BION:
I must explain why I have to speak English. It is partly
because I don't speak French, although I have learnt or been
taught French as it is spoken in the English Public Schools, but
it is not the sort of French that you would understand. There are
other reasons which will become clearer as we go on with our
discussion.
I would like you to regard this as a working conference
in which this problem is one which faces all of us. For example, a
young man of twenty-five complains of having an unsatisfactory
family life; I am not sure what family he is talking about, and in
the course of a preliminary discussion I ask him his age and he
says forty-two. Forty-two? But I said twenty-five just now. As I
see him more closely I notice lines on his face, and every now and
then I think he looks more like sixty-two than forty-two or
twenty-five. Well, what is his age?
The first question I put to you is, will you take this
patient or not? I am not suggesting that you should tell the
patient or me or anybody else, but what do you tell yourself? If
you want to write down your immediate impression now, it would
perhaps be interesting to you to make a note saying 'yes' or
'no’. To answer that question I propose to use a procedure in
which I assume a 'vertex' from which I could form some impression
as to whether I want to see this patient again.
Suppose you walked into a bookshop, picked up a book,
turned a few pages and read what I have just said. Would you put
the book down and pass on to another? Or would you like to turn
over some more pages before making up your mind whether to read
that book or not? So there's my second question: are you
interested in this story; do you want to read any more of it?
I'll try another one: suppose it was a piece of music you
were hearing. Would this sort of music interest you? Would you
decide to go to a concert and hear the rest of the piece of music?
Or would you decide that it was not your kind of music? That is
another vertex. Of course, in reality we haven't so much time,
but here we can play this little game.
Changing the vertex again: suppose you were walking
through a building and saw on the ground a pattern of colours
thrown by the light coming through a window. Heredia, in the poem 'Vitrail'
,(reproduced below), describes the effigies on the tombs: they
cannot see, cannot hear, but with their eyes of stone they see
these colours spread out on the floor. As this patient is talking
to me and the light falls on this conversation, what colours do
you see? Do you like them? Would you like to spend some more time
there? Would you like to study the window through which the
sunlight penetrates to find out what sort of design there is in
the glass of that window?
I won't suggest any more because I would like you to
think of various vertices which you can employ when confronted not
with a book, not with a painting, not with a window, but with a
person. What sort of shadow does he cast in your mind?
Getting back to the analytic situation, shall we tell
this patient to come again? Shall we, as it were, open another
page of the book, or listen to some more bars of music, or shall
we stop there? Each one of us has to answer that question all
alone. I am not asking you to take a psychiatric vertex at this
point - it is too early. You have only had a few sentences (of
conversation) and only a few moments in which to see this man. Do
you feel inclined to say, “Well, I think I had better see you
tomorrow”, or next week, or “I would like to see you again in
a month's time''? Nobody can tell you what to do because nobody
knows what kind of person you are or what you are capable of.
Another reason why I am speaking English is this: I am
familiar with phrases such as, green with envy, yellow with
jealousy, black with despair, red with rage. Do you think like
that? If so, what are the colours that you see in this
conversation? In what colours would you paint that conversation?
You may say you are not painters, but it is very important for you
to know who or what you are. That is one reason why we advocate
that people should have an analysis in order to get accustomed to
who they themselves are. It is very unlikely that you have
discovered that yet. So although your tendency may be to say you
don't paint, I say you do. Therefore, get out your colours; don't
write notes about this story, make some marks on paper. Use a few
simple colours like blue, black, yellow, green. Then look at it;
there you will get an idea of how that patient struck you. If you
were a musician, what piece of music would you compose? If you
were a writer, what language would you choose? French? French as
it is spoken in Paris, or the Midi, or the Touraine?
So, listening to the conversation between yourself and
your patient, what language is being talked, either by him or her,
or yourself, or both of you?
Q: It is
interesting to note that in French we say, 'Yellow with envy'
rather than green.
Bion: That
is why it is so important to know not what language is spoken in
France or England - these geographical boundaries are not of
importance when it comes to a question of the mind or character or
personality - but to borrow the language of painters, musicians
and so on, and to use it in this extraordinary subject with which
we are concerned.
Q:
Do you think we are able to choose the vertex?
Bion:
Yes, and the more you know about yourself, the more you
know which vertex to choose in order to look at the problem. For
example, looking at this man who I have tried to describe, would
you choose him to go mountaineering with? Would you choose him as
one of your team in the Tour de France? Never mind about
psychoanalysis or psychiatry for the moment - is there anything
you would choose him for? Whether we like it or not, the choice is
an arbitrary one because analysis has to be
done by each of us alone - it is a lonely occupation.
We have become used to the idea that psychoanalysis is
an attempt to make a scientific approach to the human personality.
It is a view which attaches great importance to facts, to the
truth, to the real thing. If that is so, there are plenty of
people who are scientists without that official categorization. A
painter, for example, may believe that a painting should be true
to truth, should show you some aspect of reality which you might
otherwise not notice. He is not a psychoanalyst, but he paints a
picture. Look at this picture and then you may see what a tree or
a face looks like. If an author writes about imaginary characters
like Falstaff, Lear, Othello, Macbeth, they ought nevertheless to
remind us of real people. Does the last scientific article that
you read in the International Journal of psychoanalysis remind
you of real people, or doesn't it?
Q:
Are you suggesting that the analytic experience can be a
dehumanising once?
Bion:
I think that there is a great danger of it. I come across a
lot of what is thought to be scientific psychoanalysis, but it
doesn't remind me of anything except boredom.
The situation in the consulting room, the relationship
between these two people, could be like the ashes of a fire. Is
there any spark which could be blown into a flame? In this little
bit I have described, we would have to examine, observe, devote
care to mental debris - bits of what we have been taught, bits of
what we have learnt, bit of what the patient has been taught. In
analysis one is seeing the totality of debris. What has happened
to the face of a man of forty-two? Why does he look twenty-five or
sixty-two? Why does he say he is forty-two? It is all part of the
debris. Do those pieces come together? Would you be able to put
them together so that they make sense'
Q. (an
inaudible reference, to 'psychotic experience')
Bion:
The idea that it is a psychotic experience is very
cerebral. In analysis we are concerned with something which might
ultimately be expressible in cerebral terms, but that is not how
it appears to us as practising analysts That is one reason why we
have to reconcile ourselves to the fact that patients do not come
to us with little labels tied to them saying, 'manic', or
'depressive', or 'manic-depressive', or 'schizophrenic'. if they
do come with such labels we should regard them as more pieces of
debris. I do not mean by calling it debris that it is not worthy
of attention; I mean that it is something which has to be observed
and scrutinized with very considerable care, otherwise you might
throw away the necessary, vital spark. One cannot afford to cast
aside imaginative conjectures on the grounds that they are not
scientific - you might as well throw away the seed of a plant on
the grounds that it is not an oak or a lily but just a piece of
rubbish. This applies to all that goes on in your consulting room.
But I suggest that it would be worthwhile considering it
not as your consulting room, but as your atelier. What sort of
artist are you? Are you a potter? A painter? A musician? A writer?
In my experience a great many analysts don't really know what sort
of artists they are.
Q.
What if they are not artists?
Bion: Then
they are in the wrong job. I
don't know what job is any good because even if they are not
psychoanalysts they need to be artists in life itself A
mathematician can see that an algebraic formula is a beautiful
one; a musician can hear a manuscript which is simply black marks
on paper Even using the language I know best, I cannot tell
you what an 'artist' is; I prefer you to go beyond that word and
see what I am trying to convey to you by this very inadequate
word. It is certainly not somebody who is able to deceive your
eyes, to make you think that there is a tree there when there
isn't one, but somebody who has made you able to see there really
is a tree there and its roots even if they are underground.
I suggest that behind this forty-two-year-old man is
hidden a person, and that person has roots, an unconscious which,
Like the roots of a tree, is hidden from sight. There are not only
branches which are ramified and have veins, but under the surface
it has roots. So when this person comes into your room, what do
you see? I am not asking simply what do you see with your eyes,
but also what does your intuition enable you to see?
Q.
When you relate the roots of the tree with the unconscious,
do you have an image of something that can be experienced as roots
of the unconscious, or the unconscious as roots?
Bion:
No. 'Unconscious' is simply one of these
words invented by Freud in an attempt to draw attention to
something that really exists. But, as usual, one gets caught up in
the word, and then there are these interminable, wearisome -to me-
arguments about Kleinian theory, Abraham theory, and all sorts of
theories.
I cannot be interested in them because they obscure the
fact that there is, as far as I am concerned, actually such a
thing as a human mind or personality. I don't believe that anybody
has yet discovered how that human character or personality is to
be described although a really good portrait painter can paint
something which shows not just the colour of the skin or the shape
of the person. An artist in England painted a portrait of Winston
Churchill. His wife hated it so much that she destroyed it. And
yet plenty of people thought it a very fine portrait. The artist,
Graham Sutherland, was not a psychoanalyst, not in that category,
that box, but was he an analyst or wasn’t he? Similarly, you
might say to me, 'Ah yes, but I m not Cezanne, I’m not
Sutherland'
I don't want to flatter you, but all I can say is, how do
you know that you aren't? Have you been to your atelier and
discovered what sort of artist you are?
Q.
Would you say something about what you have described as a
catastrophic situation.
Bion:
The word 'catastrophe'
has also to be understood in the light of something which goes in
the opposite direction. I think of it as 'breaking down' which is
very close to the metaphor, ‘breaking up'.
In an analytic situation the analyst is concerned with
trying to make conscious, trying to bring to awareness something
which the patient has often spent his life trying to make
unconscious. There are two people in the room who come together at
the same time, in the same place, but the directions in which they
are thinking are different. They could agree if the analyst
consented to become very disturbed and afflicted with the same
kind of neurosis or psychosis as the patient, but it is usually
supposed that the analyst should not lose his capacity for being
aware of the world of reality, although he may be drawing
attention to a world of a different form of reality. The simplest
example I can give is this: we are in the state of mind which is
usually known as being awake or conscious and aware of what is
taking place - so we think. But when we are asleep we are in a
different state of mind. This division into day and night is not
very illuminating, but I think it is useful if one can retain the
valuable quality of being able to go to sleep, as well as the
valuable quality of being able to wake up. That 'marriage' often
seems not to be harmonious. For example, patients may admit that
they had a dream but they don't take it seriously; they don't feel
disposed to tell you where they dreamt and what they saw. They
say, ‘Oh, I just
dreamt it'.
I don't know why they 'just dreamt it'. If the acorn
said, 'Oh, they're just roots', what would one think? After all,
even an acorn on an oak owes something to the roots. So what is
one to make of a patient who thinks he 'just dreamt it'? Freud
considered that dreams ought to be treated with respect - I think
that is the most important part of his work, but I don't believe
we have got anywhere near to reaping the consequences of treating
dreams with respect.
Q.
(Questions about the meaning of the terms 'breaking down'
and 'breaking up'. There are no direct equivalents in French)
Bion:What
does the patient say to you when he thinks he is going mad' ?
You have to find out from the patient what it means. When
he says he is breaking down, presumably that is what a breakdown
looks and sounds like. You don't have to believe that the
patient's diagnosis is correct, but you can look at the picture
yourself which he calls 'breaking down'. You
then have a chance of using your senses to tell you what
this word means and also what language the patient is talking. It
is no good saying he is talking French or English that is too
clumsy.
Q.
Is it the specificity of the language which develops in the
'atelier'?
Bion:
Yes, and the specificity of what the analyst does.
Cezanne's pictures of the Montagne Sainte Victoire are not the
same as mine would be if I took photographs of it. What is the
difference? You have to look at the paintings to find out; they
are the only language Cezanne could speak to convey to me what I
ought to be able to see if I look at that mountain.
Your patients are not really very good artists, but they
do usually know what it feels like to feel their feelings. When
they try to tell you, they haven't much of a vocabulary. So you
listen to what they say and look at what they are, compare the two
and then form your own conclusions about whether they are - to use
the English language - breaking up, breaking down or breaking
through.
The patient is usually describing something which I am
sure exists - mental pain.
When it is physical you can ask, 'What sort of pain is
it?'
With the kind of patients that we have we need to be able
to recognise the different names which are given to pain: anxious,
frightened, terrified, embarrassed, ashamed, and so forth. They
are all different varieties of pain. If you were trying to paint
them you would have to use different shades of colour, but
psychoanalysts have to invent the language; Our material is not
visible, it is not palpable.
Sometimes a patient doesn't seem to be able to
communicate and wants to hold your hand, to have a physical method
of communication. Most analysts restrict themselves to verbal
communication, but that is only a recently discovered method of
communication - not a very good method but the best we know.
Q. I recently had
a patient who didn't feel it was necessary to talk in order to
communicate with me.
Bion:
Such patients don't really understand the possibilities of
verbal communication. They do understand the possibilities of
being able to evacuate their urine, their faeces, and even their
breath. So when they talk they are aware of the muscular activity
of expulsion, not the mental quality of thinking.
Q. That
confirms my experience with this patient. Once he was frightened
about a friend called Pierre. He thought he was very hard
..(inaudible sentence....) …similar to throwing stones out of
his mouth.
Bion:
It is very difficult to get any
impression unless you are with the patient. One possibility
is that he is impressed by muscular movement. In that way he would
be afraid that he would either lose some part of his
personality if he spoke, or he might injure the analyst with these
stones; he could say things which were very hurtful, rude things,
insults. Even, a rational conjecture could be, that he is afraid
that if he is spontaneous or natural he will say insulting things
which would make the analyst very angry.
When this patient talks to the analyst what aspect of
himself is being expressed? Could he be aware of the growth of
renal calculi (stones – Ed) long before any thing showed in
X-rays or in physical palpations? As well as the more accepted
ideas of our response to the free associations of the patient,
there can be this complication: a bodily symptom, a chemical
symptom, the formation of calculi, shows up earlier in the mind
than it does in any other way. The question is, what are you to
say to the patient?
How do you transform your thoughts, feelings, ideas about
what is presenting itself to you, into a verbal language which the
patient would understand and which would also be correct. It is a
very tough problem and I see no way of answering it unless you are
in your consulting room.
Q.
I wonder if it is what happens with children as well ...
(inaudible passage)
Bion:
It is difficult to know where the origin of the pain is.
Children today are often acutely sensitive to what is going on;
they know a great deal about their schools, their teachers, the
town or city or country that they live in. But it is not the same
thing we know as grown-ups. So when they tell you something you
can be reasonably sure that their information is very acute but
their experience is not great; they have not lived long enough to
be able to understand what their knowledge or their senses tell
them. It may be perfectly natural for a child to be loyal to its
contemporaries and not therefore want to pass on information to
somebody who is of a different generation. So there is a division
which is not simply between one's unconscious and one's conscious,
although it is similar to that; it is a division between what the
child reminds you that you once were, with what you know you are
today.
You may have forgotten that the child you were was loyal
to other boys and girls and did not tell your parents things you
knew and didn't regard as dangerous, because you did not have
enough experience to know they were dangerous.
So you have this problem which is partly to do with
yourself, partly to do with the actual child who comes to you, but
is also concerned with what I have described as 'the vogue'. I am
not talking about the mode, just a passing manifestation of the
vogue, but the vogue itself - that force which exists, always
exists and is very powerful.
I feel that we have left the interview with the man of
forty-two for rather a long time. Here we can discuss the problem
at considerable length, but not in the consulting room. The
question is, why does he remind me of a young man of twenty-five?
And why, as I look at him, does he remind me of a man of
sixty-two? At this point I wonder if he has any children. Would
they make him older or younger? I think I would like to see him
another day; I might then find out whether he is married or not,
or if be and his girl friend have produced children.
I am used to the idea of mental conflict, but are there
physical conflicts? Can a person look twenty-five and sixty-two at
the same time, but not forty two? What bodily muscles are being
used? Some of them are vocal cords. but what else? What about his
skin? What about the lines or the lack of them on his face? How is
that done? Do we as psychoanalysts have to
be aware of physical as well as mental conflict?
I recall one patient who was always very co-operative and
after a time - probably after too long a time I'm afraid - it
became clear to me that he was the only patient who didn't disturb
the appearance of the couch; when he left, it was almost as if
nobody had lain on it. Then it occurred to me that he lay in
exactly the same place every time he came. That made me think that
it was a sort of catalepsy, mental catalepsy.
I could never honestly say he had a dream; I could never
honestly say he was awake; he was between the two. He wasn't
unconscious; he wasn't conscious. How did he live in such an exact
state of mind? Physically he could lie in exactly one position on
the couch: now it became clear that he was doing the same thing
mentally.
Q.
There are two points I would like to raise. First, here in
Paris there are complaints that there is no discussion about the
choice of patients. Second, I have been told several times that
patients want to stop analysis but their analysts don't want to
wean them.
Bion:
I would fall back on an expression I find useful, borrowing
a term from the mathematicians: 'absolute initiative'. By
'absolute' I mean in either direction - initiative to go back;
initiative to go forward. The important point is the initiative,
not the direction. That seems to me to be very close to something
fundamental and basic, even physically, almost like the functions
or the impulses which are born when the adrenals become active,
making it possible to fight or run away, to run into the danger or
away from it. I say 'initiative' to give this neutral spot in
between the two. Who gives birth to a child? The mother, or the
full-term foetus? Does the full-term foetus in some way indicate
that it has had enough of being in the mother's inside? Or does
the mother indicate that she has had enough of carrying that load
with her? That is putting it in pictorial terms. Let's start
again.
Does the patient want to see the analyst, or does the
analyst want to see the patient? I think the cataleptic situation
does represent a sort of refuge; you don't do either.
The other day I heard an interesting account of a patient
who seemed to mention the Fourteenth of July. He apparently said
quite a lot, but nothing about the Fall of the Bastille or the
people dancing in the streets celebrating the holiday. That seems
to me to be rather like looking at an X-ray in which you can see
the lungs, but why is it hazy in this part? Why can't you see the
ribs clearly? What is the matter with this story? While you are
looking at this debris, as I call it, you also need to be aware of
what is wrong with the story that you are being told. What is
missing? You have only heard the beginning and would almost
certainly have to see the patient again. But when you do that, you
are also starting analysis and you may discover that you don't
want to go on with that patient but that patient: does want to go
on with you. You have to be aware of that possibility at any
moment. The same thing applies in your atelier: you may not have
decided what sort of artist to be, but as you see what you are
fairly good at, you may have to 'make the best of a bad job', as
we say, and decide to find out what you can do with what you have
in your atelier.
It is very important to be aware that you may never be
satisfied with your analytic career if you feel that you are
restricted to what is narrowly called a 'scientific' approach. You
will have to be able to have a chance of feeling that the
interpretation you give is a beautiful one, or that you get a
beautiful response from the patient. This aesthetic element of
beauty makes a very difficult situation tolerable. It is so
important to dare to think or feel whatever you do think or feel,
never mind how un-scientific it is.