Tag Archives: Wilfred Bion

About reviews, popularity

Ever get the feeling someone’s trying to tell you something by not telling you something? Psychotherapists (that identifier feels awkward for some reason) have to learn to interpret the unsaid, by thinking about non-verbal information: everything from muted sighs to averted glances at a hidden clock, to I’m-running-late text messages, belated vacation or business trip announcements; e-mail terminations. Relationships in some people’s lives end with tumbling regularity. Exchanges are transient. Promises are easily given, and more easily withdrawn or better yet, forgotten. If you wrote it down, good for you. Kudos for the documentation, signifying that something meaningful happened.

I don’t spend a lot of time documenting psychotherapy, largely because it makes for dull reading, the type of notes one is meant to write for nosy overseers. It makes for good stories however, not that I can lift them directly from my clients’ shares. Instead, it’s an exercise in grabbing at pieces, tossing them at a blank page, worrying later about the links. For my first four novels I’d picked sketchily from my clients’ backstories, preferring to represent moments, unidentifiable fragments of individuals’ lives, maintaining everyone’s confidentiality. Except mine, of course. It’s several years since my first effort, the much somethinged Living Without Blood, about somebody named Eric Metcalf and his friend Richard something else, coming together after years of gradual estrangement in order to…actually, I’ve forgotten what they did together. I loved LWB at its time of publication—2009. It was my first-born: a sloppy, muddled beginner trying to find its legs after a nine-month labor, but occasionally standing tall, inspired by a self-consciously prosy flow. Skip to 2012: the release of Crystal From The Hills, a picaresque adventure that I’d conceived as a 600-page novel, only to split the story in half, releasing its follow-up, The Situation, two years later. Crystal took three years to write, in sporadic bursts in between semesters of my post-graduate training program at the Masterson Institute. Written three times, suffered over like a still-birthed thesis, it was my best effort thus far I thought, and I was confident enough of its value to submit a manuscript for review, with Kirkus magazine, a reputed den of literary cognoscenti.

Kirkus didn’t like Crystal From The Hills, calling it “sprawling”, “meandering” (a reference to its many flashbacks, childhood background material to make John Bowlbyesque sense of my protagonist’s disturbance). I got my first real taste of a reviewer’s, and presumably an average reader’s distaste for disrupted narrative, impatience with detail. I learned that some might find my prose difficult to read, for it was “ponderous”, “stacking of clauses and syllables”; containing way too much minutia. Gee, had they ever read David Foster Wallace? There wasn’t much complaint (from Kirkus) about the plot as such, or about character development—rather a suggestion that readers prefer heroes to be heroes, or at least charming, as opposed to being self-absorbed underdogs, or as one reader put it, losers. Ironic, for the novel’s underlying theme was empathy, so I did indeed fail in my task. I absorbed the criticism graciously, I think, noting that for my modest investment I’d received more honest feedback in two paragraphs—indeed more feedback, period—than I’d received from most non-paid (friendly or not) readers over the previous three years. Seriously, outside of the odd sympathetic review posted on Amazon, my readers, which include one loving family member, plus a rough crossection of my friendship circle, have given me little interest over the years. Some of them don’t care for psychodrama, preferring sci-fi, fantasy, non-fiction, or pleasant yarns about dogs or foreign travelogues. I think some struggle with the opening pages of my books, are left sucking oxygen within minutes having regarded my prose as if it were like the text of vacuum cleaner manuals. Most think that theme is subordinate to plot, which I agree with to some extent, except that some just don’t register ideas, only action. And some just don’t read. Period.

Oh well.

The effort to engage strangers moved on. The Situation received a warmer review from Kirkus, as in lukewarm, with concessions that it contained less of its predecessor’s flaws, as in less background material, less “meandering” plot. This was a somewhat hollow non-criticism, as the novel was a sequel and therefore did not require much backstory. However, other elements, like theme, the relatively fast pace or crisp prose, plus what I thought were clever plot devices (For example, Crystal’s opening, “He’s dead”, regarding a referenced character named Weed, is mirrored by Weed’s opening line of Situation: “I’m alive”. Reaction from Kirkus: nothing). Clarion/Foreword reviews didn’t notice this and other plot tidbits either, but otherwise offered a glowing review of The Situation, giving me four stars out of five, and remarking that my text was “captivating”, my writing assured; the story humorous, adventurous and fast-paced: gratifying, if not quite redemptive of the story as a whole. Kirkus’ reticence continued to irk me. I held the impression that their reviewer was holding something back, thinking my novel worthwhile but not wanting to say so.

This idea was reinforced earlier this year by their latest (and likely the last I’ll solicit) review, for my new novel, Venus Looks Down On A Prairie Vole. I was cautiously optimistic this time, half thinking my third submission would be the charm, otherwise simply believing my latest novel is pretty damn good. Alas, it was not to be. Upon providing a typically competent synopsis of the plot and a begrudging recognition that I was “drawing attention to an important issue”, Kirkus then complained that my protagonist, the sarcastic, at times pathetic Daniel Pierce, is not likeable. No kidding. According to them, he is pompous, contrarian (like that word, actually), and anti-feminist—a problem, apparently. Actually, as a therapist he’s resolutely neutral: a Bionion depository, as he puts it, “lacking memory or desire” (a famous Wilfred Bion quote). Outside his office he’s not so much anti-feminist as anti that which co-opts platitudes for self-serving aims, which is why he might be unlikeable. I suppose that negativity is not likeable, which I further suppose depends upon point of view. Anyway, it should tell me something, this reaction: something I’ve known at least since high school: in this world, in nearly all endeavors, it’s not enough to be good. BTW: my novel is damn good! But here’s the thing: you have to be liked.

 

 

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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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The War of evidence-based psychotherapy: part two

 

Turnaround is fair play. That’s what it seems like when the champions of psychodynamic models like Jonathan Shedler caricature their CBT counterparts. As I’m no more in their offices as they are in mine, I don’t really know what they do or don’t do in their interventions, but I glean. I don’t glean that my CBT colleagues use workbooks like cookbooks, offering rote interventions that they either memorize or read from a sheet. Nor do I think that most CBT therapists interrupt when a client is speaking of family of origin material; that they scoff at such unstructured navel-gazing and inform clients that exploring the past is a waste of time. Many believe in a structured approach, one that mimics a teaching paradigm to some extent: passing out information worksheets, assigning homework…educating. I recall working in an agency that made copious use of defense analysis worksheets. Clients were meant to read along in a group or in one-on-one meetings, examples of typical defense mechanisms matched to illustrative phrases. They were meant to reflect and say, “I think I do that”, and so on, presumably so they’d learn to not exercise those habits in the future. I’d give lectures to groups on defense mechanisms, codependency—a host of topics I liked expounding upon—delivered bullet-point style, to individuals who appeared to lap up didactic material, to learn if not wholly integrate into their minds, because the learning they need isn’t academic. It simply isn’t. Anyway, the promulgaters of structured approaches think it necessary to, as they sometimes put it, set the limb (with information) before they encourage the broken patient to walk (meaning, explore). It was/is a catchy turn of phrase and powerful use of metaphor, only it doesn’t really work. The mind isn’t like a limb.

But ultimately, it doesn’t matter, this debate between proponents of CBT versus the range of psychoanalytically-derived therapies. It doesn’t matter because the establishment that drives mental health treatment has made its choice, based upon economics (the supposition that CBT is a more cost-effective approach), but justified publicly by invoking evidence-based research. Meanwhile, adherents of psychodynamic models ever hold space for a deeper, longer-lasting, sometimes abstruse and painful descent. Students of these models are on the workplace fringe unless working independently. They sometimes meet, in apparent secrecy, in ‘forums’ in hospital basements, Saturday morning church halls, to discuss their older theories like freemasons keeping one step ahead of orthodoxy. Analyst Wilfrid Bion wrote half a century ago that the role of the mental health provider was to be a container for the pathological patient who attacks his or her mind, and to operate without memory or desire so that an unfettered examination of projections and introjections can occur. His approach wouldn’t fly in most mental health agencies, psychiatrist offices today. He ethos is going to sound a lot different on a treatment plan than, say, “Client will use tools to reduce behavior X over the ensuing 90 days”, or “Take 30mgs of Effexor each day”.

The Bion line wouldn’t go on a treatment plan. It would scarcely enter a ‘team’ meeting, or a consult with a fellow professional. And it’s not because professionals don’t think there’s value in the approach of analysts like Wilfrid Bion or his latter day followers. That’s why the debate doesn’t matter, because it’s not really about which approach is better, but rather which approach is more plainly understood; about what can be quantified, studied, measured, published and disseminated widely so that insurance companies, program clinical directors, and possibly consumers—all looking to varying degrees for ‘evidence’ of what works or doesn’t work—can point to something tangible and say, “hey, this looks like it has substance to it.” It’s about what’s utilitarian, more readily conveyed across channels, such that teamwork, professional fusion—that popular if suspect notion of ‘being on the same page’—can transpire.

When I was a clinical supervisor in a mental health agency, back in the day, I used to assuage interns with non-conformist leanings that the external voices of what is evidence-based are not ‘in the room’ with them (though some try to be or think they are ‘in the room’). This ambiguous freedom comes with responsibility, to decide what’s right for a patient, which often means what ‘feels’ right for a patient, when in the dense meaning of a therapeutic moment. Those patients, the consumers of mental health services, rely upon a sage and flexible approach, and they stand to lose if providers simply conform to that which is prescribed. The notion of ‘what works’ in mental health is quasi scientific, semi-observable; the phenomena of desired outcomes in mental health tend to be thinly defined, and observable only over short durations, which doesn’t speak to the lasting and unknown changes that the consumer seeks.

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Unconscious Heat

It would not have been understood. My Thanksgiving thoughts, jaundiced as they may be, would have sprinkled awkwardly over the All American ambiance: an afternoon of football, the latest video games, the turkey dinner; the Hollywood movie. I’d stopped by the previous evening for the initial gathering of the clan. My arrival was greeted with good spirits, good-natured yet somewhat edgy verbal jabs. My neo-Hobbit hairstyle would take a hit over the next day or so; so too would my age, now halfway through its forties, but getting an advanced estimate by reps of the younger generation in attendance. It was a loving if unknowing occasion, with tight hugs all around to replace words that might get in the way of the basics. We are all living disparate lives, in truth: there’s a sense that everyone is nurturing ambitious ideas inside while being passingly aware of each others’ trials. The exceptions are those events that become known through soundbites: the busy working life, the tough job, the grades from the last quarter, and most thankfully–the successful operations. We substitute games for conversation, and play it safe with our vanilla “what’s new” overtures. The rooms in which we bond have little room for intimate talk, and in its place we are becoming stranger and ever more bizarre and unconscious in our repartee.

The after dinner mint was the aforementioned movie, much hyped as a comic action film to have us rolling about, guffawing in concert with contemporary pop culture. “We’ve seen it three times!” boasted one viewer, apparently eager to give it a fourth run. The would-be gem in question, The Heat, received proselytizing laughter throughout from guests predisposed to its appeal. However, it was in my opinion an excremental cop adventure; an exercise in casual misandry disguised as light, if vulgar comedy.  As buddy movies go, this flick was not without its social conscience, though it is this very conscience that should cause offense. Sandra Bullock plays a nerdy (but quietly “hot”, of course) and careercentric FBI agent saddled with an obnoxious partner, played by Melissa McCarthy. McCarthy’s character is a cross between Jabba The Hut and Roseanne Barr, and aimed at audiences who have at least forgotten who Barr is. Bullock is a gifted light comedienne of Mary Tyler Moore pedigree, and the juxtaposition of her act against the antics of McCarthy are tolerably entertaining for about a half hour. After that, the movie’s attitude becomes harder to stomach. 

About two thirds of the way through, the movie sort of announces that it has something to say about the mistreatment of women, especially in the workplace. This from a script which features, by my rough count, about a half dozen scenes in which men’s genitals are either shot at, maimed, or plainly insulted. High minded morals/hypocritical low humor, coupled with staggering inattention to irony: sadly, this is a Hollywood tradition, though I can’t remember the last time I watched a movie in which such comic cliches were resorted to quite as often. Then there’s an incongruous scene in which McCarthy’s character callously brushes off a former one night stand after grabbing the man’s face and kissing him aggressively. The joke here appears to be that she is an unlikely manizer. But what else is the point, I wonder?

Now, let us pause. Had I given voice to any of the above opinions at any time during the holiday festivities, then two things would have occurred: firstly, my comments would have been drowned out by the teasing over my use of unnecessarily 50-cent words like misandry (BTW: merely the analogue of the popularly-known word misogyny); secondly, I would have been taken to task for being ill-humored and over-analytical. “It’s only a movie,” some say, implicitly disrespecting an entire medium. I obviously disagree, and I’d put it to my nay-sayers that if The Heat had instead made light of violence towards women, especially sexualized violence, then each and every one of them would have thought it the cinematic atrocity that it actually is.

But the blinkered political correctness doesn’t stop there. Also of note are the racial demographics depicted. By my observation, there are three male characters in The Heat (out of many) who are not portrayed as being either villainous, stupid, or feckless. There is the Latino supervisor of Sandra Bullock’s character, a more or less decent, if disapproving man; a charming, if benign African-American character played by Marlon Wayans, who appears to have a crush on Sandra Bullock (this plot point goes nowhere–an indicator of scenes being cut, maybe); and a comic, though street-smart drug dealer, also African American. All the other men: White, Irish, or at least European-looking, are buffoons or villains. Again, if those demographics had been reversed, I’m convinced that many would and should complain, light comedy or not.

Full disclosure: a backdrop of this latter reaction is that I have been largely unexposed to the opposite trends which have no doubt persisted for decades. Though I know from childhood that Westerns have traditionally given a raw deal to Native Americans, for example, I have not followed the racial-profiling trends of action or action/comedy films nearly as much over the last twenty to thirty years. This is mostly to do with taste. Since becoming a discerning viewer, I simply have not patronized action movies with any kind of regularity, so I have not observed the raw deal that minority actors have gotten through movies with titles like–come to think of it–Raw Deal.

Regardless, this issue is a beta element, as psychoanalyst Wilfred Bion would have said–it is meaning drawn from a thin pastiche of life. The bigger issue is that of fragmented discourse in all units of society: across social groups, between branches of government…within families. The first pair of arenas are big sandwiches to bite into. Closer to home, I have to wonder, if privately, what the rules are for the youngest and, in all probability, least conscious of observers. At some point over the holiday, the youngest member of the dinner gathering, an 11 year old who seemingly enjoyed The Heat, learned that he would not be allowed to watch Monty Python’s classic Life Of Brian (admittedly, not a “light” comedy) because–get this–it features nudity. I held my tongue. Not my place, and all that. I guess the biases of this society are reflected in such moments, or else implied by a ridiculous movie ratings system. So, imagine the memorandum from studio heads to producers, directors, and writers: “penises can be blown off as long as they are clothed during the process.”

 

 

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Sprawling, muddled and hard to follow

Consider the following beta elements: Hitchcock, Bolinas, fire, towering infernos, The Wizard of Oz, terrorism, telecommunications, and Birnum Wood. A meaningless collection of terms? Maybe…that’s what you’d think upon a quick read through of my novel, Crystal From The Hills. My “sprawling”, “muddled” brainchild was written intermittently over the last three years, and is currently receiving a smattering of appreciation, interspersed with triage-like criticisms, some valid and useful, some merely indicative of a drive-by reading. It’s early days yet. Mostly there is silence and the resounding feel of indifference. As with Weed, my villain, there is an overriding absence.

It’s to be expected. I’m not sure what kind of readership I’m aiming for, except for one of fantasy: an ardent following that reads things over and over again, ever searching for nuance. One review suggested a Joycean or Proust-admiring following–wrong. A book of minutia? The word implies triviality, or meaninglessness. I guess Wilfred Bion’s concept of beta elements doesn’t register for average readers; it doesn’t resonate. What do I mean? you may wonder…may wonder. Well, here goes, again: in drama, as in life, there is repetition; repetition that reveals. That’s basic Freud. The paraphenalia of society serve as microcosms of existence, illustrating the unconscious while it fills out the canvas of life. Chris Leavitt’s life is a canvas of elements, speaking in code and then blended into an inchoate mass. Alfred Hitchcock was a fan of psychoanalysis, which informs the themes of CFTH; the same is true of the many motion picture references contained in the novel. Other examples: Macbeth was a man who denied reality, and who failed to understand clues. Fires are part of the back-story of the protagonist, while towering infernos and terrorism now fuel the paranoia of American culture. Texting, e-mail, and the ubiquity of cell phones may dominate as mediums of communication, but it is ancient oral traditions that will whisper truths and pass them along, perhaps especially in small towns in West Marin County, where cell phone towers don’t exist still. Bolinas: the Luddite enclave. May the best grass roots movements of the future be born amongst your wooded seclusion. Within the mass of elements there is order and meaning, and for the attentive observer (as in reader), there is a pattern; an internal logic that ultimately should not baffle. Thus, events unfold in a manner that should feel familiar, perhaps like deja vu. There is a sense of things congealing with centripetal urgency (oops! careful Graeme–that’s a lot of syllables you’re stacking there.)

I guess not everyone will see things as I see them. That, after all, is the point of Crystal From The Hills. Take, for example, a climax of sex in CFTH (not the only climax). A critic has complained that a sexual episode between Chris and his girlfriend Jill–a clumsy grapple and possible rape–retroactively colors their relationship. My response: this passage is foreshadowed about once every ten pages of the novel without actually revealing the event (of course, I’m doing that here). Colors the relationship? The protagonist is guilt-ridden yet avoidant; Jill? she is conflicted: contemptuous and shamefaced, yet uncertain in her revenge. The explicit revealing towards the end is matched by the undercurrent that develops over the course of the narrative. The unconscious in which I place faith enables the reader to find logic and continuity in the unfolding. Meanwhile, the psychologically-minded know that the traumatized take their time, forget and distort, and even when finding clarity, they gauge the safety of those poised to hear their secrets. Is it safe to let you know what’s really been happening? How far have you made it into the novel? Are you ready to hear what its characters really have to say?

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