Grigorios Vaslamatzis' Paper

CONTAINING A DEAD OBJECT

(Container-contained and reverie concepts in understanding the analytic process treating patients with "dead mother complex" a case study).

by Grigoris Vaslamatzis, MD.

INTRODUCTION

It is evident that Klein presumed that the internal mental mechanisms (e.g. projection) and drives imprint their action on unconscious phantasies (like, projection identification). In her text, "Notes, on some schizoid mechanisms" (1946) makes reference to the outbursts of anger in infants and records that "the other line of attack derives from the anal and urethral impulses and implies expelling dangerous substances (excrements) out of the self and into the mother. Together with these harmful excrements expelled in hatred, split-off parts of the ego are also projected into the mother [...] are meant not only to injure the object but also to control it and take possession of it" (1).

Bion continuing this line of thought made the transposition of what happens to an infant to what happens in the link between mother and infant. He gave emphasis to the mother's ability to contain the primitive anxieties which the infant experiences and which are projected to her.

This description of link is facilitated by a bipolar image. It is the metaphor of the concept "container" - "contained". As such, Bion refers to the very early relation of the infant has with the mother's breast, when, that is, the infant directs his anxieties on the breast. If this experience is pleasant (a mother who can endure and contain anxiety) a feeling of reassurance is established. If the experience is not pleasant (a mother who by nature is anxious and unable to hold the aggressive and anxious trends of her infant) then the feedback sent by his projections does not contain any processing which in turn inundates his immature "ego".

In this relationship Bion includes another aspect: the mother's reverie which complements the infant's projective phantasies. Reverie is a specific reaction of the mother which allows her to feel the infant in her, and to give shape and words to the infant's experience. This, according to Bion, is possible since the mother is influenced by the infant's preverbal material (that is, she is influenced by his projective identifications) and produces her own thoughts and reveries, in which this given material is processed in her own particular way (2,3).

Seen from a clinical point of view, the proposition of Odgen recorded by him in his book "Subjects of Analysis" could be suited to my understanding of the therapist's reverie. According to him during a session, "the analyst's psychological life in the consulting room with the patient takes the form of reverie, concerning the ordinary, everyday details of his own life [....] which are not simply reflections of inattentiveness, narcissistic self-involvement, and the like [....] rather represents symbolic and protosymbolic (sensation-based) forms given to the unarticulated (and often not yet felt) experience of the analysand..." (4).

In this respect, reverie is a special condition experienced by the therapist and is connected with countertransference. Its analysis and elucidation of experience will allow, progressively, the effect of a useful therapeutic function including the understanding and interpretation.

The analysis of preverbal experience is a prerequisite for an analyst who is sensitive to non-verbal communication and countertransference and who is able simultaneously to create words and to describe non-verbally expressed anxieties. The analyst takes into consideration that he must become the container of these anxieties and subsequently must understand them with empathy that the patient has the need to project these anxieties and the non-tolerant aspects of his personality. And this, because he himself is unable to endure it or expects someone else to understand what he has gone through. In this process, moreover, discourse and interpretation co-exist, and are viewed in an overall psychoanalytical relation. Evidently, they will form a successful process when the therapist discovers the specific method of function for his patient: when to speak, when to interpret, when to be silent.

This technical form acquires a particular meaning in case of patients encountering internal dead objects, and subsequently, in relation to this, severe depression. The existence of dead objects within the psychic reality is connected, on the one hand, with unbearable psychic pain and on the other hand, with a subjective inclination to relieve himself of these, or to bring them back to life.

Psychoanalytic therapy provides the patient with an opportunity to relive these feelings, wishes, defences, with at times beneficial or destructive results.

A clinical case
(omitted here)

DISCUSSION

This clinical case could be more thoroughly understood based on the theoretical proposals of the work by Wilfred Bion which is of important clinical value, that is, the concepts of the container/contained and the function of the reverie in the therapist.

The efforts of Ms L to become relieved from the internal dead object via projective identification led to relationships which were characterized by feelings of misery, unsatisfaction and "death" in both parts. This is the repetition of the primitive object relations. The mother decathected from little L due to the fact that her husband had withdrawn from their relationship. Also the father was a "dead object" in part due to the projective identifications of little L, and also due to his narcissistic pathology. An unresolved "dead mother complex" was therefore formed, whose description we owe to Andre Green. According to him, the basic characteristics in this case is, first, that "it takes place in the presence of the object which is itself absorbed by a bereavement" and second, the loss in this case is the "loss of meaning" (5).

The transference influences in an intense manner the countertransference. The projective identification of L makes the therapist to contain the dead object, such as it appears when the therapist phantasizes that he cannot be of help and questions the change (eg. destruction) of analytical setting to that of a supportive technique. During the session the therapist makes "reverie" by two methods: he tries to find meaning for the feelings of misery or pain, as a mother does when she contains these projections by her infant. The psychoanalytical thoughts are also a form of reverie. On the other hand, when he phantasizes the relationship with his patient, he is making, in first view, a non logical connection: good parent - good therapist, and wonders about this connection. The meaning, I think, concerns a therapist, who like a mother, is anxious whether he is a good parent-therapist. In a deeper level, being mourned his own losses and traumas, and being confronted with the patient-child he can elaborate them and help the patient to surpass her anxieties. Regarding this topic, Alexandris notices that the patient's analytic voyage in the unresolved mournings of his life is connected with the processes the analyst makes simultaneously with his own mourning (6). At this point I have to add an autobiographical note. My understanding for the unresolved mourning which was projected by the patient to me as well as my own particular reverie are connected with an image of my childhood years. Being myself an emigrant from a town of the Near East, for which Ms. L. often referred to, and also keeping my feelings of sadness and loss, I realized that I had accepted her infancy's lost objects. I was keeping my empathic stance even though it was difficult to understand her vague narrations. And when she was talking about her trips it affected me; I felt elated and fell into a reverie. But most important was my reverie during the crucial period of sessions I have described. My reverie made up by Ms L's projections into me and by the resonance on my internal objects and emotions. I have shown how this process was not an obstacle to perceive the deeper loss-anxiety of my patient, which concerns initially the "loss" of her mother, initially, and secondly, that of the father (as a substitute of the mother). (Note: Andre Green presumes that in the case where the mother is decathected very early, a defensive, "primitive and unstable triangulation" is evident and the child becomes attached to the father) (5). The second dream shows that initially there is a good (erotic) relation with the object, which finally withdraws and is transformed to a dead object. Ms L pursues thereafter to reinstate it in her life. It would be therefore correct to place my reverie within the framework of a double influence, on the one hand, that of my patient (with her archaic projective identifications) and on the other hand my own internal psychic sources (with my particular mournings and defence mechanisms).

Bion, with his clinical work and his theory, has established an efficient frame of reference in our therapeutic attempts with difficult cases. In this study I tried to bring to light how we can understand the clinical material and the transference -countertransference of a regression which is apparent in a patient with "dead mother complex".

REFERENCES

1. Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis, 27:99-110.

2. Bion, W. (1959). Attacks on linking. International Journal of Psychoanalysis, vol. 40. Also in:Second Thoughts, London: Heinemann (chapter 8).

3. Bion, W. (1962). A theory of thinking. International Journal of Psychoanalysis, vol. 43. Also in: Second Thoughts, London: Heinemann (chapter 9).

4. Ogden, T. (1994). Subjects of Analysis. London : Karnac Books.

5. Green, A. (1990). The dead mother. In: On Private Madness. London.

6. Alexandris, A. (1993). A parallel voyage of mourning for patient and analyst within the transference - countertransference voyage. In: Counter-transference: theory, technique, teaching (eds:Alexandris A, Vaslamatzis G.). London: Karnac Books.

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Grigorios Vaslamatzis, MD
Athens University Medical School
10, Dimitressa str.
Athens GR-11528
Greece