EMOTIONAL EXPERIENCE: THE ROAD TO UNDERSTANDING THE MINDS OF PATIENT
Paschoal Di Ciero Filho**
The emotional field has been under study since the dawn of psychoanalysis. Freud (1912), studying the phenomenon of the transference, observed there the feelings and emotions of the patient toward the analyst. What he underscored, however, and took into account in his analytic work, was the patient's emotional link with the analyst. He made no reference to the analyst's link with the patient, recommending only that the analyst maintain an attitude of neutrality.
With Heimann (1950), the analyst's subjective experience began to be regarded more seriously. She understood as countertransference those feelings that the analyst experiences in relation to his patient, and that are aroused by him. For her, these feelings are data for investigating the patient's inner world.
Attention to the analyst's person began to spark the interest of other theoreticians. Bion (1977) is one of the most significant authors among those who consider the analyst subject to the same emotional experiences as the patient. He shows the importance of the analyst's capacity, through reverie, to sense the patient's feelings in order for a real understanding of what is going on. Bion holds that a containing mother can sense the child's fear, for example, without losing her own emotional balance. This makes her able to understand what the child is going through. The analyst's receptivity to the patient's feelings, and his containing them, enables them to be understood, so they can be transformed into something more tolerable for the patient. These feelings can then be verbalized to the patient, who receives them back in a mitigated way. Projective identification is like a vehicle the patient uses to put feelings and anxieties into the analyst, so that the analyst can understand them. Bion considered this mechanism from an angle that had not been brought up until then, namely, projective identification as a means for emotional communication.
In Joseph's article "Projective Identification" (1989) it can be seen how her understanding of the patient and her subsequent interpretations are based not only on the emotional link, but also on the feelings that the patient projects into the analyst, the analyst's grasping of them, and his consequent verbalization. She also attempts to understand the emotional effect that the patient tries to exercise on the analyst.
Green (1988) clearly shows how there has been a change in the psychoanalytic field and considers that this change is to be found in the analysts themselves. He believes that the analyst obtains understanding through his subjective experience, which is determined by the effect on him of what the patient tells him, consisting of his affective impressions and his mental functioning. According to Green, the analyst's working through is also induced by the patient and mobilizes patterns in the analyst's thinking, from the most elementary to the most complex, aimed at symbolization and later verbal communication.
Bion (1991) considers that the analyst's sphere extends from the point where he receives the sensorial impressions, by listening, for example, to where he expresses the transformation which takes place, the interpretation.
From these authors it can be seen how the analyst, having experienced emotional reactions and subsequently worked them through, has eventually come to be considered an important variable in the psychoanalytic field, influencing it and being influenced by it. It can also be seen that the analyst, in his work during the sessions, employs his internal, personal resources much more than the theoretical instruments he may possess.
My objective in this paper is to discuss the emotional experience common to patient and analyst, in continuation of earlier papers (Di Ciero Filho, 1987, 1992) .
I see emotional experience located at the non-verbal level, and I consider this level important for the analyst's observation. It is there that psychoanalytically important emotional phenomena move about, such as transference, projective identification and countertransference.
The above considerations will be illustrated with clinical material to be describe as follows.
Many of the patient's experiences were also mine. In this respect, Green (1988) says that the patient's psychical reality is also felt by the analyst.
I also see the living encounter between the two of us as a result of our victorious struggle over our own destructiveness, which had served as a vehicle to swallow us up in a dark, heavy wave of our dead objects. The good thing that V. felt, and which I also felt, was our rediscovery of the fact that we were alive and that once again we had overcome death. We had prevented the shadows of the dead objects from hovering over us (Freud, 1915), as they had so often hovered over V. for so long a time. The nice feeling we had was also because of the victory of analysis, defender of life.
On this point, I think that analysis and life link up and move along together. What I mean by this is that the final object of analysis is to uphold life itself. As I said to V., in view of this, what we can do is keep the dead farther away, so that life can expand and become more dense. V. is aware of this. She said she wants to live the only alternative possible for her, to acknowledge her dead loved ones and her losses.
I referred to the interplay of emotions and feelings of both patient and analyst as a means of communication. This takes place at a non-verbal level. To further consider non-verbal communication, I would like to relate a fragment of a session with another patient, whom I have called M.
M. told me something, but I felt dispersed, and found it hard to grasp what she way saying. Even so, I could observe the form of her discourse. Her language was precise, with very consistent reasoning, and based on data from reality. I also observed that there was security and calm in her voice. My attention was called to a feeling of paralysis in one of my legs. I was afraid. I supposed that this emotion might be coming from the patient.
When she paused for a moment, I asked her if she was afraid of something. She answered in the affirmative. She said she had been afraid before she came in. She wanted to come, but she had a feeling of paralysis that seemed to keep her from moving ahead, or from walking. By this time my feeling of paralysis had disappeared.
I believe that my feeling of paralysis was a way for the patient to somatically deal with her fear, by using my body as depositary of this emotion and symptom, through using projective identification. For projective identification to actually take place, regressive processes in myself had to also be stimulated, so that I could formulate a primitive mode of expression: somatization. This was the same way that she used it, for me to understand what she was going through.
As I stated above, Green's position is that the patient's psychic reality is experienced by the analyst (Green , 1988). This communication at more regressed levels takes place through the archaic mechanism of projective identification (Bion, 1977). This leads me to think that for the patient's projective identification to be contained, the analyst must also immobilize his own most primitive nuclei. I thus believe that the regressive phenomenon that occur in the analyst, if carefully used, may serve as one more instrument for better understanding the patient's psychic world.
M.'s use of articulate and consistent verbal language was a way of masking very primitive forms of conflict solving, in this case, the symptom, which was an expression of archaic non-verbal language.
The author makes use of theoretical references of other authors to show how the analyst is affected by the patient's reaction and how this effect is useful for the analyst to understand what is happening in the analytic relationship. The author attempts to show how the analyst, by observing the emotional experience inherent in this relationship, is able to understand his patient's mental world by observing his own world. Following a description of clinical material from two different cases, he attempts to show how this emotional experience sustains and promotes the development of the analytic work and an understanding of what takes place with the patient. The author considers that it is in this emotional, non-verbal field that raw material for interpretation can be found. It is there that important variables in the psychoanalytic field originate, such as transference, countertransference and projective identification. This underlines the importance of observing this emotional field for the development of the psychoanalytic science.
The author considers that the psychoanalyst's principal working instruments are his intrinsic resources as a person, more than any theory he may possess.
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