Oscillating on a very rickety bridge between too much and not enough
EPF Stockholm, March 2015
I found the theme of this meeting extremely interesting.
Its very indeterminacy leads us to consider a plethora of clinical, technical and theory of technical problems in the everydayness of our work. I am going to try to study some of the many points that came to mind, and I’ll leave others implicit even if how we might approach them will always be the same.
I’m thinking of a television series that captivated me and which takes place on the border between two cities, between the United States and Mexico. (I found out that the same series also uses the bridge between Sweden and Denmark.)
The woman detective from the American police force suffers from a sever form of Asperger’s that hinders her from understanding, recognizing and using emotions adapted to different situations. She is purely rational. Compared to her, the Mexican police officer is extremely passionate, he burns life at both ends, one of those lives in which “he’s never late” (so goes the famous Italian song). Naturally, the title of the series is The Bridge.
Endlessly building a bridge between two extremes seems to me the only possible solution; in other words, the key for resolving the problem, in my view, is a continuous oscillating between too much and too little.
Do you recall to what degree the idea that PS could evolve in the direction of D could be sad and claustrophobic?
Do you recall the relief that some among you felt when Bion introduced the idea that PS and D were constantly in oscillation?
Is the same thing not true for negative capacity and the selected fact? That is, between the expansion of the field and its interpretation?
We have thus come to the first quaestio vexata that I have chosen to delve into.
1) Too much or too little interpretation/a bridge with high-volume traffic
A great deal has been written about the fact that we had to privilege saturated interpretations of the transference, or those in the transference (less saturated) or enzymatic, or narrative, or allusive, indeed tangential or even silent interpretations.
I believe that the solution lies in “the bridge” between these different types of interpretations. Here we are helped by something that functions like a buffer system: the fact of using the patient (I should rather say a place in the field intended for the adjustment) like a GPS system capable of continuously giving us information as to the appropriate or inappropriate character of our interpretation or its lack.
After an interpretation we would thus hear ourselves say:
– last night during a storm a lightning bolt destroyed the house next to ours;
– last evening at my aunt’s there were only two boiled and cold pieces of asparagus for dinner;
– yesterday my son’s teacher succeeded in teaching difficult concepts without ever humiliating the children.
Last year my way of thinking, which I believe you are familiar with, that is, the need “to constantly regulate the play between interpretations and transformations” (due to narrative or enzymatic interventions) underwent a slight but significant development.
I was driving in the car of an American friend and colleague who used both the GPS mounted in his car and a TOM TOM that he had on his cell phone; this for the good reason that several times he had become lost while using only a single satellite navigator. In the same way, when we are in session, we should turn our attention to all the signals in the field and understand whether for a given patient’s functioning our interpretation was too strong, whereas for another patient’s functioning it was insufficient.
In other words, we should know how to speak as much to the passionate cores as to the Asperger cores.
2) Oscillation between neutrality (deciphering) of the analyst and self-disclosure of a reverie (co-construction)
Here, too, the only solution is the bridge.
In this connection I would like to present two clinical vignettes from different periods of my work as an analyst, which might illustrate the two extremities of the bridge.
a) A suspicious neutrality. A female patient in analysis told me the following dream: through a small hole in a door she observed a Nazi officer dressed in leather and who entered a room by forcing open the door in a very threatening manner. I am a little disturbed in relating here my “neutral” interpretation, which aimed at being centred on the unconscious corporal fantasy: the patient spoke of a foetal fantasy in which, from inside the uterus, she observed her parents’ coitus, the Nazi officer being the father’s penis which penetrated the mother. In other words, a primitive scene viewed from the privileged vantage point which constituted the inside of the uterus by someone observing what was happening.
The fact that I found an analogous interpretation in Bion’s “Attacks on Linking” hardly consoles me: we know nothing about the beginning of the session and Bion then interpreted by telling the patient that he was present at a sexual act between two individuals. A short while later the patient said that he had the sensation of receiving a “stabbing attack” (that is, that he’d had a hallucination) instead of understanding that the stabbing attack was the received interpretation. Moreover, just after my interpretation my patient spoke about a film seen on television in which Indians shot incendiary arrows and burned a house in which children had taken refuge.
b) In contrast here is a clinical situation in which I “leaned” far too much towards a kind of excessive illustration of a reverie, The Belfry in Ruins.
An irritated female patient of around thirty-five recounted that her mother had told her, “You’re old enough now to no longer put off the important decisions in your life.”
During the next session she said that she felt angry without understanding why and that her fiancé was even more so her fiancé.
After a moment of silence I suggested to her: “Do you want me to tell you the dream that your fiancé had last night?”
“What?” (the patient jolted with paranoia). “You heard our conversation at the bar while we were having lunch? How do you know that my fiancé had a dream and that he told it to me?”
“Right, do you want to know yes or no?”, I said somewhat violently.
“Yes, then,” she answered.
“So, here’s his dream,” I told her. “There was a church belfry that was being restored and they placed a clock far up at the top, where it was supposed to go; a clock that at first didn’t have any hands (like in Wild Strawberries, Bergman’s film) and then they added the hands, which showed noon.”
(All of this was the fruit of visual imagination [reverie] which was activated in me from the beginning of the session, when I repeatedly “saw” the scene of the handless belfry in the film by associating it with the theme of time passing in the patient’s remarks.)
The patient was stupefied. “No, I don’t believe it”, and she added: “Mattia’s dream was: I saw in a dream an old church in ruins whose belfry was being restored and you were there waiting for me.”
“Normally it’s the groom who waits for the bride,” I told her, “but that will do just the same.”
This unconscious and half-serious “dreamlike dance” moved us to take up the themes of the mother, time and the mourning of time.
The patient then said, which I think important, that the clock showed noon, neither seven nor nine o’clock in the morning nor five nor eight o’clock in the evening: there was still time to do something.
(Plainly what was implicit reflected the fact of assuming her responsibilities.)
Marriage, children, existential decisions, the length of fertility, the period of mourning for the loss of omnipotence. The church in Catholic culture with its references to time: baptism, marriage, burial.
3) Oscillation between realistic listening and dreamlike listening,
that is, between those who advocate the importance of taking into consideration the reality of certain of the patient’s communications and, on the contrary, those who try to think of the session as a dream or at least emphasizing the oneiric aspect of the session itself. One might think of this as the fruit of differing theories: on the one hand, historical reconstruction as the central point of the analytic work and, on the other, the centrality of the development of instruments for thinking, feeling and dreaming.
In this connection, we might recall the interesting observation made by Bion (1957) when he said that Freud’s archaeological metaphor does not take into account that “the catastrophe” is not something that has taken place (as Winnicott tends to say in “Fear of Breakdown”) but something that continues to take place and that is brought like burning lava into the present of the analytic field.
In this case I believe that a capacity for oscillation within the session imposes itself, which is why if on the one hand “we take and contain” the reality that the patient offers us, on the other we know, without denying his point of view, how “to dream” it in search of other possible meanings.
Facts/metaphor/dream oscillation: Luigi and the Rifle
Luigi was a severely obsessional librarian. During the first meeting he said that he had a father with an aortic aneurysm and a paralyzed uncle.
(During this time I considered two functionings, one incontinent, the other which immobilized like obsessive rituals).
He then said that he spent a great deal of time “cleaning”, “sweeping” and tidying up the plants in his garden in which animals sometimes dug “holes”.
In his ritual-filled world (which included his work as well as before he went to bed), it seemed that Luigi had some room for freedom: he had the hobby of hunting (la chasse in French and la caccia in Italian).
He looked after two dogs, cleaned his rifles and organized the first day of the different hunting seasons. He then spoke about the terrible experience that his grandfather had had when he’d returned home from the war and found his house destroyed and all his relatives dead, killed by a fighter plane (in French, un avion de chasse; in Italian this kind of aeroplane is called un caccia) which had bombarded the site.
During the next session he spoke about Mario Tobino and his well-known work, Le libere donne di Magliano [The Mad Women of Magliano] (an introduction to the theme of madness?)(1), then he mentioned an inexplicable tic: whenever he became tense, he raised his right shoulder and threw it back.
In course of the lengthy narrative that he then told, the words “burial” and “hunting rifle” (fusil de chasse) were often repeated. At this point everything fit together like the pieces of a puzzle.
The movement of rejection towards the back and raising the right shoulder was that which the “backward movement” of the rifle normally triggered: Luigi was a kind of killer, he continuously killed anyone who made him tense. You could not see the rifle but you saw everything else; the backward movement, the cleaning rituals after each crime, the holes in the garden to be filled so as not to leave any trace of the buried individuals.
When his anger was great, he got into the cockpit of his “fighter” plane (avion de chasse) and killed everyone.
Here is the dream that I had for him: together we now had to see how these themes would develop, to see what use Quentin Tarantino could have with this Django Unchained dressed as a well-behaved librarian.
Obviously this model and my technique originate in the work that I have carried out with patients presenting serious pathologies (borderline and psychotics, and also with children) but I believe that it is possible to apply these technical methods to neurotic patients, at least if one wishes to reach and explore with them the deepest levels of the psyche in which one finds sections of serious pathology (psychotic, borderline and autistic sections).
4) The provisional bridge between truth and lies
On the one hand there are those who defend emotional truth as an inalienable point of analysis, who would like envy, hate and the attack against linking to be interpreted straight away. On the other are those who think that an equilibrium between different defences and thus different lies is the utmost to which our species might aspire. Bion himself emphasized the necessity that someone should write a book entitled, Dreaming reality.
After about a half-hour of silence a patient said to a pre-Bionian Bion, “a piece of iron had fallen on the floor”. Bion came upon how to interpret the patient’s hate and envy.
I think that I could have possibly suggested, “a leaden or iron-like silence has fallen in the session” (and above all I cannot see any reason for not intervening earlier: this would be as if a life guard only intervened after the patient had verbally asked for help and not if he saw him “only in the middle of drowning himself”.)
The point of view differs if one considers “O” as something that must complete a journey to column 2 of Bion’s Grid, that of lies and the dream, as Bion calls it.
In other words, so as to be thought, “O” must undergo a certain degree of falsification and “the lie requires a thinker”.
5) Another dialectic: between verbal communication and projective identification and reverie
What place might we make and what recourse might we have for our capacity for reverie, that is, the capacity for using images that present themselves to our psychic apparatus during the session?
According to one point of view, our ground for investigation is the patient’s “verbal communication”. (If I were to take sides, I would ask: What then do we do with play, drawing and movement in child analysis?)
According to another point of view, the functioning of reveries is just as meaningful: it constitutes an entire range that goes from the simple appearance of an image, which one then tries to organize into thoughts and which will become an interpretation, all the way to progressive uses more explicit of the reverie itself, which leads to self-disclosure, which we tend to think of as a diabolical practice….
Patient B related an undeniably traumatic fact: while he was on holiday, the rocket of a pyrotechnic game landed on him, leaving him with second- and third-degree burns and crushing his thorax. What could be truer than that? How could I not open myself up to the truly traumatizing character of the event, which also involved his wife who was hospitalized for months? How could this event be bereft of any consequences?
I believe that opening oneself up, containing and making possible the narrative of this event is what any analyst would do.
But if it is “O”, are we able to dream the fact? Can we make it become a shared narrative…? By continuing to speak with the patient… it evolves, Bion would say, it emerges, Stern would say in reference to a powerful theory of the field….
I would like to point out that all analysts inevitably choose his or her own “fact” which is used for organizing an interpretation (if a patient was speaking about premature ejaculation… then about a child with bed-wetting and an uncle who had had a haemorrhage, a possible selected fact might involve an emotional “impossibility for contention” that someone in the field was suffering from), where an excess of the analyst’s negative capacities which led him to spread the interpretation out in time was then dreamed by the patient as the terrible experience of someone who was waiting to be shot in the back and who heard the noise of soldiers who never made up their minds to fire: this would have been a release.
Already in “Attacks on Linking” (1959), Bion gave an admirable definition of what, once it became better organized, would become his model of the psychic apparatus and which helped ensure that the analyst’s interest move from the contents to the “tools for thinking, dreaming and feeling” (Ferro, Torments of the soul: passions, symptoms, dreams, 2015).
Projective identification is considered to be a normal modality of functioning, capable of creating a link between the analyst and patient, or between the child and breast.
There are analyses in which projective identification becomes the principal means of communicating either because the patient has not sufficiently evolved from this modality or because the analytic situation itself provides the occasion for developing it.
Here Bion had a stroke of genius—which would lead to his very strongly relational theoretical model, to the “patient as the best colleague” and to “without memory or desire”: the patient “sometimes observes that an object hinders him from using projective identification”.
And who is this object?
It is the analyst himself whose psychic apparatus may not be sufficiently receptive for such projective identifications or even, if it is, it may be too distressed by this reception. Which is very much like what can happen in the primary relationship between the child and mother.
The patient tormented by annihilation anxiety tries to project it into the analyst with the hope that it might remain in him long enough to be made good and transformed. But if the analyst wishes to release it too hastily, this hope comes to grief, which will result in an increase in tension and projective identifications, which will become increasingly violent and subversive for the analyst’s mental functioning.
We have here a description, in different terms, of the model of the psychic apparatus that Bion would next postulate: a psychic apparatus develops if there exists the capacity for evacuating (projecting) the beta elements (sense) into another psychic apparatus capable of receiving them, retaining them and transforming them thanks to its own capacity for retention and transformation, into alpha elements (pictograms) which will be restored in the psychic apparatus which had evacuated them, but with the method (or functioning of the method), that is, the alpha function capable of bringing about these functions of retention and transformation.
The step that leads the alpha elements to their concatenation in the dream thought of the previous evening and then to the capacity for dreaming day and night is brief enough. In other words, the senses treated by the analyst’s capacity for dreaming lead to the development of the mental, which coincides with the oneiric, with the capacity for dreaming. There then exist situations of negative reverie which hinder this process if the O contents are in excess in relation to the O capacities.
In such cases, due to a kind of vaginismus of the other’s psychic apparatus, to an occlusion due to an excess of anxiety already present in the other’s psychic apparatus (an encumbering which may even simply be an excess of theory) or even to an excess of projected beta elements, one will have a malfunctioning of the entire process which should have led to the development of the psychic apparatus (including the capacity for experiencing emotions) as well as an inversion in the alpha function and the phenomena of evacuation which will lead to transformations into hallucinosis.
But let’s return to the Bion of 1957 who again found himself straddling two theories: the first turned on the object (whether analyst or mother) and its possible malfunctioning and the other on the patient (or child) as bearer of a primary “aggressiveness” which is insufficiently improvable by the receptive capacity of the other’s psychic apparatus (if only because the good experience of receiving may give rise to envy and hate).
The first theory seems to accord greater place to the capacities of the analyst-mother capable of receiving “the nameless dread”, that is, the fear of dying which inhabits the patient and the newborn.
6) Oscillation between primary destructiveness or destructiveness secondary to the failure of early relations
We are very familiar with this unresolved problem, which I will try to resolve thusly: for the moment we are a species which has an excess of beta elements or O in relation to the capacities of the alpha functions and O. There will thus always remain an accumulation of beta elements which overflow like tsunamis, impossible to contain and transform, which in itself is not destructive but which has inevitable destructive effects wherever it strikes.
7) The unstable bridge between reality and narration: the context
Someone tormented by panic rings the fire department in order to say that his house is burning. A calm fireman replies to him that he doubtless wanted to tell him that he feels tormented by emotions that are impossible to contain and ready to explode: those without a doubt which have long been at the bottom of his anxiety crises.
A patient says to his analyst that his vegetable garden is dry, that the tomatoes and beans that he had planted are not growing because the ground is arid, no one has watered it or taken care of it. The analyst suggests to the patient that he accompany him to water the garden because there is a reserve of water and he is capable enough when it comes to cultivating plants.
In both cases I have the impression that there is something that does not function: legitimate communications receive slightly mad responses, or at least those which do not take into consideration the context.
No one, in a house in flames, would want a fireman who delivers interpretations and no patient with a dry and arid field would want an analyst with a watering can.
Is there a way out? I believe there is! By assuming the fact that we are in a session of analysis. In other words, one must consider all this like a dream communicated by a “dissatisfied” patient in analysis, who upbraids his analyst for either not intervening seriously (the inadequate fireman) when the house is burning or for intervening in a concrete way (the watering can), which does not help him resolve his problems.
Patients come to us laden with “reality”, sensorality. It is up to us to receive this reality and be attuned to them, as the poet Szymborska says in one of her verses: “what’s important is participating”. One must be attuned to the patient and not decode too early a meaning which has not yet formed (avoiding, then, playing the fireman who arrives with the fire truck to extinguish the emotional fire). One must put to work the mental operations of transformation and then other mental operations which make it possible for the field to flower and produce emotions.
By radicalizing, I might say that the strictly analytic operations are those which make it possible to dream reality and, in a way, transform it.
But are there realities that cannot be transformed? An “O”, beta elements that cannot be accompanied to column 2 of the Grid?
I would reply that there are situations in which it is meaningless to do an analysis, but that if one does an analysis, the “sometimes tragic play” of the analysis is to transform the facts into narratives in order to then rediscover a dream reality.
Obviously one must listen to the fact, one must be in unison with it, but the analyst must mourn the reality and accept being only a developer, indeed, a creator of tools for thinking, feeling and dreaming.
Our power of analysis comes to a standstill before the kryptonite of reality (I am referring to this mysterious radioactive substance in the face of which a well-known cartoon hero loses all his powers).
Are there situations in which the transformations into dreams made by the analyst, indeed, the transformation into dreams of the whole session (Ferro, Chicago) is unacceptable (to an acceptable setting)?
I do not fear saying, NO!
The analytic context, if it is operational, is always worthwhile so long as keeping it active is meaningful.
If a patient, after an interpretation, drew his hand to his heart and said that he felt a sharp pain, if he became pale, began sweating and vomiting, it would then be necessary to turn the setting off and call an ambulance. On the other hand, if a patient recounted that he dreamed of shooting his analyst, one certainly would not call the police.
My thesis is paradoxical: in analysis, so long as it has any meaning, there is never too much dream transformation; but outside analysis, communications are uniquely real, and if a friend whom I haven’t seen in a long time tells me that his level of iron (ferro in Italian) is low, that certainly does not mean that he wants to see me more often.
8) Oscillation between somatization and thinkability: bearable truth and necessary lie
Let’s return to the theme of lying, which we’ve already alluded to and which seems to me central to analytic work.
Stefania suffered from patchy baldness that gave her many problems. At times her head of hair was normal, at others holes appeared which grew wider and spread out to each other. One day she recounted a dream: from the helicopter in which she found herself, she saw a zoo with cages and animals; the animals were so hairy that it was almost impossible to distinguish between the species. Some time later she decided to go for a helicopter ride and she observed that in several parts of the zoo the cages and animals had disappeared, “as if everything had been sucked up by the ground”.
Here are two maps that illustrate the situations described by Stefania:
The zoo as it appears in the first half of the dream:
(lion, zebra, monkey, sheep, wolf, tiger, giraffe).
The zoo as it appears in the second half of the dream:
(wolf, lion, zebra).
I have obviously made these diagram reconstitutions but they seem to me to explain adequately what the patient wished to express: periodically, her emotions were eradicated or buried and in their place there remained only emptiness, patches without hair.
You will regularly notice the fur of the tiger, lion and gazelle disappear (each of these species corresponds to a particular emotion). Each time that an emotion is buried the map of the scalp appears to reproduce the phenomena exactly.
The lie is a way of creating worlds that are more easily liveable.
It is common in science fiction narratives, novels and films that a spaceship that comes from an inhabitable world attempts to land on the Earth or, conversely, that spaceships leave the Earth, where there are no longer resources, in order to go in search of new worlds.
Frequently the spacecraft or the new habitable world is the lie: it is one of the many defences that we see at work so as to survive. The examples are not lacking: beginning with Ulysses who says to Polyphemous that he is called “No one”; this saves him from the anger of Cyclopes when, blinded by Ulysses, he calls his brothers for help but replies “No one” when they ask him who made him blind!
Another well-known example is that of the Bishop in Les Misérables, who saves Jean Valjean, who had stolen all his treasures, when he declared to the gendarmes who had arrested Jean Valjean that it was not a matter of theft but a gift that he himself had given to Valjean.
At bottom, Bion recognizes the value of the lie as much through what is known and born as the “metaphor of liars” as when he affirms that the lie is in need of a thinker.
In other words—and in a particular and paradoxical way—the lie needs a thought that is creative; think of the especially rich and ornate worlds that those who have an extramarital relationship invent, worlds that otherwise would have never existed.
The lie, or at least the gradients of the lie, spare us unbearable truths for thinking: that there is nothing after this life, that we live in the most absolute contingency, that we no longer feel love for someone that we had loved and that we should thus leave.
The lie, the compromise, opens us up to countless ways of existence which have the advantage of possessing dampers.
At bottom, all defence mechanisms are possible gradients of the lie whereas the truth, “O”, is not only impossible to know but is often also impossible to bear.
I thus think that the capacity to lie signals that a certain psychic maturity has been reached and further (but this is not the only signal) that one might consider the end of the analysis.
It is obvious that I am not referring here to those who use the lie and the fact of lying as a life style, beginning with themselves (Baranger M 1963), but to those who use it in cases of extreme (and sometimes chronic) urgency and, I would add, with the possibility of bearing this defence mechanism with elegance (Lewkowicz S, Flechner S 2005).
Lastly, all defence mechanisms are lies in relation to an intolerable truth.
9) From “O” towards “K”: the oscillation between the dream that deciphers and the dream that “makes unconscious”: Manuela and Giacomo’s theft
Manuela was a young girl aged ten in analysis. She was extremely smug and in competition with her sister of twelve. The latter had just gotten over a serious illness and the parents, so as to make her dream a reality, gave her a wolf-dog puppy.
Manuela’s analyst was very disturbed by what he considered was an imprudent purchase, an intrusion by the parents in the analysis of Manuela, who had a “phobia of dogs”. He decided to speak with them and admonish them for having thoughtlessly troubled Manuela’s analysis.
Acting thus, Manuela’s analyst let “a fact” (the puppy’s purchase) remain “a fact”, that is, that within the therapy he let an “O” remain” an “O” without directing this “O” towards its subjectification within the analysis itself, thus without making possible the transformation of the “fact in itself”, beta elements if you wish, into K, into alpha, into narrative.
In other words, any “O”, if we are in analysis, can but move towards column 2 (precisely, that of lies) so as to be transformed in the subjective truth of the analysis which is in any case a distortion/disguise/transformation of “O” (as Grotstein constantly reminds us, 2007).
At bottom, from this perspective the little dog could be dreamed as the hooligan Manuela was afraid of, as something living and new that happened in the analysis and in Manuela’s psychic life, and the parents who made the purchase could be, from a certain point of view, the dreamed description of the work of the analyst who was able to bring something new and living into the analysis.
This gaze towards the possible subjectification of “O” should be the gaze of the analyst who should be increasingly led to perceive the transformations of “O”.
Obviously other points of view are necessary, but they are not as intrinsically psychoanalytic.
At bottom, initiating a transformative narration occurs through the fact of dreaming “facts” so that they can become narremes of a complete narrative. This implies the courage to consider the dream not as a way of coming into contact with emotional or psychic truth but as a lie capable of bending “O” to our need for meaning and narrative that organizes emotions, affects, contingencies and meanings.
After his analyst missed a week of analysis for personal reasons, a patient dreamed that he was robbed by his own son, Giacomo, who he had always trusted and from whom he did not expect such behaviour.
Let’s go further into the exercise: the “fact” is the cancellation of four sessions by the analyst; inserted into column 2, this gives birth to the dream: someone in whom the patient had trusted betrayed this trust by stealing something from him, that is, that the cancelled session “fact” became: you, the analyst, you stole something from me, I was not expecting this, can I still trust you?
In other words, the dream became the instrument of the subjectification of “O”, a lie that made it possible for us to think, feel and give meaning.
But what interests me in addition to clarifying the “presences” in the field of such situations is to know how to live drowned in these contradictions.
My grandfather in Sicily(!) bid his children and grandchildren to avoid going out if there was any wind, that is to say, an “air current” that made the laundry on the clothesline shutter.
If an electric current is to exist, there must be a potential difference; for there to be an atmospheric current, there must be a temperature difference between two points.
We are thus in the presence of two theories: the first requires that we live with solid theories, without currents, without tremors; theories that provide solid anchoring and stable certainties ensuing from the cohesion of the membership group: I am Kleinian, I am Freudian, I am Kohutian, I am Lacanian.
The other theory is the one which exists amid the currents, in the landslides and earthquakes, at the heart of change and doubt, continuously placing us in the face of the provisional and the shifting. Naturally we cannot live without a minimum of support, but I believe that we must accept the capacity to keep our balance on a sometimes rickety support, like the bridges in the films of Indiana Jones!
The bridge I spoke about at the beginning is not real, it’s a bridge that comes to life only when we know how to oscillate between differing points of view; if for me infantile sexuality in the session is a narrative means for recounting the coupling or the malfunction of coupling between the analyst’s psychic apparatus and the patient’s, or the coupling or non coupling of the projective identifications and reveries, there also exists a colleague for whom infantile sexuality is, apart from any metaphor, one of the pillars of psychoanalytic thought.
If we both know how to give up—the two of us understood as characters in the field which we bring to life—the “certainty of our points of view”, we create an analysis, or keep it living, in which the “potential or temperature difference” makes possible the vital pulsations, the oscillations from one point of view to another, in order that, by getting a grip on scraps of knowledge, we dare to throw ourselves at a new unknown without fearing prejudicing the supposed orthodoxies.
Translated from the French by Steven Jaron, Paris.
 Mario Tobino’s book recounts his experience as a psychiatrist in the women’s department of the psychiatric hospital of Maggiano.