As a practitioner of contemporary multi-perspectival psychoanalysis , unless I am especially anxious or feeling lost in a therapeutic relationship, theory is not in my conscious mind. But all the theories that have moved me are indelibly part of the matrix of my mind, and in some instances they shape the way I hold the clinical experience. I have found that clinical work undertaken when Meltzer’s aesthetic conflict spontaneously rises to the foreground as a compass inevitably shares the poetic and dramatic qualities of the theory – while not necessarily sharing its poetic brilliance. As in love, the ragged moments and the impasses created by apprehension are as inevitable as the recovery of beauty in clinical work.

G, a 42-year old physician in an organization for workers’ compensation cases, initially came to see me as he was in constant conflict with the female office manager. He complained bitterly, “She doesn’t understand me”– the psychoanalytic cautionary tale as overture, which I came, necessarily, to take very personally. G was the sixth of twelve children in a fundamentalist Christian family, living in poverty in a small coastal town. His mother, a locally renowned anti-abortion activist, played the organ in church and taught piano for a living; father did garden maintenance. He told me his mother had given up a very promising career as a pianist at age 20 to marry father, a misanthropic autodidact, prone to frequent rage attacks on the entire household, as he found the noise of the children he had spawned though not fathered intolerable. He and the older boys constructed a jerry-built row of cells resembling a motel at the end of their lot for all the children.

G was apparently the only child to inherit his mother’s functional intelligence and musical ability. Fortunately, he secretly safeguarded this positive link, his identification with her, keeping alive a yearning for recognition from her, despite his deep damage, hurt and disappointment. This survival of desire probably forestalled even more drastic psychosis than the profound dissociation and disaffection from which he suffered.

He had several interests: was an avid musician, studying Classical Spanish guitar; became an oenophile and gourmet cook; and an expert gardener. He also surfed daily, which I think functioned mostly as a means of autistic, auto-sensual self-regulation. G was the only child to attend college and then a Christian medical school, working as a teacher to support himself throughout his education. He reiterated daily how he hated his patients and often denied them treatment, and finally managed to transfer into an administrative position in the organization.

In describing the course of treatment, I move back and forth between my initial anxious and defensive responses to G, and my subsequent re-dreaming, once my anxiety had been allayed and my counter-projective identification analyzed, so that I could finally be alive in the room, reverie and imagination restored. The early phase demonstrates both G’s need and my resistance to meeting it, which kept us both in an impasse.

For the first two years of his analysis, G, who resembled an aging boy, dressed in nondescript Salvation Army jeans, t-shirt and flip-flops, wafted in to the room, an insubstantial dust mote in the air, making neither eye contact nor having any kinesthetic exchange with me of the very subtle kinds we make implicitly as humans, acknowledging each other’s presence. He chose the couch, and always seemed to hover somewhere above it, a barely apprehensible presence. There were long blank silences, and when he spoke at all, it was in such a childish and inaudible voice that I had to crane forward to hear him. To my consternation, I could neither think nor leave, psychically. It seemed my life depended on sensing him, connecting, but he remained an ungraspable absence. I felt stuck there, far from reverie, stuck together, I imagined, in adhesive identification, a sad perversion of at-one-ment: together in a death vigil, anxiously awaiting either death itself (a treatment rupture), or a miraculous (i.e. not attributable to anything I provided) sign of life. I felt, strangely, that his absence required my full presence, albeit with absolutely no yield for my attention. It was as though he needed to devour my essence just to remain vegetatively alive. I also imagined he hated me for this need. I felt smeared by some vapour of vague hostility, but mostly I felt depleted, sucked dry. I urgently needed to eat after every hour with him. I later thought that the omnipresent hostility was not only narrowly personal, but our mutual allergic response to alterity, so vexing, when what we - especially infants - most need are experiences on the continuum of being-at-one-with, of identification and inclusion, that do not subsume our equal and opposite need for “isolation” (Winnicott, 1963, p.187) or non-object-relatedness.

Being so de-mentalized, I resorted to reflexive habits of thought, particularly dread of the bugbear envy, theorized as an attack on myself as analyst. My (silent) responses, somatic and psychic, were self-protective and hostile, ironic and critical. For example, I wondered whether he enjoyed controlling me, by his tiny voice and lack of eye contact; and even whether he wanted me (my analytic function) dead.

With hindsight, aided by my night dreams, a recovery of imagination, and dream-alpha-function operating on all my detailed observation, I could re-dream this. I became able to think that the control he exerted on me was not subjugating and omnipotent, but better understood as his effort to re-present to me his internal world, which was devoid of interpersonal contact, and of any capacity for reflection about feelings and experiences. I realized that he had successfully communicated his infantile experience and that we had enacted his desperate need to contact an unavailable, overwhelmed (probably psychotic) mother. We had also enacted her failure to take him in to her mind. I could then imagine, both in his living arrangement with a young mother and her infant girl, and in what was to emerge as a pattern of relationships with single mothers and female babies, his identification with baby girls and his desire to evoke the beautiful mother’s love for himself as her beautiful baby, so like her. He was eventually able to achieve this essential aspect of the aesthetic conflict with me – both meanings of the apprehension of beauty being in play.

G lived in a room off the kitchen at the back of the house of a couple with a baby. He was contemptuous of the father (an older deadbeat who soon left his partner and infant girl), and very engrossed in his relationship with the baby and mother, in that order. I silently understood this, at first, in a canned “Kleinian” way, as his having banished and supplanted the father; and also as his envious usurpation and one-upping of the young mother, being in fantasy a better mother and father than the biological couple.

At the start, when he talked, the manifest content of his sparse communications was relentlessly, destructively envious. He recounted daily, with blatant triumph, how at work, he had turned down requests for treatment from ignorant and corrupt doctors for their malingering patients. Close to the surface of his intensely-dead presentation – an accurate oxymoron – was simmering contempt expressed as derisive snort-laughs. He listened to a particularly crass right-wing radio talk-show host, Michael Savage, on his drive up to analysis, and would recount his barbarity with triumph, while I winced, feeling myself savaged. Mostly I (mal)functioned as a toilet breast (Meltzer, 1967), flushing my own dread along with his rage, while at best, silently mis/understanding these attacks on patients and caregivers (myself) as expressions of his envy of couples in which care was provided for the one in need. When finally, desperate to be an analyst, I attempted inferential interpretations of his unconscious states of mind, however empathically, he’d snarl with contemptuous impatience: “All I want is to be able to get married and have a family. I don’t want to hear about myself and how I affect other people. It does nothing for me.” He found interpretations terrifyingly alien, so I learned to refrain and wait, not knowing how we might move out of this entrapment.

Through our work, I came to appreciate deeply how the more pathological the earliest introjected self- and -object relational processes are, the more immune from reflection the transference will be, and the more dependent on projective identification for communication of preverbal experience. I had underestimated the degree of foundational, environmental provision he needed, so profound was his privation, before any vestiges of authentic subjectivity and intersubjectivity could be experienced.

I realized I had resisted G’s states, especially his long dissociative absences, and my corresponding urgency to reach him, largely because of familiarity. My father was one of 13 children, (only two of whom survived, in a very poor Jewish refugee family). He was profoundly dissociative, and as a child I struggled to reach him. (Later I felt ashamed of him, furious at him and sometimes contemptuous too). In the logic of the unconscious, I dreaded that by receiving G, I would become my father. As I surrendered, and in fact did become my father, i.e. realize his presence in me, in my own psychic work, including a bout of his psychosomatic symptom, I was afforded a significant reworking of my relationship to both G and my father.

A few years into this analysis, the code blue siren screeched. He travelled long distances to see me, three times a week, and began to make it abundantly clear that he only continued to do so as I was barely better than nothing. At this point I became so desperate to find a vital connection with him that I demanded he sit up facing me. I believe the immediate catalyst for this unprecedented action, unconsciously, was a disturbing dream I had had the previous night: I am on the beach of my childhood, the particular end of the beach where I had had a near-death experience as a 7- year-old, drowned in a massive breaker and revived by mouth-to-mouth resuscitation. My father, who died 35 years ago, appears like a ghost, an apparition, calling out to me, arms outstretched, desperately beseeching me to come and rescue him. He is in a huge fog bank, like a cloud of dense ocean spray, and his voice is coming to me distorted and wavelike through water, so that I can’t decipher the words but feel in my bones the urgent appeal. In fact, during my childhood out-of-body experience, I was hovering about 25 feet above where my 4- year old brother was screaming; “Dawnie, don’t leave me! Come back!”

Sitting G up facing me proved to be a radical intervention, instantaneously more deeply informative and ultimately mutative than anything I had attempted so far. He was completely flaccid, lacking in tonus like a limp newborn, so that I had to prop him up with many cushions. His head lolled about dangerously, and his eyes were unfocused. This powerful impression galvanized my attention to the most primitive level of un-organization that underlay the rigidly armoured character - a version of Bick’s “second skin” (1967) - of this infant, who had lain his deceptively athletic body on my couch, spitting nails in defence of terrifying and absolute helplessness. I felt penetrated by his forlornness. He seemed the embodiment of one of the lost children of myth, who needed to be rescued out of limbo and into life, out of the jaws of the underworld presided over by the god Dis, (Kalsched, 2005) the god of dis-appointment, dis-affection and dis-sociation. The means at my disposal proved to be primarily the music of my voice, and also my face (breast).

I found myself thinking consciously in terms of affective, developmental neuroscience. I had recently completed a series of seminars on this topic with Dr. Allan Schore. Thanks to Ogden’s re-casting of this phenomenon (2016, p.25) I was able to consider this as my positive engagement with sane, symbolizing thinkers, who were knowledgeable about primitive states, conversing with me and helping me tolerate this a-symbolic field long enough to see this phase of work through.

Over time I became aware of his surreptitiously looking at my face, however glancingly, while I was looking away or in thought, and I imagine he read that, in the most primitive terms, I was good and he was safe. I felt he was taking little sips of me. I wondered too whether he might have feared being overwhelmed with ecstasy as Tustin (1981) describes infants who resort to autistic defences do, if he took in more beauty and love. Did his expression also hold some conflict as Meltzer describes it, over my very presence: was his rapture at my beauty accompanied by pain that I remained enigmatically unpossessable by him?

A photograph he showed me left a powerful impression on me. His father was likely the photographer. A months’ old infant, he is being held up in the air, close to his mother’s body, while she gazes at him, smiling. Some other siblings are playing, scattered around on the drab lot in front of the cells. To my eye, the mother and baby G are a luminous focus, evoking the Holy Couple. Bion’s hypotheses about the enduring impacts of perinatal experience came to my mind. It seemed to me that both infant G and his mother were enraptured by the sensory beauty of “the world”– each other. And I thought, retrospectively, that G’s lifelong love for his mother might be attributed to his love of and gratitude for her internal beauty: her psyche, and the Mind of music.

That he never became curious about my psyche in the transference, or about the psychoanalytic method as an object of beauty, suggests to me that, as the cliché attests, the map sometimes does not correspond to the territory. His biological mother remained his primary aesthetic object, in his conscious mind. During this phase, on several occasions, I noticed a peculiarly sweet smile flit across his face, (the smile some infant observers have characterized as non-specific, an indicator mostly of organismic, environmental - object pleasure). This was poignantly reminiscent of an expression of my father’s, when, for a nanosecond I believed he registered my presence as benign. And I realized that we were at long last falling in love.

This shift in our work towards privileging prosodic attunement has left me considering the analytic field as a non-linear, dynamic system, in which change in one input, regardless of how it comes about, changes the entire dynamic of the system.

As G’s trust in my interest in knowing him grew, his childhood amnesia lifted, and he shared many stories of his current and past family life. I was moved by the poignancy of these stories, all of which evoked a sensitive small boy, dis-possessed, “nobody’s boy,” frozen in terror at the violence of his father and feral brood of siblings, and frozen too in abject shame for the abusive-neglect he had suffered at the hands of a mother he had not fully given up on. He had received very basic physical care from his oldest sister who was 10 when he was born and into whose young arms he was thrust for bottle feeding. One episode in his conscious memory rankled: as a young teenager, he fell down a cliff and broke his arm, but since his mother didn’t believe in Western medicine, only in prayer, he was not taken to a doctor. Weeks later, when it was not healing, a teacher took him to the hospital to have it set. He emphasized that the injury kept him out of the ocean and off the sports field for a year, depriving him of his only sense of being alive. Recounting this, he cried, exclaiming with surprise, “Water is coming from my eyes?!” He believed he had never before cried.

One day, he came in quivering with fury: his bike had been stolen, and he had run across the boy who had stolen it, and was so enraged, he feared he was going to attack and kill him. By now it had become clear to me that however apparently inimical to life his fantasies and feelings were, they were libidinal attempts to defend a nascent self who had been completely abandoned in a domestic war zone. His hitherto-dissociated rage was finally becoming explicit and thinkable. This opened up memories of how his brothers had always stolen whatever small treasures he had, no matter how he had tried to hide or protect them; how helpless he was to protect himself; and that it had never occurred to him to ask either parent to intercede. His was an each-one-for-himself world; that was just the way it was.

No one had ever reflected on their own or other’s experience, as we were doing, now. It was at times difficult for me to bear the vitriolic hatred he expressed towards his father and some siblings – hatred with internal as well as external consequences – without fear for whether we would ever be able to repair his inner world. Perhaps I also dreaded receiving the full brunt of his hatred.

The more he recounted his childhood experience, the clearer it emerged that hurt, shame and yearning were his signature affects. He told me his mother had composed a piece of piano music for each of her first five babies, but not for him. He wondered whether there was something about him that did not inspire her, but on the contrary, dried her up, repelled her. He believed that he was “just not interesting or appealing in any way.” His undying desire for the gift of her music –a poignant metaphor, for her loving voice - was palpable, and over the next few years of his analysis he did everything he could think of to help her compose a piece for him. He had her five compositions upgraded from tapes into digital CD’s; then he transposed her compositions for guitar, using his weekly guitar lessons to practice playing them. When he felt he played them well enough, he rented a recording studio to make a CD of his guitar versions of her compositions, as a gift for her. As a last resort, he bought a small keyboard and delivered it to her trailer park home. He was utterly demoralized when she did not even open the box, but told him later that she had given it to her church as a gift.

Despite his failure to evoke her reciprocal love, he persisted in seeking recognition both of his appreciation of her music, and for the evidence that his musical gift was like hers. He was desperate to generate “primary communion” (Broucek, 1997, p.54). His experience, however, was that this irresistibly desirable woman could not respond to him with any passion, but channelled it all into her pro-life advocacy, and her church. I thought my own “pro-life” hope for his aliveness, and my faith in the church of analysis might have been implicated too, but I elected not to make direct transference interpretations at this time. He felt she listened grudgingly to his musical offerings and was unmoved, and he was devastated. He had been cruelly deprived of the shared experience which generates pride, and is en-joy-able – literally generates joy – and frequently fell into the desultory, dissociated state, shame.

One day, earlier in the analysis, he walked determinedly into the consulting room carrying a guitar case, put it on the couch and moved a straight-backed chair into the centre of the room, facing me. When he opened the case, I was so taken with the beauty of its deep burgundy velvet lining that I gasped in admiration. His pleasure at being seen this way was touching. “No-one has ever noticed that before,” he said, in his deceptively flat voice in which I could by now intuit the delicate feeling he could not express otherwise. He played a very technically challenging piece of music he had been struggling to learn for months, as he felt he was finally getting the hang of it. But he was disappointed in his performance, felt he had not done the piece justice, as he had stumbled over notes a couple of times and momentarily lost the tempo. I thought how for all of us, nothing we create ever seems to do justice to the enormity of what we have destroyed or lost - which is why we persevere, create ongoingly. The entire experience, from the moment he entered, clearly overcoming great trepidation by his forcefulness, left me literally speechless. I believe all I said that hour, were sounds representing interest and pleasure. After his lifelong struggle to come alive, and our struggle to be alive together, he certainly was mastering the art of sharing his vulnerable self.

Interspersed with recollections and more feeling-full accounts of dysfunctional contemporary family life, there began to be many hours of simply spending time together, companionably, from which he seemed to leave refreshed. I too enjoyed the mutual squiggling, without any need to know who said what or what it all meant. As he left, he would turn around at the door and nod briefly. The content of many of these conversations was intermittently as banal and unworthy of recounting as are the regular conversations of mothers and babies, or of lovers, to any third party. We spoke about the particular piece of music he was practising at the time; about the plants he noticed in my garden as he walked to my consulting room; the plants in his garden; his blueberry crop; the wine he was learning to enjoy. Our exchanges were symbolic, affective and prosodic. He needed me to know him in his uniqueness and to be in aesthetic reciprocity to “the most beautiful baby in the world.” We were simply being together, communing, the only pressure being that of time as the end of the hour approached. It was at this time that he requested a fourth hour, by phone. To manage this he had to pull off the freeway on his way home from work and find a quiet place with cell access to call me. This reflected both his acceptance of his need for me, and also his enacting in the transference his experience of doing everything in his power to elicit love from this once obtuse and dried up mother, who finally seemed to be getting the picture. He began to bring me small gifts, such as plants and blueberries from his garden, and unlike his mother, I accepted them graciously.

In this context, nachtraglichkeit began to perform its magnificent re-membering. He told me, for example, that the happiest times in his childhood were summers spent at the church’s summer camp. The counsellor in charge of the kitchen made bread and peanut butter available at all times in case the children became hungry between meals. Not only was it the best he had ever tasted, but she was very kind and seemed to welcome him. “I think she liked me,” he said, tentatively and with surprise, as a few tears rolled down his face. Three years later he showed me, matter-of-factly, in his final hour, (when mostly, he had come in to tell me he was going to get married in late summer), that he had saved some Kleenex tissues in a plastic bag from his first cry in the room with me, as well as some tissues from a few subsequent thaws. They somehow felt valuable to him. I thought out loud that they were precious reminders to him of how he came alive after a near-death existence; were souvenirs of his psychic birth; and also perhaps stood for the teddy bear he never had. And I accepted his showing them to me as a gift of gratitude and love.

The next several years were primarily spent in two content areas in which it became possible to fruitfully address his envy and destructive self-envy, which remained in dialectical relationship with his shame, as well as with growing self-acceptance, and with gratitude. His functioning was more fluid and he could now oscillate to a good-enough sense of himself.

One content area involved his rehabilitation of the once contemptibly ignorant and self-serving doctors whose requests for treatment for their patients he now granted most of the time. He accepted with shared humour my light transference understanding of this. Our primary focus concerned his beginning to date women. He was attracted to a series of younger, single women - all around the age his mother would have been at his birth – and each of whom had one young female child, to whom he invariably became very attached and with whom he wishfully identified. This required much working-through at both pre-Oedipal and Oedipal levels.

He grumbled bitterly about how unappealing the “older women” who were interested in him were, and that he couldn’t imagine living with them. I was relieved that he was able to recognize my limitations, while still clearly accepting my care. After all, I was an older woman, and it felt appropriate to his psychic age that he seek an exogamous partner. At this time too he expressed disappointment that the interior designer he had hired to help him furnish his home had made a few choices he didn’t like. I never discovered which aspects of his internal world I/we had changed were disappointing to him. He never became interested in such insights; but regardless, he certainly made catastrophic changes. Finally, he began to date a younger woman to whom he was attracted, and a roller-coaster courtship ensued, with much re-working of his terror of beauty. But that is another story…

Around Christmas time 5 years after termination I received a letter from him, describing his very happy family life, and including photographs of himself, his wife and their two young children, a boy and a girl, in the garden of their suburban home – the antithesis of the trailer park of his childhood. He annotated these photos ironically, pointing to the contrasts and expressing his happiness; and he reiterated his gratitude to his 94-year old mother for her gift of music, and told me he had written and played a song to her at his wedding. He expressed his love for his wife and for her beautiful mothering of their children, and made a smiley face beside his ironic comment that he almost discovered “god” again through his family life; and that he felt he had been “saved” in the nick of time, by this later-life marriage. (He was 55). That he had finally attained the capacity for depressive position functioning is attested to by the compromise he described with his wife: she loved ballroom dancing, while he loved surfing. They negotiated a compromise whereby he’d go dancing with her, and she’d learn to surf with him.

Not unexpectedly, his perception of beauty did not approach Meltzer’s thoroughgoing understanding (See his case vignettes especially those in The Apprehension of Beauty and in Dream-Life , 1983) of how the recovery from aesthetic conflict involves acceptance of our aloneness and of the other’s separateness; remorse for past ignorance and its acts; bittersweet awareness of time and its inexorable march forward, to our personal death; and transcending all, the enigmatic beauty of this mystery, our human lives.

Dr. Dawn Farber, Psy.D. MFT has been a personal and supervising analyst, faculty, and co-chair of the Outreach and Public Information Committee at PINC. She has a private practice in Oakland and teaches and consults widely in the community. Currently she teaches the entire post-Kleinian canon, notably the work of Bion and of Meltzer. She taught Bion to the psychoanalytic programs at Stellenbosch and Rhodes universities in 2015, as well as a course on Shame, to the Self Psychology group in Cape Town. Dr. Farber enjoys writing psychoanalytically informed essays, book and movie reviews, and poetry, and is published in Fort Da and in Culture and Psyche, in these genres.

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Going Home/Not Home

As a practitioner of contemporary multi-perspectival psychoanalysis , unless I am especially anxious or feeling lost in a therapeutic relationship, theory is not in my conscious mind. But all the theories that have moved me are indelibly part of the matrix of my mind, and in some instances they shape the way I hold the clinical experience. I have found that clinical work undertaken when Meltzer’s aesthetic conflict spontaneously rises to the foreground as a compass inevitably shares the poetic and dramatic qualities of the theory – while not necessarily sharing its poetic brilliance. As in love, the ragged moments and the impasses created by apprehension are as inevitable as the recovery of beauty in clinical work.

G, a 42-year old physician in an organization for workers’ compensation cases, initially came to see me as he was in constant conflict with the female office manager. He complained bitterly, “She doesn’t understand me”– the psychoanalytic cautionary tale as overture, which I came, necessarily, to take very personally. G was the sixth of twelve children in a fundamentalist Christian family, living in poverty in a small coastal town. His mother, a locally renowned anti-abortion activist, played the organ in church and taught piano for a living; father did garden maintenance. He told me his mother had given up a very promising career as a pianist at age 20 to marry father, a misanthropic autodidact, prone to frequent rage attacks on the entire household, as he found the noise of the children he had spawned though not fathered intolerable. He and the older boys constructed a jerry-built row of cells resembling a motel at the end of their lot for all the children.

G was apparently the only child to inherit his mother’s functional intelligence and musical ability. Fortunately, he secretly safeguarded this positive link, his identification with her, keeping alive a yearning for recognition from her, despite his deep damage, hurt and disappointment. This survival of desire probably forestalled even more drastic psychosis than the profound dissociation and disaffection from which he suffered.

He had several interests: was an avid musician, studying Classical Spanish guitar; became an oenophile and gourmet cook; and an expert gardener. He also surfed daily, which I think functioned mostly as a means of autistic, auto-sensual self-regulation. G was the only child to attend college and then a Christian medical school, working as a teacher to support himself throughout his education. He reiterated daily how he hated his patients and often denied them treatment, and finally managed to transfer into an administrative position in the organization.

In describing the course of treatment, I move back and forth between my initial anxious and defensive responses to G, and my subsequent re-dreaming, once my anxiety had been allayed and my counter-projective identification analyzed, so that I could finally be alive in the room, reverie and imagination restored. The early phase demonstrates both G’s need and my resistance to meeting it, which kept us both in an impasse.

For the first two years of his analysis, G, who resembled an aging boy, dressed in nondescript Salvation Army jeans, t-shirt and flip-flops, wafted in to the room, an insubstantial dust mote in the air, making neither eye contact nor having any kinesthetic exchange with me of the very subtle kinds we make implicitly as humans, acknowledging each other’s presence. He chose the couch, and always seemed to hover somewhere above it, a barely apprehensible presence. There were long blank silences, and when he spoke at all, it was in such a childish and inaudible voice that I had to crane forward to hear him. To my consternation, I could neither think nor leave, psychically. It seemed my life depended on sensing him, connecting, but he remained an ungraspable absence. I felt stuck there, far from reverie, stuck together, I imagined, in adhesive identification, a sad perversion of at-one-ment: together in a death vigil, anxiously awaiting either death itself (a treatment rupture), or a miraculous (i.e. not attributable to anything I provided) sign of life. I felt, strangely, that his absence required my full presence, albeit with absolutely no yield for my attention. It was as though he needed to devour my essence just to remain vegetatively alive. I also imagined he hated me for this need. I felt smeared by some vapour of vague hostility, but mostly I felt depleted, sucked dry. I urgently needed to eat after every hour with him. I later thought that the omnipresent hostility was not only narrowly personal, but our mutual allergic response to alterity, so vexing, when what we - especially infants - most need are experiences on the continuum of being-at-one-with, of identification and inclusion, that do not subsume our equal and opposite need for “isolation” (Winnicott, 1963, p.187) or non-object-relatedness.

Being so de-mentalized, I resorted to reflexive habits of thought, particularly dread of the bugbear envy, theorized as an attack on myself as analyst. My (silent) responses, somatic and psychic, were self-protective and hostile, ironic and critical. For example, I wondered whether he enjoyed controlling me, by his tiny voice and lack of eye contact; and even whether he wanted me (my analytic function) dead.

With hindsight, aided by my night dreams, a recovery of imagination, and dream-alpha-function operating on all my detailed observation, I could re-dream this. I became able to think that the control he exerted on me was not subjugating and omnipotent, but better understood as his effort to re-present to me his internal world, which was devoid of interpersonal contact, and of any capacity for reflection about feelings and experiences. I realized that he had successfully communicated his infantile experience and that we had enacted his desperate need to contact an unavailable, overwhelmed (probably psychotic) mother. We had also enacted her failure to take him in to her mind. I could then imagine, both in his living arrangement with a young mother and her infant girl, and in what was to emerge as a pattern of relationships with single mothers and female babies, his identification with baby girls and his desire to evoke the beautiful mother’s love for himself as her beautiful baby, so like her. He was eventually able to achieve this essential aspect of the aesthetic conflict with me – both meanings of the apprehension of beauty being in play.

G lived in a room off the kitchen at the back of the house of a couple with a baby. He was contemptuous of the father (an older deadbeat who soon left his partner and infant girl), and very engrossed in his relationship with the baby and mother, in that order. I silently understood this, at first, in a canned “Kleinian” way, as his having banished and supplanted the father; and also as his envious usurpation and one-upping of the young mother, being in fantasy a better mother and father than the biological couple.

At the start, when he talked, the manifest content of his sparse communications was relentlessly, destructively envious. He recounted daily, with blatant triumph, how at work, he had turned down requests for treatment from ignorant and corrupt doctors for their malingering patients. Close to the surface of his intensely-dead presentation – an accurate oxymoron – was simmering contempt expressed as derisive snort-laughs. He listened to a particularly crass right-wing radio talk-show host, Michael Savage, on his drive up to analysis, and would recount his barbarity with triumph, while I winced, feeling myself savaged. Mostly I (mal)functioned as a toilet breast (Meltzer, 1967), flushing my own dread along with his rage, while at best, silently mis/understanding these attacks on patients and caregivers (myself) as expressions of his envy of couples in which care was provided for the one in need. When finally, desperate to be an analyst, I attempted inferential interpretations of his unconscious states of mind, however empathically, he’d snarl with contemptuous impatience: “All I want is to be able to get married and have a family. I don’t want to hear about myself and how I affect other people. It does nothing for me.” He found interpretations terrifyingly alien, so I learned to refrain and wait, not knowing how we might move out of this entrapment.

Through our work, I came to appreciate deeply how the more pathological the earliest introjected self- and -object relational processes are, the more immune from reflection the transference will be, and the more dependent on projective identification for communication of preverbal experience. I had underestimated the degree of foundational, environmental provision he needed, so profound was his privation, before any vestiges of authentic subjectivity and intersubjectivity could be experienced.

I realized I had resisted G’s states, especially his long dissociative absences, and my corresponding urgency to reach him, largely because of familiarity. My father was one of 13 children, (only two of whom survived, in a very poor Jewish refugee family). He was profoundly dissociative, and as a child I struggled to reach him. (Later I felt ashamed of him, furious at him and sometimes contemptuous too). In the logic of the unconscious, I dreaded that by receiving G, I would become my father. As I surrendered, and in fact did become my father, i.e. realize his presence in me, in my own psychic work, including a bout of his psychosomatic symptom, I was afforded a significant reworking of my relationship to both G and my father.

A few years into this analysis, the code blue siren screeched. He travelled long distances to see me, three times a week, and began to make it abundantly clear that he only continued to do so as I was barely better than nothing. At this point I became so desperate to find a vital connection with him that I demanded he sit up facing me. I believe the immediate catalyst for this unprecedented action, unconsciously, was a disturbing dream I had had the previous night: I am on the beach of my childhood, the particular end of the beach where I had had a near-death experience as a 7- year-old, drowned in a massive breaker and revived by mouth-to-mouth resuscitation. My father, who died 35 years ago, appears like a ghost, an apparition, calling out to me, arms outstretched, desperately beseeching me to come and rescue him. He is in a huge fog bank, like a cloud of dense ocean spray, and his voice is coming to me distorted and wavelike through water, so that I can’t decipher the words but feel in my bones the urgent appeal. In fact, during my childhood out-of-body experience, I was hovering about 25 feet above where my 4- year old brother was screaming; “Dawnie, don’t leave me! Come back!”

Sitting G up facing me proved to be a radical intervention, instantaneously more deeply informative and ultimately mutative than anything I had attempted so far. He was completely flaccid, lacking in tonus like a limp newborn, so that I had to prop him up with many cushions. His head lolled about dangerously, and his eyes were unfocused. This powerful impression galvanized my attention to the most primitive level of un-organization that underlay the rigidly armoured character - a version of Bick’s “second skin” (1967) - of this infant, who had lain his deceptively athletic body on my couch, spitting nails in defence of terrifying and absolute helplessness. I felt penetrated by his forlornness. He seemed the embodiment of one of the lost children of myth, who needed to be rescued out of limbo and into life, out of the jaws of the underworld presided over by the god Dis, (Kalsched, 2005) the god of dis-appointment, dis-affection and dis-sociation. The means at my disposal proved to be primarily the music of my voice, and also my face (breast).

I found myself thinking consciously in terms of affective, developmental neuroscience. I had recently completed a series of seminars on this topic with Dr. Allan Schore. Thanks to Ogden’s re-casting of this phenomenon (2016, p.25) I was able to consider this as my positive engagement with sane, symbolizing thinkers, who were knowledgeable about primitive states, conversing with me and helping me tolerate this a-symbolic field long enough to see this phase of work through.

Over time I became aware of his surreptitiously looking at my face, however glancingly, while I was looking away or in thought, and I imagine he read that, in the most primitive terms, I was good and he was safe. I felt he was taking little sips of me. I wondered too whether he might have feared being overwhelmed with ecstasy as Tustin (1981) describes infants who resort to autistic defences do, if he took in more beauty and love. Did his expression also hold some conflict as Meltzer describes it, over my very presence: was his rapture at my beauty accompanied by pain that I remained enigmatically unpossessable by him?

A photograph he showed me left a powerful impression on me. His father was likely the photographer. A months’ old infant, he is being held up in the air, close to his mother’s body, while she gazes at him, smiling. Some other siblings are playing, scattered around on the drab lot in front of the cells. To my eye, the mother and baby G are a luminous focus, evoking the Holy Couple. Bion’s hypotheses about the enduring impacts of perinatal experience came to my mind. It seemed to me that both infant G and his mother were enraptured by the sensory beauty of “the world”– each other. And I thought, retrospectively, that G’s lifelong love for his mother might be attributed to his love of and gratitude for her internal beauty: her psyche, and the Mind of music.

That he never became curious about my psyche in the transference, or about the psychoanalytic method as an object of beauty, suggests to me that, as the cliché attests, the map sometimes does not correspond to the territory. His biological mother remained his primary aesthetic object, in his conscious mind. During this phase, on several occasions, I noticed a peculiarly sweet smile flit across his face, (the smile some infant observers have characterized as non-specific, an indicator mostly of organismic, environmental - object pleasure). This was poignantly reminiscent of an expression of my father’s, when, for a nanosecond I believed he registered my presence as benign. And I realized that we were at long last falling in love.

This shift in our work towards privileging prosodic attunement has left me considering the analytic field as a non-linear, dynamic system, in which change in one input, regardless of how it comes about, changes the entire dynamic of the system.

As G’s trust in my interest in knowing him grew, his childhood amnesia lifted, and he shared many stories of his current and past family life. I was moved by the poignancy of these stories, all of which evoked a sensitive small boy, dis-possessed, “nobody’s boy,” frozen in terror at the violence of his father and feral brood of siblings, and frozen too in abject shame for the abusive-neglect he had suffered at the hands of a mother he had not fully given up on. He had received very basic physical care from his oldest sister who was 10 when he was born and into whose young arms he was thrust for bottle feeding. One episode in his conscious memory rankled: as a young teenager, he fell down a cliff and broke his arm, but since his mother didn’t believe in Western medicine, only in prayer, he was not taken to a doctor. Weeks later, when it was not healing, a teacher took him to the hospital to have it set. He emphasized that the injury kept him out of the ocean and off the sports field for a year, depriving him of his only sense of being alive. Recounting this, he cried, exclaiming with surprise, “Water is coming from my eyes?!” He believed he had never before cried.

One day, he came in quivering with fury: his bike had been stolen, and he had run across the boy who had stolen it, and was so enraged, he feared he was going to attack and kill him. By now it had become clear to me that however apparently inimical to life his fantasies and feelings were, they were libidinal attempts to defend a nascent self who had been completely abandoned in a domestic war zone. His hitherto-dissociated rage was finally becoming explicit and thinkable. This opened up memories of how his brothers had always stolen whatever small treasures he had, no matter how he had tried to hide or protect them; how helpless he was to protect himself; and that it had never occurred to him to ask either parent to intercede. His was an each-one-for-himself world; that was just the way it was.

No one had ever reflected on their own or other’s experience, as we were doing, now. It was at times difficult for me to bear the vitriolic hatred he expressed towards his father and some siblings – hatred with internal as well as external consequences – without fear for whether we would ever be able to repair his inner world. Perhaps I also dreaded receiving the full brunt of his hatred.

The more he recounted his childhood experience, the clearer it emerged that hurt, shame and yearning were his signature affects. He told me his mother had composed a piece of piano music for each of her first five babies, but not for him. He wondered whether there was something about him that did not inspire her, but on the contrary, dried her up, repelled her. He believed that he was “just not interesting or appealing in any way.” His undying desire for the gift of her music –a poignant metaphor, for her loving voice - was palpable, and over the next few years of his analysis he did everything he could think of to help her compose a piece for him. He had her five compositions upgraded from tapes into digital CD’s; then he transposed her compositions for guitar, using his weekly guitar lessons to practice playing them. When he felt he played them well enough, he rented a recording studio to make a CD of his guitar versions of her compositions, as a gift for her. As a last resort, he bought a small keyboard and delivered it to her trailer park home. He was utterly demoralized when she did not even open the box, but told him later that she had given it to her church as a gift.

Despite his failure to evoke her reciprocal love, he persisted in seeking recognition both of his appreciation of her music, and for the evidence that his musical gift was like hers. He was desperate to generate “primary communion” (Broucek, 1997, p.54). His experience, however, was that this irresistibly desirable woman could not respond to him with any passion, but channelled it all into her pro-life advocacy, and her church. I thought my own “pro-life” hope for his aliveness, and my faith in the church of analysis might have been implicated too, but I elected not to make direct transference interpretations at this time. He felt she listened grudgingly to his musical offerings and was unmoved, and he was devastated. He had been cruelly deprived of the shared experience which generates pride, and is en-joy-able – literally generates joy – and frequently fell into the desultory, dissociated state, shame.

One day, earlier in the analysis, he walked determinedly into the consulting room carrying a guitar case, put it on the couch and moved a straight-backed chair into the centre of the room, facing me. When he opened the case, I was so taken with the beauty of its deep burgundy velvet lining that I gasped in admiration. His pleasure at being seen this way was touching. “No-one has ever noticed that before,” he said, in his deceptively flat voice in which I could by now intuit the delicate feeling he could not express otherwise. He played a very technically challenging piece of music he had been struggling to learn for months, as he felt he was finally getting the hang of it. But he was disappointed in his performance, felt he had not done the piece justice, as he had stumbled over notes a couple of times and momentarily lost the tempo. I thought how for all of us, nothing we create ever seems to do justice to the enormity of what we have destroyed or lost - which is why we persevere, create ongoingly. The entire experience, from the moment he entered, clearly overcoming great trepidation by his forcefulness, left me literally speechless. I believe all I said that hour, were sounds representing interest and pleasure. After his lifelong struggle to come alive, and our struggle to be alive together, he certainly was mastering the art of sharing his vulnerable self.

Interspersed with recollections and more feeling-full accounts of dysfunctional contemporary family life, there began to be many hours of simply spending time together, companionably, from which he seemed to leave refreshed. I too enjoyed the mutual squiggling, without any need to know who said what or what it all meant. As he left, he would turn around at the door and nod briefly. The content of many of these conversations was intermittently as banal and unworthy of recounting as are the regular conversations of mothers and babies, or of lovers, to any third party. We spoke about the particular piece of music he was practising at the time; about the plants he noticed in my garden as he walked to my consulting room; the plants in his garden; his blueberry crop; the wine he was learning to enjoy. Our exchanges were symbolic, affective and prosodic. He needed me to know him in his uniqueness and to be in aesthetic reciprocity to “the most beautiful baby in the world.” We were simply being together, communing, the only pressure being that of time as the end of the hour approached. It was at this time that he requested a fourth hour, by phone. To manage this he had to pull off the freeway on his way home from work and find a quiet place with cell access to call me. This reflected both his acceptance of his need for me, and also his enacting in the transference his experience of doing everything in his power to elicit love from this once obtuse and dried up mother, who finally seemed to be getting the picture. He began to bring me small gifts, such as plants and blueberries from his garden, and unlike his mother, I accepted them graciously.

In this context, nachtraglichkeit began to perform its magnificent re-membering. He told me, for example, that the happiest times in his childhood were summers spent at the church’s summer camp. The counsellor in charge of the kitchen made bread and peanut butter available at all times in case the children became hungry between meals. Not only was it the best he had ever tasted, but she was very kind and seemed to welcome him. “I think she liked me,” he said, tentatively and with surprise, as a few tears rolled down his face. Three years later he showed me, matter-of-factly, in his final hour, (when mostly, he had come in to tell me he was going to get married in late summer), that he had saved some Kleenex tissues in a plastic bag from his first cry in the room with me, as well as some tissues from a few subsequent thaws. They somehow felt valuable to him. I thought out loud that they were precious reminders to him of how he came alive after a near-death existence; were souvenirs of his psychic birth; and also perhaps stood for the teddy bear he never had. And I accepted his showing them to me as a gift of gratitude and love.

The next several years were primarily spent in two content areas in which it became possible to fruitfully address his envy and destructive self-envy, which remained in dialectical relationship with his shame, as well as with growing self-acceptance, and with gratitude. His functioning was more fluid and he could now oscillate to a good-enough sense of himself.

One content area involved his rehabilitation of the once contemptibly ignorant and self-serving doctors whose requests for treatment for their patients he now granted most of the time. He accepted with shared humour my light transference understanding of this. Our primary focus concerned his beginning to date women. He was attracted to a series of younger, single women - all around the age his mother would have been at his birth – and each of whom had one young female child, to whom he invariably became very attached and with whom he wishfully identified. This required much working-through at both pre-Oedipal and Oedipal levels.

He grumbled bitterly about how unappealing the “older women” who were interested in him were, and that he couldn’t imagine living with them. I was relieved that he was able to recognize my limitations, while still clearly accepting my care. After all, I was an older woman, and it felt appropriate to his psychic age that he seek an exogamous partner. At this time too he expressed disappointment that the interior designer he had hired to help him furnish his home had made a few choices he didn’t like. I never discovered which aspects of his internal world I/we had changed were disappointing to him. He never became interested in such insights; but regardless, he certainly made catastrophic changes. Finally, he began to date a younger woman to whom he was attracted, and a roller-coaster courtship ensued, with much re-working of his terror of beauty. But that is another story…

Around Christmas time 5 years after termination I received a letter from him, describing his very happy family life, and including photographs of himself, his wife and their two young children, a boy and a girl, in the garden of their suburban home – the antithesis of the trailer park of his childhood. He annotated these photos ironically, pointing to the contrasts and expressing his happiness; and he reiterated his gratitude to his 94-year old mother for her gift of music, and told me he had written and played a song to her at his wedding. He expressed his love for his wife and for her beautiful mothering of their children, and made a smiley face beside his ironic comment that he almost discovered “god” again through his family life; and that he felt he had been “saved” in the nick of time, by this later-life marriage. (He was 55). That he had finally attained the capacity for depressive position functioning is attested to by the compromise he described with his wife: she loved ballroom dancing, while he loved surfing. They negotiated a compromise whereby he’d go dancing with her, and she’d learn to surf with him.

Not unexpectedly, his perception of beauty did not approach Meltzer’s thoroughgoing understanding (See his case vignettes especially those in The Apprehension of Beauty and in Dream-Life , 1983) of how the recovery from aesthetic conflict involves acceptance of our aloneness and of the other’s separateness; remorse for past ignorance and its acts; bittersweet awareness of time and its inexorable march forward, to our personal death; and transcending all, the enigmatic beauty of this mystery, our human lives.

Dr. Dawn Farber, Psy.D. MFT has been a personal and supervising analyst, faculty, and co-chair of the Outreach and Public Information Committee at PINC. She has a private practice in Oakland and teaches and consults widely in the community. Currently she teaches the entire post-Kleinian canon, notably the work of Bion and of Meltzer. She taught Bion to the psychoanalytic programs at Stellenbosch and Rhodes universities in 2015, as well as a course on Shame, to the Self Psychology group in Cape Town. Dr. Farber enjoys writing psychoanalytically informed essays, book and movie reviews, and poetry, and is published in Fort Da and in Culture and Psyche, in these genres.

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