Where’s the breast?


A comical question, no doubt. Somewhat crazy: inappropriate, eccentric. Welcome to the world of psychoanalysis, or more specifically, Kleinian or Bionian analysis. This is what a Bionion therapist might ask of a group making what he/she would call a ‘basic assumption’ of a dependent group (seeking a leader), and floundering in midst of unfulfilled expectation. Yesterday I attended a four hour presentation about the work of Wilfred Bion, whose name, like his copyrighted interventions, have dotted this blog over the last year or so. This essay follows the spirit of Bion, the seminar I attended on a sluggish Saturday morning: it will be inchoate, elusive in meaning; seemingly interchangeable at times with ideas that many working in or else consuming mental health systems will take for granted. A discussion of Bion’s ideas begins plainly enough, with references to having an ‘ordinary conversation’, the ‘subjective experience’ of the patient; a search for the ‘real’ experience. Yet there is a secret attached: a sense that understanding is something that is transiently captured but then hard to retain, as if the desired knowledge (if that’s the correct term) was not meant for us.

Having taught a class once on Bion I knew the bio: born into an aspiring gentry in India at the end of the 19th century, Wilfred went to boarding school at age 8 to one of those stiff, militant academies that Harry Potter has since immortalized; he faced peer cruelty, the incomprehensibility of adults…their occasional kindness. He recounts a story of a headmaster who rebuked him for a game in which a playfriend is harmed by a game involving a rope without a knot, tied around a neck. The game might have killed the boy, the headmaster admonished. The headmaster later spoke to an assembly of boys, sparing young Wilfred humiliation, but drawing attention to the dangers of exploratory play. Young Bion felt chastened but not shamed, and oddly understood. An incident with an initial meaning took on another meaning, and its evolution was understood and modified by what Bion would later term the ‘reverie’ of an adult.

World War I was a setback in many ways. Obliterating men, obliterating meaning, Bion never felt more foreign that when he fought on European soil as a tank commander, his responsibility that of determining enemy positions, orienting his comrades. Impossible, he decided, observing the chaos. Impossible also to take in the purpose and meaning of all that slaughter, though he noted the primitive attempts, the glorifications of Winston Churchill, for example, who wrote with seeming ecstasy about the sensuous whistle of bullets in the field. After a momentous campaign in Cambrai, France, Bion was offered a Victoria Cross medal for his bravery, but declined, and when interviewed by an admiring General, later reported: ‘I couldn’t think what to say’. So Bion’s development was one of estrangement from commonplace human aspirations: for power, status, or even belonging. An outsider, Bion contemplated trauma, dissociation, the breakdown of thinking, and links to emotion, and later brought to psychoanalysis an almost mystical view of the human mind.

To consider the types of scenarios wherein Bion’s ideas are relevant, a student should invest some time and read his seminal papers of the late fifties, early sixties: “Differentiation of psychotic and non-psychotic personalities”, “Attacks on linking”, “A theory of thinking”, in which Bion asserted that many patients in psychotherapy communicate via a primitive defense known as projective identification (a defense first explicated by Melanie Klein), inserting into another’s mind a disturbed experience, which is then to be either ‘contained’ or not, metabolized or not, and re-directed back to the patient for internalization. Bion offered that the psychotic individual, or he/she existing in like borderline states, experiences their mind as composed of furniture, ‘things in themselves’, not modified by symbolic function as language, dream and metaphor (the ingredients of what Bion termed Alpha function), but lost in minutia. Thus we consider the experience of the patient who enters an office in which the therapist has made alterations to the (literal) furniture, and is rendered uncomfortable, and is not only incapable of putting words to that experience, but is also blocking of the therapist’s attempt to reflect back and give meaning. Lacking this fund of knowledge, or ‘K’ as Bion dubbed it, the patient in this proto-psychotic state exists in a world of things, drained of ideas, meaning, and feeling.

Later in his career, Bion expanded his theory to include the concept of ‘O’, or ‘being’, to denote a mystical, transformative experience. In his worldview, the outsider is a key figure: he or she is a genius, an innovator; contained by an established order, that (like me) dilutes ideas so as to make them digestible by a mass audience, the outsider is restrained only by God, ultimately. Bion’s book, Transformations, may have alienated him somewhat from the psychoanalytic community, who appear to have inherited or internalized Freud’s supposed distaste for the spiritual, but it crystallizes for the modern therapist an essential task when sitting with patients. Why? Because patients or clients don’t come into our offices with explicitly organized complaints like “Who am I?” or “I need to figure out how I think?” As therapists, our precociousness (yesterday’s speaker’s term) leads us to give premature insights, to show off our minds, deliver solutions; understand our patients before they understand themselves. We want to do that. I want to do that. And I believe the people who come see me want this also…sort of. But it is not cheaply arrived at, and between complaint and working through there is, more often than not, a nameless wasteland that elicits dread: it is a space of boredom and emptiness; it is painful in ways that are hard to describe on a somatosensory level, though we may be arrested at that point of entry. It is a dead zone of sorts, and a therapist, the person standing before an uncertain process,  is a kind of Grim Reaper.


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