Contribution to Psychoanalysis and Narrative Medicine Conference
University of Florida, Gainesville, 19-22 February 2004


Janet Sayers

“I can feel him. I can smell him. I can hear him. It’s too real.” So saying a woman complains of the abuse she has suffered. It eludes feeling and telling. Neuropsychology tells us that in trauma “the high level of emotional arousal impairs memory and the hippocampus can atrophy from high levels of the stress hormone cortisol.” Hence “the memory difficulties of trauma victims who retain the physical and emotional aspects of the experience, the encoded body changes of emotional memory, but cannot recall the actual details of the event” (Emmanuel n.d: 7).

Trauma evades narrative memory. Paradoxically, in this, it is akin to the beyond words ineffability or transcendence of mystical or religious experience. One of the founding fathers of today’s academic psychology, William James (1902), regarded just such experience as a cure for the ills of what he described as “the divided self”. Today, by contrast, thanks to developments in psychoanalysis associated in England with the work of Winnicott and Bion, healing trauma is now seen in terms of the narration made possible by the intersubjectivity associated with what could be called feminine receptive empathy. In her recent trilogy, Le génie féminin, however, the literary theorist and psychoanalyst, Julia Kristeva, adds to this the projective empathy of women as daughters and mothers as means of transubstantiating and metamorphosing the formlessness of trauma into semiotic, symbolic, and narrative meaning. In explaining all this I will begin with James.

William James
In his 1890 book, The Principles of Psychology, James told his readers: “It is, in short, the reinstatement of the vague to its proper place in mental life which I am so anxious to press on the attention”. Quoting this approvingly, Anton Ehrenzweig (1953, 1967) argued that just such vagueness, or “chaos”, is the starting point of all that is best in music and art. James, himself, argued that it is the fount of all that is best in religion. More crucially, as regards narrative medicine, he maintained that the vague, evanescent, fleeting, mystical oneness with what is God-like or divine of mystical experience often marks the turning point in healing those otherwise suffering from crippling self-division between love and hate, good and bad.

James described mystical oneness with God as mediated by the subliminal or unconscious self accessed, he argued, by the usual barrier between it and wide awake consciousness being lowered. He allied this lowering, or surrender as he also called it, with examples of women healed from hysteria through the injunctions of their doctors put to them under hypnosis. He likened it also to the openness of the women mediums he studied as a psychical researcher to visitations from the dead.

He himself was fearful of such spectres. Perhaps that was why he scarcely, if ever, experienced the mystical states of mind he so lauded as healing in others. He described them as revelatory - as “noetically” insightful - and as beyond words ineffable. Possibly it was the very fears that contributed to these experiences eluding him that contributed to the ills for which he often sought religious mind-cure therapy.

Freud rejected such treatment as unscientific. He was also vehemently opposed both to religion and to mystical experience. He characterised it as defensive and regressive return to primary narcissism and the illusion of oneness with one’s mother as a baby. Nevertheless he borrowed from mysticism in developing his methods of evenly-suspended attention and free association in encouraging his analysands to say whatever occurred to them in association, for instance, to the bits and pieces of their dreams. Neuropsychologists today tell us that just as the hippocampus may fail to function in trauma its intact functioning may be crucial to dreaming. Meanwhile psychoanalysts have begun to view dreaming, and the proto-narratives involved, as healing and as brought into being through the intersubjectivity of self and other, of analysands with their analysts, which some compare to women’s relation to others as lovers and mothers. In this these analysts’ characterisation of analysis is quite unlike Freud’s experience of it. He confessed to his analysand, the poet H.D., for instance, “I do not like to be the mother in the transference. It always surprises and shocks me a little. I feel so very masculine” (in Sayers 1991: 8).

In England the modelling of psychoanalysis on women’s mothering is often associated with Winnicott. He argued, in effect, that our ability to sustain the vague, mystical states of mind celebrated by William James depends on early experiences of being held psychologically as well as physically by those who first mother us such that we can bear, even enjoy, such states of “primary unintegration”. If all goes well, he wrote,

There are long stretches of time . . . in which a baby does not mind whether he is many bits or one whole being, or whether he lives in his mother’s face or in his own body, provided that from time to time he comes together and feels something. (Winnicott 1945: 150).

Through her identification with her baby, he went on, the mother anticipates and meets what could be called its proto-narrative fantasies or illusions. She thereby enriches them with details of what is “actually available” (Winnicott 1945: 153). Mother and child thereby “live an experience together” (Winnicott 1945:152 - emphasis in original).

At first, of course, the baby has no knowledge of its fantasies and dreams. Nor does it know of their interrelation. It does not know that “the mother he is building up through his quiet experiences is the same as the power behind the breasts that he has in mind to destroy” (Winnicott 1945:151). Infants and children need the assistance of others to get to know what they imagine and tell themselves when they are asleep. Or, as Winnicott added, “It is normal for small children to have anxiety dreams and terrors. At these times children need someone to help them remember what they dreamed” (Winnicott 1945: 151).

In his book, Looking for Spinoza, the neuropsychologist, Antonio Damasio, cites ethological evidence indicating that baby monkeys need to see their mothers feeling frightened of snakes to become frightened of them themselves. Damasio concludes from this and from many neurological and other findings that our feelings are an effect of the brain’s mapping of the body’s response to “emotionally competent stimuli” coming from others as well as from oneself (Damasio 2003: 53). Winnicott (1945, 1947) likewise argued long ago that knowing one’s feelings of love and hate depends in the first place on one’s mother facing and knowing about these feelings in herself.

Winnicott furthermore argued that getting to know our fantasies depends on our mothers physically and psychologically surviving our fantasies of destroying them so we can use them and others as figures on whom to vent and thereby get to know better these and other fantasies. This is the means by which inner subjective and outer objective reality come together without which, as Winnicott’s close colleague and friend, Marion Milner, put it, “the world becomes grey, lacking in affective colouring, prosaic” (Milner 1952: 191).

Milner allied this with mysticism. So did Bion. But, like Winnicott, he too argued, in effect, that the transformation in psychoanalysis of experience into narrative meaning is akin to what one could call the receptive empathy or identification of women with their lovers and babies. Shortly after falling in love with, and marrying his second wife (his first wife having died in 1944 just after giving birth to their daughter, Parthenope), Bion noted, apropos group therapy

In group treatment many interpretations, and amongst them the most important, have to be made on the strength of the analyst’s own emotional reactions . . . [to a group atmosphere or] proto-mental system in which physical and mental activity is undifferentiated (Bion 1952: 149, 154)

In another essay written at about the same time he wrote of the obstruction in schizophrenic states of mind to transforming such undifferentiated activity into what can be known and thought about through the narrative form of dreaming. He quoted as illustration an analysand saying with several minutes’ silence in between each utterance

“I have a problem I am trying to work out.”
“As a child I never had phantasies.”
“I knew they weren’t facts so I stopped them.”
“I don’t dream nowadays.”
“I don’t know what to do now”

As he said this he became distressed. Bion commented “About a year ago you told me you were no good at thinking. Just now you said you were working out a problem - obviously something you were thinking about.” “Yes.” Bion accordingly concluded, “without phantasies and without dreams you have not the means with which to think out your problem” (in Sayers 2003: 205). In other essays Bion gave examples of such analysands ejecting sensations as things by convulsively jerking their bodies, depositing what they took in visually onto walls and into corners of the consulting room such that it became a hallucination, attacking any link with Bion taking in and making what they experienced bearable, and enviously attacking links between themselves and others.

Armed with such clinical data, Bion cogitated on the mathematician, Poincaré’s notion of a “selected fact” which, he said
must unite elements long since known, but till then scattered and seemingly foreign to each other, and suddenly introduce order where the appearance of disorder reigned. Then it enables us to see at a glance each of those elements in the place it occupies as a whole. (in Sayers 2003: 208)

Bion attributed the lack in schizophrenic states of mind of any such selected facts, which are, of course, often essential to narration, to inability to tolerate the frustrations of getting together with others, or of others getting together with each other. The result, he argued, is that

In the psychotic we find no capacity for reverie, no a, and so none of the capacities . . . which depend on a, namely attention, passing of judgement, memory, and dream-pictures, or pictorial imagery that is capable of yielding associations. (in Sayers 2003:211)

More usually, he argued, narrative “dream-work-a is continuous night and day”. It operates on stimuli arising both within and beyond the psyche. In psychosis, however, there is no such integrative function, nor any disintegrative function neither. In psychosis, he noted, there is “a lack of associations . . . as if the word were a counterpart of the pure note in music, devoid of undertones or overtones” (in Bion 1992: 63).

In such cases, Bion maintained the analysand needs the analyst to be like an artist or scientist of whom Bion wrote

He is someone who is able to digest facts, i.e. sense data, and then to present the digested facts, my a-elements, in a way that makes it possible for the weak assimilators to go on from there. Thus the artist helps the non-artist to digest, say, the Little Street in Delft by doing a-work on his sense impressions and ‘publishing’ the result so that others who could not ‘dream’ the Little Street itself can now digest the published a-work of someone who could digest it. (in Bion 1992:143-4)

Bion also compared this process of transformation to mothers metamorphosing their babies’ sense data and self-sensations into the stuff of narrative thinking. He speculated that, experiencing frustration at the mother not feeding it when it wants might become the beginning of a thought, “no breast”. Alternatively the baby might experience this frustration as a “ß-element” thing or “bad object” to be got rid of with the risk that it returns as a persecuting “bizarre object”. The answer, Bion further speculated, resides in the mother neither collapsing nor being indifferent. It resides in her “containing” the baby’s projected ß-elements and transforming them, through her “capacity for reverie” into the a-elements needed for experience to be registered, stored, known, and narrated. Bion also conceptualised this in sexual terms, in terms of a man contained by his woman lover in sex. He accordingly schematised the analysand-analyst, contained-container relation as “[signs for male and female]”.

Further sexualising this coupling, Bion urged the importance of treating its resulting interpretations as pre-conceptions open to revision by whatever their future “mating” with reality might reveal. He urged openness to the same vagueness, in a sense, as William James advocated. He theorised it in terms of free movement between what he described (adopting Melanie Klein’s terms) paranoid-schizoid and depressive states of mind. He schematised this free movement as Ps?D. He argued that it entails the analyst’s capacity to tolerate the anxieties involved in the two states of mind involved, anxieties which, as previously indicated, William James seemingly found it hard to bear.

Some argue, however, that the analytic stance advocated by Bion is too passively contemplative. Kristeva, by contrast, depicts psychoanalysis in much more active terms in her recent trilogy, Le génie feminine. Previously she had depicted psychoanalysis, as Winnicott and Bion had, as essentially involving what one could call receptive empathy. She conveyed that analysts should model themselves on the idealised female figure, Sonia, in Dostoevsky’s novel, Crime and Punishment, taking in and being non-judgementally receptive to the man, Raskolnikov, who becomes her lover. Dostoevsky describes her receptive empathy thus following Raskolnikov’s confession to her that he is the murderer of her friend, Lisaveta

[Sonia] looked at him helplessly for some time, and with the same expression of terror on her face [as Lisaveta] and thrusting out her left hand all of a sudden, she touched his chest lightly with her fingers and slowly began to get up from the bed, moving farther and farther away from him and staring more and more fixedly at him. Her feeling of horror suddenly communicated itself to him: exactly the same expression of terror appeared on his face; he, too, stared at her in the same way, and almost with the same child-like smile. (Dostoevsky 1866: 424)

Later, as Dostoevsky also put it, “when all her heart was turned to him, he felt and knew that he was infinitely more unhappy than before” (Dostoevsky 1866: 435). In Bion’s terms, Sonia had arguably transformed, through her receptive empathy with Raskolnikov, his previous ß-element thing-like terror and agitation into consciously experienced a-element form.
Summarising this transformation, Kristeva writes

According to Dostoevsky, forgiveness seems to say, through my love . . . I recognize the unconscious motivations of your crime . . . It raises the unconscious from beneath the actions and has it meet a loving other - an other who does not judge but hears my truth in the availability of love, and for that very reason allows me to be reborn. (Kristeva 1987: 204, 205)

Generalising this to psychoanalysis Kristeva has since written

Forgiveness - that is to say, the gift of meaning at the heart of the transference - is also at the heart of the talking cure of psychoanalysis. . . . From beneath action, it involves the encounter of the patient’s unconscious with a loving other, who does not judge, but who understands the patient’s truth without acting on the love that enables their rebirth. (in Sayers 2003: 235)

Having thus presented psychoanalysis as, ideally, a process bringing about the analysand’s rebirth through what could be called the analyst’s receptive feminine empathy, Kristeva has recently described the work of the analyst more as a process of projection in transforming what is thing-like, piecemeal, inarticulate, and beyond words into narrative form. She illustrates the point with the example of Melanie Klein’s transformation of her 4-year-old son, Erich’s proto-fantasies into full narrative form through projecting and weaving her ideas and images together with his. As illustration she quotes the following vignette, as described by Klein

He had spoken of his ‘kakis’ as naughty children who did not want to come . . . I ask him, ‘These are the children then that grow in the stomach?’ As I notice this interests him I continue, ‘For the kakis are made from the food; real children are not made from food . . . they are made of something that papa makes and the egg that is inside mamma.’ (Klein 1921: 33)

Kristeva also illustrates the point with the example of Klein’s analysis of another 4-year-old, Dick, who might today be diagnosed as an instance of autistic spectrum disorder. Certainly Dick seemed very autistic and blank at his first meeting with Klein. He ran aimlessly around the room, and treated her as though she were a piece of furniture. In the absence of his expressing any interest or feeling Klein relied on her own ideas and on what she had been told about Dick and his obsessions, particularly with trains. Taking up two toy engines and calling the bigger one the “Daddy-train” and the smaller one the “Dick-train”, she put them side by side. At this Dick picked up the Dick-train and rolled it to the window, saying “Station”. Arguably projecting into the situation her mother-centred version of Freud’s Oedipus complex theory, she hazarded; “The station is mummy; Dick is going into mummy”. To this Dick responded by running in and out of the space between the double doors of her room saying “dark”. Klein interpreted, “It is dark inside mummy. Dick is inside dark mummy” (Klein 1930: 225). With this, it seems, Dick became less cut off from his emotions. He became visibly upset and, voicing his fear, asked when his nurse was coming to collect him.

In subsequent sessions he expressed other emotions, notably violence and aggression. He pointed, for instance, to a little toy coal-cart, saying “Cut”, at which, wrote Klein, “Acting on a glance which he gave me, I cut the pieces of wood out of the cart, whereupon he threw the damaged cart and its contents into the drawer and said, ‘Gone’” (Klein 1930: 225, 226). Another time, she wrote, “Dick lifted a little toy man to his mouth, gnashed his teeth and said ‘Tea daddy,’ by which he meant ‘Eat daddy’”. Later he expressed concern for her, saying “Poor Mrs Klein”. He thereby put into words the “premature empathy”, said Klein, which she claimed had been “a decisive factor in his warding-off of all his destructive impulses . . . [and] brought his phantasy-life to a standstill by taking refuge in the phantasy of the dark, empty mother’s body” (Klein 1930: 227).

Kristeva comments that, by putting Dick’s fantasies into words, Klein transformed his mental universe from one “based on identities” (e.g. father = train) to one “based on similarities” (e.g. penis akin to father). She transformed his mental universe from one based on what Lacan called the Real to one based on the Imaginary (Kristeva 2000: 139). Generalising from such cases, Kristeva argues that, on the basis of her experience of being mothered and mothering, Klein evolved a technique akin to that by which mothers bring their fantasies together with the pre-narrative “proto-fantasies” and drives of their babies, already geared from birth to their mothers, to imitating their mouth movements for instance (see e.g. Trevarthen & Aitken 2001). Through mothers projecting their fantasies into their babies, says Kristeva, they transform their object-related drives into semiotic, symbolic, and narrative meaning.

Analysts, she claims, do something similar in projectively identifying or empathising with their analysands thereby bringing or restoring their psyche to life. Women analysts, she suggests, might be particularly adept at this (albeit men analysts, she argues, can do it too), given their experience of their mothers’ “seductive osmosis” with them when they were babies. Kristeva emphasises that, in this, the mother also has in mind her desire for her father or for her child’s father. Either way, such is the biological receptivity of the girl’s genitals, as well as of her mouth and anus, she greets this seduction with bodily excitement. Kristeva adds that women compensate, as infants, for thus being the objects of their mothers’ seduction by elaborating “an identificatory and introjective link with the seductive and intrusive object constructed by the mother” (translated from Kristeva 2002: 549). The little girl thereby forms her first “internal representation”. It launches her into the organisation of her psyche - “psychisation” - and, from here, eventually into narrative. Kristeva illustrates the point with the novels of Colette which she traces to her seduction by her mother, Sido, and by her first husband, Willy.

Kristeva notes that, applied to psychoanalysis, the analyst’s maternal seduction or projective identification with the analysand raises the problem of treatment by suggestion. But Kristeva does not deal with this problem. Others, by contrast, have dealt with it as it affects mother-daughter relations. Nancy Chodorow, for instance, argues that women are much more at risk than men of their mothers’ seductive projections into them as infants. She notes the analyst Enid Balint’s observation that, as a result of their mothers’ “false empathy”, women often grow up feeling they cannot “interpret the world in their own way”. Balint illustrated the point with the example of a woman whose mother responded to her as an infant more in terms of “her own pre-conceived ideas as to what a baby ought to feel . . . [rather than] what her baby actually felt” (in Chodorow 1978: 100-1). To this Chodorow adds case histories of women whom she describes as similarly “unable to empathize with their children” except through the narcissistic “closeness” involved in “projecting themselves onto the child” (Chodorow 1978: 102).

Generalising from such observations, Chodorow argues that boys, as well as girls, go through an early “symbiotic phase of unity, primary identification, and mutual empathy with their mother and then go through a period of differentiation from her” (Chodorow 1978: 108n). But, she adds, this process of differentiation is less marked in girls since, because of her shared sex with her daughter, the mother is liable “to experience a sense of oneness and continuity with her”, thereby projecting into her “unconscious meanings, fantasies, and self-images about this gender and . . . her own internalised early relationships to her mother” (Chodorow 1978: 109, 167). As a result, says Chodorow, “Girls emerge from this period with a basis for ‘empathy’ built into their primary definition of self in a way that boys do not” (Chodorow 1978: 167). But this, as I have indicated, results from the projective identification of mothers with their daughters, of whom Marilyn Lawrence (2002) now writes that they often grow up being, and experiencing their mothers and analysts as being projectively over-intrusive. This account of oneness could hardly be more different from William James’ male-centred account of healing oneness with God with which I began.

Unlike Chodorow, many celebrate the female-centred empathic oneness with another involved in mothering, femininity, and “feminine genius”, to use the term Kristeva adopts in commending Klein’s achievements in child analysis. Much can certainly be said in favour of psychoanalysis as a successor to the ineffable oneness with God espoused by William James and by many of his contemporaries. Much too can also be said in favour of psychoanalysis, in contrast to religious therapy, putting into words what James celebrated as transcending any such transformation. For, by putting into words what goes on psychologically between the analyst and analysand, the resulting interpretations and narratives can be tested against reality unlike the ineffable, beyond words, mystical experience to which religion all too often appeals in refusing to open its dogmas to scientific investigation. The transformation of psychoanalysis from a male and impersonal surgical procedure, as Freud (1912) once depicted it, into one that is more linked with women’s femininity and mothering is also beneficial in highlighting the importance of empathic oneness of analysts with their analysands, likened by Kristeva, Winnicott, and Bion, as I have sought to convey, to women’s identification with, and receptivity to their children and lovers. Together with projective empathy it can be healing in transforming the beyond words ineffability of both mystical experience and trauma into knowable narrative form. But if the resulting narratives and theories become rigid there is the danger of psychoanalysis becoming as ossified and impervious as religion to the truth which it has been so much the genius of psychoanalysis, not least through its mysticism-based method of free association, to help expose and confront.

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Winnicott, D.W. (1947) Hate in the counter-transference. Ibid pp. 194-203

[Gainesville paper - 4,325 words]