Body-Mind Dissociation in Psychoanalysis

Development after Bion

Riccardo Lombardi

• Publisher: Routledge
• Year: 2016
• ISBN:
  9781317329268
• Edition: 1
• Topic: Psychology
• Subtopic: Psychoanalysis
• Index: Psychology

The conflict and dissociation between the Body and the Mind have determinant implications in the context of our current clinical practice, and are an important source of internal and relational disturbances. Body-Mind Dissociation in Psychoanalysis proposes the concept as a new hypothesis, different from traumatic dissociation or states of splitting.

This approach opens the door to a clinical confrontation with extreme forms of mental disturbance, such as psychosis or borderline disorders, and strengthens the relational power of the analytic encounter, through a focus on the internal sensory/emotional axis in both analyst and analysand. The book details this importance of the analyst's intrasubjective relationship with the analysand in constructing new developmental horizons, starting from the body-mind exchange of the two participants.

Body-Mind Dissociation in Psychoanalysis will be of use to students, beginners in psychotherapy, mental health practitioners and seasoned psychoanalysts.

Chapter 1

Body–mind dissociation and transference onto the body

According to the Presocratic philosopher Heraclitus, conflict is the source of everything. Conflict was immortalized by the sculptor Phidias in the metopes of the Parthenon at the dawn of western civilization: he portrayed conflict between humans and beasts, and the barbarians and the civilized Greeks, or what finally comes down to conflict between the body and the mind. Freud placed conflict at the root of his notion of depth psychology. In our practice today we are facing new horizons of such a kind that the repressed unconscious is considered together with the unrepressed unconscious and its more pervasive role (Bion, 1970; Matte Blanco, 1975; Lombardi, 2015), with the result that conflict reveals deeper implications, regarding, first of all, the body–mind relationship.

Plato, in his dialogue Phaedo, expresses a conflictual concept of the body–mind relationship, a potential source of dissociation: “we make the nearest approach to knowledge when we have the least possible intercourse or communion with the body, and are not surfeited with the bodily nature, but keep ourselves pure.”¹ Although Plato’s position is not without provocative implications – not least because of his worry about the danger that man may sell his soul for “the gold of pleasure”² – Plato nonetheless introduces a dissociative supposition between body and mind when he speaks of “keep[ing] ourselves pure” – i.e., separate from the body – and of not being “contaminated” by its nature. This dissociative supposition was to become a constant throughout the history of western intellectual development.

At its inception, psychoanalysis had a revolutionary view of the individual as grounded in her body and its instinctual nature, thus granting the connection with the actual body much more prominence than it was to have later on with the development of object relations theory. Bion provides a lapidary summary of the initial psychoanalytic revolution when he states “The inescapable bestiality of the human animal is the quality from which our cherished and admired characteristics spring” (1970: 65–66).

The attention paid to reality –which is compromised in the major forms of mental illness such as psychosis – led Freud (1911a) to conceive of the organizational role of consciousness in correlation to the sense organs and also of thought as a function with the task of containing motor discharge. In this Freudian model of the origin of consciousness, a principal matrix of physicality, consisting of the sense organs, becomes capable of generating a perceptional flow from inside towards the outside world, and hence mental activity capable of recognizing reality and of delaying instinctual gratification, which to some extent reconciles the subject to the exigencies and limitations of reality.

From this same viewpoint of the continuity between the somatic and the psychic, Freud (1915b) underlined the need for continuity between the concrete and the abstract, distinguishing between “thing presentation” (Dingvorstellung) and “word presentation” (Wortvorstellung): “When we think in abstractions,” he writes,

there is a danger that we may neglect the relations of words to unconscious thing-presentations, and it must be confessed that the expression and content of our philosophizing then begins to acquire an unwelcome resemblance to the mode of operation of schizophrenics.

(1915b: 204)

Freud thus maintains that the dissociation of the verbal sign from its “thingy” matrix can reduce a word to an abstraction shorn of its actual referent, hence confining the “thingy” nature of the world to an independent existence, extraneous and unrelated to representation.

Psychoanalytic practice now involves a much broader range of illnesses than what Freud contemplated in his day, so these hypotheses spanning body and mind can be seen to have a renewed timeliness and a potential for expansion in the context of a new clinical epistemology, which could release psychoanalysis from excessive abstraction and from the awkward straits of a systematic concept, and place it at the source of experience. The problem of conflict is now increasingly encountered in extremely radical forms, in which the body and the mind assume absolute roles, excluding each other entirely: when the body–mind conflict becomes intolerable, body–mind dissociation takes the upper hand. A psychoanalysis that takes the most primitive levels of inner integration for granted, concentrating too early on developed mental dynamics and object relations, is in danger of becoming anti-developmental and anti-therapeutic, and of turning into another of the many varieties of body–mind dissociation that are characteristic of contemporary life.

Insufficient maternal rêverie and loss of contact with the body

Freud’s theories originated in empirical research: he always defended the experiential basis of his hypotheses, underlining the distinction between scientific theories that are the fruit of empirical research into real data and purely speculative notions. We should not, however, disregard the context in which Freud conducted his investigations, the Vienna of the Finis Austriae, pullulating with positivist yearnings and late Romantic affinities. The world we live in today is radically different from Freud’s, and so is our phenomenology of mental illness. The agreeable patients who paved the way for Freud’s discovery of the unconscious were part of a culture that guaranteed the continuance of the care that is given in the earliest phases of individual development. The modern world, instead, presents us with problems that increasingly express a very primitive complaint, traceable to one’s earliest post-natal experiences – marked by the impact between the newborn and maternal rêverie– if not actually to the period of intrauterine gestation. The scarcity, deformation, or absence of maternal care has as its result such a distortion of development that it undermines a harmonious body–mind relationship, i.e., what Freud considered the instinctual and affective matrix from which the individual personality springs: a distortion so radical as to involve a dissociation from the body.

When I speak of body–mind dissociation, I mean a situation in which the body in itself continues to exist concretely, but disappears from the mind’s horizon, just as the actual baby, originally pure physicality, may not feel accepted onto the horizon of the person looking after it: a reaction that obviously intersects with constitutional factors, so that certain babies are more liable to it than others. Deficient maternal care implies the baby’s being required to adapt to external reality at a moment of its development in which it has not yet evolved sufficient resources to reconcile internal instinctual demands with external exigencies. This precocious adaptation causes a distorted development of ego functions (James, 1960; Winnicott, 1958c) such that the connection between the perception–consciousness axis and the emotion–instinct axis is particularly disturbed. Given how early this sort of problem appears, it is outside the conscious purview of historic reconstruction that characterizes the traditional psychoanalytic vertex. It requires instead a working-through focused on the present, on the heart of the analytic relationship, and on the activation of an awareness of one’s own inner mode of functioning.

Bion (1970: 71ff.) was the first to call attention to the fact that a psychoanalysis that is up to evolving needs a container and a functioning container–contained relationship: a disorganized container–contained relationship makes the ordinary phenomena of psychoanalytic observation impossible, as well as preventing growth and personal development. Even though Bion never formalized a vertex centered on the body–mind relationship and the damage resulting from body–mind dissociation, his hypotheses about the container–contained relationship clearly refer to such a vertex, at a higher level of abstraction. When, for example, Bion (1970: 71) asserts that he is not in a position to “observe Mr. X because he will not remain ‘inside’ the analytic situation or even ‘within’ Mr. X himself,” he is, without explicitly saying so, focusing on the implications of a body–mind dissociation such that the analysand can seem to be, as it were, not inside himself, or dissociated from the bodily reality that would be able to contain him, and is keeping himself similarly outside or unrelated to the psychoanalytic situation. This brings us back to the importance of the body as the container of subjective experience. The concept of the container likewise refers back to the importance of the setting, so that “the analysis has a location in time and space … the hours arranged for the sessions and the four walls of the consulting room” (Bion, 1970: 71). If the field of analysis does not have these limits, Bion maintains, all psychoanalytic observations and any development of the analysand become impossible.

Body–mind dissociation, body–mind dialogue, and creativity

If we posit that the reception and the reflection that the mind accords the body form the indispensable starting-point of any form of thinking – Damasio (1994) would say that it was only through the body’s need for it that the mind arose – then the absence of reference to the actual body inevitably implies the absence of a functioning mind as well. When I speak of body and mind, I do not mean to promote a Cartesian-style body–mind dualism: instead I intend to underline the operational divergence effected by the body and the mind in the course of human functioning – what Damasio (1994) calls functional dualism in the context of a position that recognizes a significant continuity between body and mind.

Even if we start from a unitary conception of the human being, we must take note of the existence in psychoanalytic practice of forms of profound dissonance in the body–mind relationship, justifying the term body–mind dissociation, a dissociation that is not about to take the place we are used to recognizing as belonging to the role of the unconscious. At the dawn of psychoanalysis, when Freud and Janet had their controversy about dissociation (cf. Ellenberger, 1970), they were both dealing with much more superficial phenomena than what we face in our practice today.

The conditions we shall seek to describe in the course of this book show a distinct tendency towards impasse in analysis because, as we shall see, the preconditions for internal working through, rooted in the body, have been compromised. In addition, the absence of bodily participation can easily lead to the ascendancy of unconscious falsehood (Bion, 1970), or to a condition of pseudo-existence characterized by imitative mechanisms that do not correspond to a solid personality basis. We find ourselves not only in a realm where outright psychopathology holds sway, but also faced with a profound anthropological conflict that is exacerbated by particular aspects of our contemporary world, so that we now feel as if we were taking part in the drama of the replicants in Blade Runner (dir. Ridley Scott, 1982), who are indistinguishable from us, although they are not human, or as if we lived in the condition shown in Spike Jonze’s Her (2013), where the virtual reality of an operating system has taken the place of a flesh-and-blood partner. Being is under pressure from Seeming, causing an inner tension whereby the Freudian duality of thing-presentation and word-presentation is in danger of internal fracture and the whole representative system may be replaced by baseless abstractions. The presence of the body then seems relegated to a lost world, in which its needs and instincts are similar to a sort of Jurassic Park (dir. Steven Spielberg, 1993): simultaneously desired, feared, and denied. The only option left for the denied body may be just going its own way: rebellion and revenge by means of the violence of psychotic explosions, or the degeneration that takes place when the body resurfaces threateningly with somatic illness.

So we are increasingly faced with the mind’s need to discover human limits by means of a direct confrontation with our bodily nature. Both analysand and analyst are called to the challenge of discovering our own tragic conflict of substances, the result of the bodily and mental dichotomy that inhabits us, and to find that each of us is – as Paul Klee sensed, at the dawn of the modern movements of the twentieth century – “half prisoner and half winged being” (“Halb Gefangener und halb Beflügelter”): only the toleration of the sense of powerlessness that comes from letting ourselves down into our bodily nature can give a non-mechanistic sense to our thinking and become a decisive stimulus to life and to personal creativity.

A shift of vertex

Assuming the existence of a basic primitive conflict between body and mind, which I shall be describing, together with its various implications, further on, I inevitably find myself shifting away from the standpoint from which Freud regarded it. Whereas the father of psychoanalysis emphasized the instinctual body that aspires to unbounded gratification, I, by contrast, am inclined to stress a condition of dissociation of the body, or the body’s disappearance from the mind’s horizon. In contemporary psychoanalytic practice we are faced with the explosion of an intolerance that asserts itself, first of all, through the blotting out of the body, which is felt to be the prime representative of our limits as human beings. While the Freudian vision and psychoanalytic tradition have familiarized us with the absolutization of the instinctual body, we find ourselves ever more often facing dissonant situations in which the mind has made itself independent of the body. Human beings, by structural and existential constitution, are placed between the two poles of body and mind: these are conflicting poles that draw us towards body–mind dissociation.

I should like, at this point, to insert a fragment of psychoanalytic experience, so as to begin to illustrate the theme of body–mind dissociation and its working-through – a theme that reappears, variously manifested, throughout the book. I feel I should point out beforehand that the reader will find, in these clinical examples, a rather different perspective: while in the first part of this chapter I limited myself essentially to description, in line with an etiological viewpoint – and hence I referred to dysfunctions of the mother–child relationship, which can foster a tendency to have the mind function in the absence of awareness of sensory data – the standpoint changes when we get right into actual analytic practice. In fact, we work with the current consequences of certain early dysfunctions, which have, with the passage of time, settled into a more or less stable personality order, to the point of forming an actual internal system based on organized theories of the mind, life, and relationships. The analyst thus faces the need to consider, first of all, the analysand’s working arrangement for relating to herself. This arrangement is regarded as a working one – even when it is prompted by factors that are to a great extent unconscious – so as to emphasize that the analysand is responsible for herself and for the criteria she uses. This concept of responsibility as a distinguishing feature of the analytic project is a spur to opening up to change, which the analysand can introduce into the modes and forms of her internal functioning.

Underlining – as we did earlier – the shortcomings to which the analysand has been exposed in her surroundings spotlights the deficit dimension. Without in any way denying this dimension, I would add, indeed even favor, observing the internal arrangements the analysand uses in relating to the body, the mind, and the relations between the two. Thus we can view the theme of deficit together with that of conflict, and the inexhaustible problem of the destructive and constructive pressures to which human beings are subject, as basic characteristic elements of human functioning. As I see it, the perpetual to-and-fro from the body to the mind and vice versa is actually the basis of thinking operations. Experience is built up through continual interaction between the body and the mind, and between emotion and thought, in the intimate exchange between waves of sensations and the subject’s perceptual and mental resources. When the subject chooses to avoid the often arduous work of transforming emotions into thought, he manages only to paralyze his mental functions.

In the context of our hypotheses, the pressure to dissociate from the body should be considered not only in relation to pathological distortions, but also as an expression of an existential conflict that is distinctly characteristic of man the animal. Indeed, emancipation from the body is an attempt to resolve, however factitiously, the essential conflict between sensation and thought that is structurally integral to Homo sapiens: just where concreteness and thought tend to establish themselves as independent substances, the human is faced by his own being, made up of an unhomogeneous medley of the physical and the mental (Garroni, 1992). From this viewpoint, the topic under discussion here should not be considered the expression of a merely episodic defect of...

Table of contents

• Cover
• Endorsement
• Half Title
• Series Information
• Title Page
• Copyright Page
• Dedication
• Epigraph
• Contents
• Foreword
• Permission acknowledgments
• Introduction
• Chapter 1 Body–mind dissociation and transference onto the body
• Chapter 2 Visual power, emotions, and mental growth: A clinical essay on some of Bion’s earliest psychosomatic intuitions
• Chapter 3 Intersubjectivity and the body
• Chapter 4 Primitive mental states and the body: A personal view of A. B. Ferrari’s concrete original object
• Chapter 5 The body in the analytic session: Focusing on the body–mind link
• Chapter 6 Body and mind in adolescence
• Chapter 7 Working with the body–mind dissociation in three psychoanalytic sessions
• Chapter 8 The body, feelings, and the unheard music of the senses
• Chapter 9 The hat on top of the volcano: Bion’s O and Ferrari’s body–mind relationship
• Chapter 10 Bodily claustrophobia and the music: A psychoanalytic note on Beethoven’s Fidelio
• Conclusion: Art, bodily experiences, and internal harmony
• References
• Index