence with internal and external reality. It is closer to the idea of enlightenment, both in the cognitive and perhaps also in a Buddhist sense. The latter connection has been explored in the work Shahid Najeeb, our colleague from Sydney.

In psychoanalytical terms this path to “enlightenment” is ultimately a reality based endeavour. Its aims are not omnipotent or omniscient. It is more like “making the best of a bad job”. It is not an attempt to be an ideal analyst, an equivalent of an ideal mother but, as Winnicott puts it, one that can try to be “good enough”.

Triad of change

In Bion’s model of the mind, several processes need to occur simultaneously in order for the mental processing and growth to occur. Bion’s triad of change consists of three dimensions: α function, container/contained; and (reversible) movement from the paranoid-schizoid to the depressive position.

When the digestive system metaphor is extended to include the container/contained dimension, a model for thinking about this is the mother’s mind, a “thinking breast”, which recognises, receives, processes and transforms distressing, potentially noxious and ineffable psychic elements. We can see that the previously described concept of maternal reverie includes the notion of containment.

Containment has a colloquial use but here when referring to Bion’s work in acquires particular significance. For him, the container/contained ♀♂ denotes a range of mental phenomena. We can describe container and contained aspects in the personality; in relation to thinking and words we can discern their container and contained elements; the container and contained aspects are present in relationships – between the mother and the infant, the female and the male, or between the part objects - mouth and breast, vagina and penis.

The earliest representation of the container/contained relationship is in the mother-infant couple. When this relationship is complementary, mutually gratifying and not harmful, then both the participants benefit from if, grow and prosper.

Bion uses the female and male symbols to denote the container/contained. His descriptions and symbolic language are not accidental. The thought is conceived and born out of a relationship that involves loving collaboration and helpful differentiation – a fruitful intercourse of the bodies and the minds. In this arithmetic of conception one plus one does equal two, but also makes three. Paraphrasing Winnicott’s dictum that “there no such a thing as an infant” (because there always the infant and the mother) we can say that there is no such a thing as mother-infant dyad, because there is always also a father.

The context of container/container is essential for establishment of α function and for further development of thought. This, however, does not fully determine the nature of the resulting process which can malevolent or benign, restrictive or facilitating, damaging or constructive. In order to fully appreciate the complexity of the processes involved we need to consider the nature of the emotional links – whether the connection is of the nature of Love, Hate or K – a desire for knowledge.

Thus approaching the mind and the interaction from Bion’s point of view we will be also thinking about the emotional content and its direction. In Freudian terms it will be instinctual drive, wish and defence. From the Kleinian perspective, also included by Bion, it will be consideration of the movement from PS to the depressive position. Bion associates this movement with the dimension of disintegration-incoherence vs. integration-coherence.

The paranoid-schizoid position is characterised by splitting and disintegration. However, in that position a kind of container can be postulated, formed out of β elements which are dispersed and reorganised. It is, however, an unstable agglomeration, threatened by fragmentation, in contrast to a container pertaining to the depressive position which is integrated, relatively stable and more flexible.

There are various forms of paranoid-schizoid, pathological containers observed clinically as pathological defensive organisations. They have different degrees of rigidity and stability and manifest themselves in diverse clinical pictures. Their various forms such as narcissistic, psychopathic, addictive and so on, have been described by such Kleinian authors as Rosenfeld and Steiner.

It can be useful to think of these pathological conditions from the point of view of their containing function and an equilibrium they provide for the psyche (Betty Joseph). Psychic change occurring via analysis provides a challenge to this balance and a threat to established and often entrenched ways of functioning.

The change in the mental equilibrium is also a change in the economics of pain (using Meltzer’s term), the pain that can be kept at bay by a defensive container. The change is experienced as or is feared to be catastrophic, and defences are re-mobilised to maintain the status quo. The analyst who is considered to be an agent of this change will be treated with fear and mistrust and the analytical process will meet a fierce resistance. In the presence of hostility expressed by the patient such resistance can be easily misinterpreted as just an attack on the good object (that is the analyst) and its survival function for the unstable and vulnerable ego can be missed.

It is important to acknowledge that even the most pathological defences can operate in the service of psychic survival. They may need to be respected rather than overcome by force or treated as just unnecessary and dispensable.

Bion says that, “... the search for truth can be limited both by our lack of intelligence or wisdom, and by our emotional inheritance. The fear of knowing the truth can be so powerful that the doses of truth are lethal.” For someone who is very vulnerable even small doses of truth can be indeed hard to bear.

The truth cannot conquered nor should it be pursued fanatically, regardless of consequences. There are circumstances when the pursuit of truth at any cost can be traumatic and damaging.

The truth has to domesticated and tamed in order to become bearable. O has to be transformed in order to be known and thinkable. This can be seen only as an approximation of truth, strictly speaking – a lie. It does imply acceptance of lie as a modus vivendi but it means acknowledgement of reality and of our limitations

The changes occurring within the therapeutic process that trigger off catastrophic anxieties require sensitiveness and mindfulness on the part of the analyst. Containment is crucial in this process.

Containment is a quite complex phenomenon. It is not a passive state but an active frame of mind which may or may not be expressed in an actual verbal or nonverbal activity. It is not restricted to just being there or “hanging in there”, although this is essential – there is a need for “presence of the mind. Such presence or lack thereof will be detected, particularly by a sensitive patient. The physical presence however important is not enough. The actual availability is essential and that includes physical presence, Winnicott’s holding concept and Bion’s containing.

Containment encompasses internal processing, akin to maternal reverie described before. It includes receptiveness, empathy and thinking. It can be expressed in verbal interventions such as interpretations but it does not have to be. Containment may in fact involve refraining from interpreting. However, this is not just being silent but remaining mindful of what’s going on, and of what the patient might need at the moment.

Containing responses are those which are mainly aimed at helping the patient with integration, promote tolerance of emotional experience and facilitate self-reflection. Reassurance and so called “supportive comments”, in so much as “strong” authoritative interpretations, can have containing function, but it may be short lived and spurious, when they represent a departure from facing the emotional truth and may encourage living a lie.

Analytical attitude

Having described the way psychic processes manifest themselves in the psychoanalytical situation and how they undergo transformations that can lead to psychic growth, Bion attempts to define optimal condition for facilitation of this process by considering the analytic attitude.

His starting point is not dissimilar to Freud’s. He says:

“ ... an analysis must be conducted in an atmosphere of deprivation .. The analyst must resist any impulse in himself to gratify the desires of his analysands or to crave gratification for his own. (Elements of Psychoanalysis, p.15)

But he develops it further.

Understanding of what actually happens in the session, requires, according to Bion, paying continuous attention to emerging immediate observations. They need to be looked at afresh every time rather than taken for granted and interpreted mechanically. This can happen for example with therapy breaks when they are interpreted in a stereotype way, “you felt that because you were missing me”. Meaning of a break can be different every time, and each time has to be discovered.

Bion becomes more radical when he talks about the analytical attitude of working without memory, desire and understanding. This recommendation is often quoted but not easy to accept. It becomes more understandable if we consider the shift of emphasis in his statements about the nature of truth and the essence of the analytical experience in Bion’s later work.

There, the importance of K – of “getting to know”, the direction towards understanding obtained by the use of sensory data gives way to overall importance of O. Bion considering the nature of psychoanalytic object arrives at the controversial position that it “... cannot be appreciated by the senses” (Cogitations, p.296). His attention turns to ways of appreciating transformations of O, of the elusive truth, with the use of the states of mind which can foster this. He talks about intuition but he is not satisfied with the concept. He is obviously referring to what other authors have been grappling with – for instance, Freud talking about evenly suspended attention or Reik using a more colourful concept of “listening with the third ear”.

Bion attempts to help to describe and facilitate the whole mental attitude which is likely to give as much access to O as possible, and he identifies obstructions to this endeavour.

One is reliance on Knowing – understanding. It represent a constraint which has to be maximally reduced. Relying on existing knowledge of the patient or of psychoanalytic theories relieves the anxiety about facing the unknown but prevents from learning anything new. Exercising a conscious desire to know stops actual getting to know. Bion follows the Freud’s dictum (in his letter to Lou Andreas-Salomé) about blinding himself artificially in order to better see in the dark. But he also supplements it with a metaphor of his own, of light being carelessly thrown into the open camera and exposing the film, destroying its capacity to register.

Open experiencing of the immediacy of the present can be also thwarted by the bondage of memory. Trying to remember what was prevents from facing and exploring the unknown of what is. He advocates that you have to forget about the patient you think you know, being open to meeting a new one every time.

But to attempt to forget is as bad as trying to remember, because it also detracts from being open to whatever emerges in the present. And that can be an unexpected recollection which comes up, not because is defensively forced but appears uninvited, spontaneously, like a dream, revealing something unexpected and new.

Desire creates another problem. If given in to, can stand in the way of being openness and receptiveness to whatever emerges and in whatever form. If one desires a particular outcome, or hates another possibility, this can affect not only accuracy of perceptions but can lead into directing the interaction towards further falsification which may go on unnoticed. Desire to avoid difficult material can be as detrimental as therapeutic zeal – in a pursued of desired cure or improvement, one can easily lose contact with what is going on. Bion puts is succinctly: “A desire to be a psycho-analyst obstructs being a psycho-analyst.”

Attitude “without memory and desire” requires effort, commitment and discipline, and above all, capacity to bear uncertainty in facing the unknown. This is related to Keats’ idea of negative capability (“being in uncertainties, mysteries, doubts, without any irritable reaching after facts and reason.”) Such an attitude of enhanced openness and receptiveness is akin to the mother’s reverie, to the state of maternal preoccupation, described by Winnicott, to attunement; it certainly has a lot in common with what is meant by intuition.

In relation to the other, the attitude “without memory and desire” is the exact opposite of projective identification in which one’s own qualities and perceptions are attributed to the other. It has a significance of empathic identification – a capacity of putting oneself in someone else’s shoes.

Floating in the sea of the unknown, waiting the truth to emerge and take shape, is difficult and dangerous – the sea can be full of sharks. It is experience that evokes doubt and anxiety, even a sense of persecution. It involves experiencing and waiting for realisations, at the same time going through some disintegration, akin to PS position. Only when the new ideas emerge, crystallise and are contained, a transformation can occur leading to newly formed state of affairs, which can be formulated in an interpretation.

The fear of the analyst is of psychic deterioration, of going mad. There is an awe and terror of O. Another danger in one of all-knowing position, of a dead certainty. This is falling into a godlike merger with O that can produce megalomania and dangerous departure from reality. Yet another threat comes from the analytical superego that watches out for transgressions and failings, and, when overactive, can paralyse open-mindness and reflectiveness.

Needles to say, the difficulties increase when dealing with intense and painful emotions pertaining to psychotic functioning and when excessive projective identification operates. The danger of falling victim to their impact is greater. At the same time there is a greater need for confident and containing presence, and for the mind which while remaining receptive will not be swayed by desires nor by psychotic thinking which uses pseudo-understanding, the mind which will be open to emotional experiences and able to maintain containment and thoughtfulness.

In his difficult task of maintaining the attitude “without memory and desire” the analyst draws upon his own resources. He is supported by his own analysis and his good internal objects, linked with his analytical ancestors – but in the analytic encounter he is basically alone.

This may be a sobering truth, but like other truth it also makes hope possible.

Let me finish with some quotations.

One quoted in one of Bion’s books, is by Dr Samuel Johnson, who wrote in a letter to Bennet Langton,

“Let us endeavor to see things as they are, and then enquire whether we ought to complain. Whether to see life as it is, will give us much consolation, I know not; but the consolation which is drawn from truth if any there be, is solid and durable: that which may be derived from errour, must be, like its original, fallacious and fugitive.”

Another quote is from Bion, who says,

“I am hopeful because, after many years of effort, I have at last achieved the capacity to be awed by the depths of my ignorance.”

Brazilian Lectures (1973) 1990. P.32