The technique, however, is a very simple one…. It consists simply in not directing one’s notice to anything in particular and in maintaining the same ‘evenly suspended attention’.
(Freud 1912:111) This chapter is based on a paper written jointly with John Steiner (Britton and Steiner 1994). We wanted to describe the use by the analyst of the intuitively selected fact in the evolution of his or her interpretations and to draw attention to its hazardous similarity to the crystallisation of delusional certainty from an overvalued idea. Overvalued ideas are likely to arise from overdetermined unconscious beliefs. In that paper we discussed the problem of distinguishing between the two clinically, and stressed the importance of monitoring the subsequent development in sessions following interpretations in order to try to do so. We agreed to look together at clinical material from our own work for suitable examples where we thought the selected fact crystallised the current analytic situation and where we thought an overvalued idea impeded analytic understanding. The case material we chose I have used in this chapter. By not disclosing whose work it was in either of the cases we wanted to emphasise that at times in any analyst’s work a selected fact is quite likely to be an overvalued idea. It also added some protection to confidentiality for the patients. For both these reasons I have written in this chapter as if I was the analyst in both cases.
Bion suggested that the organisation in the analyst’s mind of thoughts about the patient resembles a process described by Poincaré in his ‘Science and method’ (Poincaré quoted in Bion 1967:127). This process begins with some particular fact among an accumulation of facts arresting the attention of the scientist in such a way that all the others fall into a pattern or configuration by their relationship to this selected fact. Bion adopted the
term ‘selected fact’ because he believed a similar process took place in the analyst’s mind when, putting aside memory and desire, he achieved that state of ‘evenly suspended attention’ prescribed by Freud for analytic practice (Freud 1912:111). Bion recommended this approach when reviewing the analytic method in his book Second Thoughts (Bion 1967:127). There was in the analyst’s thinking, he wrote:
an ‘evolution’, namely the coming together, by a sudden precipitating intuition, of a mass of apparently unrelated incoherent phenomena which are thereby given coherence and meaning not previously possessed…. This experience resembles the phenomenon of the transformation of the paranoid-schizoid position to the depressive position…. From the material the patient produces, there emerges, like the pattern from a kaleidoscope, a configuration which seems to belong not only to the situation unfolding, but to a number of others not previously seen to be connected and which it has not been designed to connect.
(Bion 1967:127) I will try to illustrate this with some clinical material from the analysis of a young woman from a Muslim country with a secular upbringing, who was a writer of some success and promise. The patient was married to a fellow Muslim who was also secular in outlook and they had one child. She had a younger brother who was a lawyer. Both her parents died in her early adult life. The material is chosen because, although it is from some years ago, the notes were made immediately after the session, and subsequent developments in the analysis and the patient’s life give a reasonable degree of confidence that the selection of the interpretation in this session was appropriate when it was made.
At this point Mrs X had been in analysis for several years. Initially she was given to intellectualising, and identified with the analyst a good deal.
This changed after some years of analysis, and there was a temporary period of quite considerable symptomatic and transference disturbance.
There was a good recovery, with much greater insight but a tendency to negative therapeutic reaction. At the time of this clinical material she had taken positive new steps in her analysis and in her life, but the day before this reported session she had been ‘backtracking’, with the return of old beliefs, symptoms and discontent with her own work.
Mrs X began the session by complaining that I was a minute late and went on to describe herself as feeling cruelly evicted at the end of the previous session. After a short pause she told me a dream. She was on a mountain peak. Also on top was a giant mushroom. She was afraid of being pushed off, but she was also stuck there. Her husband said impatiently from
The analyst’s intuition
somewhere beyond the peak: ‘Come on! We have to move along to get there.’ She then added: ‘He must have been on a downward slope.’
Her immediate associations were of irritation with her father for always bringing large baskets of vegetables and fruit, and after a pause she spoke of the male patient whose session followed hers as more privileged because she suspected he was training as an analyst.
The item (selected fact) which completely took my attention was the notion that to ‘move along’ she would have to go down ‘the slope’. I took this to mean that any progress meant for her going ‘downhill’ from her imagined position on
‘a mountain peak’ of present privilege. The rest of my thinking organised itself around this notion. The thoughts which had already accumulated in my mind from the time I collected her consisted of fragmentary ideas about her envy, my satisfaction at her relative recovery from a serious depression, my awareness of her jealousy of other patients and of her brother, and a theory I had of her identification with her rather grandiose father. To these as I listened to her in the session were added, in a rather automatic way, my translation of the symbolism in the dream and my awareness of her feelings of resentment. My own conscious countertransference feeling was well represented in the dream by her husband’s impatient ‘Come on! We have to move along to get there’. Once my attention was taken by the notion that she believed that any forward progress meant her going downhill my random accumulating thoughts organised themselves around this idea and a configuration emerged in my mind.
This was that she believed giving up the nipple is not weaning—that is, moving on and developing—but eviction and displacement by a magic mushroom penis. Therefore if she had, or was, the penis she would have permanent possession of the breast. This meant simulating the penis or possession of one. This was concretely expressed in her mind in terms of
‘being an analyst’. If she could give up this illusory place on the top she could make progress, but this, as she sees it, is on the downhill slope.
My actual interpretation was: ‘You feel evicted and demoted by me because you cannot be like me.’
She responded to this by agreeing vehemently and adding: ‘But that is how it is! and I am sure it will be like that forever.’ It was only after this was well established within the session as her point of view that I completed my interpretation by adding that when she realised that taking in an interpretation did not make her an analyst, this was insight and forward movement but it felt to her like going down the slippery slope towards an inferior position.
She responded that she had the feeling once more of something irritating getting in her eye. I commented that she saw what I meant and it irritated her. ‘I feel furious that you are who you are and I am who I am!’ she said.
After a brief silence, she said: ‘I can feel that irritation beginning in my clitoris again and I was thinking about the cream.’ [This genital sensation
had formed part of a complex of symptoms, and she had adopted a tube of cream, prescribed for her by her doctor, as a fetish object, which she did not apply but carried everywhere to provide security against panic. The patient regarded this as foolish but it was compulsive for a time.]
I commented that she was intensely irritated to find she had a clitoris and not a penis, and that she thought that if she did my job she would feel as though she had a penis.
After a short silence she told me that she had taken on some new editorial, administrative responsibilities in relation to a journal for which she was a principal writer. These, she said, were very burdensome and inappropriate; she knew she should relinquish them but she felt that while she had them she was the one in charge and in control of everything.
Looking back at this I am struck by two things. One is that the selected fact not only oriented me but kept me close to the patient’s thinking, when if I had more randomly followed the material I might have become caught up in making symbolic interpretations for the sake of demonstrating unconscious representation. This would have risked introducing predetermined overvalued ideas of my own attached to such emblematic part-objects as ‘breast’ or ‘penis’. The second thing which strikes me is the patient’s unconscious communicativeness and her readiness to take in and respond to interpretation, albeit with negative affect. It is even more clear to me now that the mode by which I selected the element in the dream for attention was by identification with the figure of the husband in the dream, who was, I think, meant to represent me and who also could be seen to speak for part of herself. This unconscious identification led to my psychic orientation, which I believe in this instance led to genuine understanding. I think this was itself a consequence of the patient being in a communicative mode at that time. This contrasts very much with earlier periods in her analysis when similar unconscious identifications by me would lead us into either an impasse or an unconscious collusion. These transference repetitions or collusions would be built around an overvalued idea representing itself as a selected fact.
A ‘sudden precipitating intuition’ (Bion 1967) in the analyst may be the harbinger of insight. However, its arrival can also resemble the emergence of delusional certainty. The difference between a creative use of a selected fact and the crystallisation of an overvalued idea may not be immediately evident. It would be arrogant of an analyst to suppose that he was immune from the unconscious processes that might lead to the emergence of an ‘overvalued idea’ masquerading as an intuitive insight. It is imperative, therefore, that work begins after giving the interpretation.
Then it becomes crucially important in listening to the patient to take heed of his or her conscious and unconscious reactions to what the analyst has said.
The analyst’s intuition
Freud points to the difficulty of evaluating and validating an interpretation (or a construction) by emphasising that our formulations are no more than hypotheses, which need to be tested in the material which follows them. He writes:
Only the further course of the analysis enables us to decide whether our constructions are correct or unserviceable. We do not pretend that an individual construction is anything more than a conjecture which awaits examination, confirmation or rejection. We claim no authority for it, we require no direct agreement from the patient, nor do we argue with him if at first he denies it. In short, we conduct ourselves on the model of a familiar figure in one of Nestroy’s farces [der Zerrissene]—
the manservant who has a single answer on his lips to every question or objection: ‘It will all become clear in the course of future developments.’
(Freud 1937:265) The importance for the analyst of keeping an open mind about the correctness or otherwise of his or her interpretation has long been acknowledged, and narrow-minded analysts are easily and rightly criticised.
We are likely to find such offenders most easily among those who differ from our own chosen approach to analysis. Balint, for example, describes his stereotype of the Kleinian psychoanalyst as follows:
The analyst using this technique consistently presents himself to his patient as a knowledgeable and unshakeably firm figure. In consequence the patient seems to be kept incessantly under the impression that the analyst not only understands everything, but also has at his command the infallible and only correct means for expressing everything: experiences, fantasies, affects, emotions, etc. After overcoming the immense hatred and ambivalence—in my opinion, aroused to a large extent by the consistent use of this technique—the patient learns the analyst’s language, and pari passu introjects the analyst’s idealised image.
(Balint 1968:107–8) This is certainly at odds with Freud’s approach. Many of us would not agree that it was an accurate description of ‘Kleinian’ analysts. We would like to think that it was a description of a misguided analyst of any species, but perhaps we can all agree that this type of analysis would be extremely persecuting and destructive of true development.
It may be very difficult to know how to understand the patient’s reaction in terms of what it says about the interpretation. Agreement with the analyst may be an expression of compliance, and disagreement may be a
protest about a correct but painful or provocative realisation. The subtle and sometimes prolonged work required to determine this, together with some understanding of why this response characterises this moment in this patient, is the essence of analysis as we try to practise it. A great deal depends on the spirit in which this is done. If the interpretation is offered by the analyst and is taken by the patient to be a hypothesis that the patient is being asked to consider, then an atmosphere of inquiry is able to develop.
This is quite frequently not the case, and then an attempt must be made to understand the obstacles to achieving this. The failure may be due to factors in the patient or in the analyst, or (as often is the case) in the interaction of the two as an enactment of an unconscious pathological object relationship.
This last possibility can itself become a fruitful area for reclamation from a hitherto unrecognised latent situation if the analyst can formulate their activity in words and communicate these to the patient; however, if it remains unacknowledged it can lead to an impasse.
Perhaps the most devastating and traumatic scenario arises when the patient feels that the analyst forces wrong interpretations on him in a manner which allows no doubt, as if the analyst is subjecting the patient to indoctrination or brainwashing. This may be linked to a delusional certainty on the part of the analyst, which may be connected to the autochthonous nature of the analyst’s misuse of the selected fact to bolster his or her particular view of the world.
Shengold (1989) has described such events as ‘soul murder’, making connections with Schreber, who used this term with Winston, the hero of Orwell’s novel 1984 (Freud 1911a:14). It is particularly relevant to the experience of traumatically abused children, and it is often in such cases that such an analytic situation develops as an uncharacteristic countertransference reaction in the analyst. In some patients, when such a sense of violation is followed by a refusal to listen, withdrawal in despair or turning away in anger may follow. It is even more difficult when it becomes the basis for a perversion, with a masochistic submission by the patient.
This scenario can, however, also arise when the analyst’s original interpretation is experienced as ‘soul murder’ due to factors operating in the patient at that moment even though it is made in an enquiring mode by the analyst. This is probably when the patient is unknowingly operating in a
‘mode of action’ and believes the analyst is doing so. In such a situation the analyst first needs to clarify how the patient sees it and to communicate this before any further analytic work can be done to explore the reasons for the patient experiencing it in such a persecutory way. In other cases intense transference and counter-transference actions and reactions may be reclaimed for understanding only in the analyst’s mind, his or her interpretation remaining unvoiced for the present. But this is essential, as at least it releases the analyst from active participation in an unconscious
The analyst’s intuition
enactment, even though it does not release the analyst from the place he or she occupies in the patient’s perception of the situation. A persecutory experience by the patient or analyst may not be the only scenario to which this need for reclamation applies; unconscious enactment may take other forms, for example erotic, idolatrous or oracular.
We have described two situations: one optimal, where the necessary conditions exist for the interpretation to be experienced as a hypothesis put forward by the analyst; the other where all interventions are experienced as actions. There is a third possibility, in which a perverse or worshipful use is made of interpretation. In some analyses an interpretation may be used as a religious doctrine, or as a fetish, or as an instrument for use in a soughtafter sadomasochistic relationship. In this last category an interpretation encapsulating an overvalued idea of the analyst would be particularly welcome to a patient seeking misunderstanding as a masochistic satisfaction.
How is it possible, when the analyst thinks he or she understands something, to distinguish between the useful discovery of a formulation and an overvalued idea which the patient is then pressed to accept. An example of the analyst’s use of an overvalued idea might help us to consider this.
The patient, Mr L, was a highly obsessional man who filled many of his sessions with detailed accounts of the way his wife blamed him and berated him for his various failures in life and in their marriage. One day he began describing how he was attacked for impulsively buying a suit. He was especially criticised for not taking his wife with him, which he explained was because it was the last day of a sale, so that he was unable to arrange a time which would accommodate her.
I interpreted that he seemed to have great difficulty waiting, so that acting impulsively helped him to avoid waiting.
He asked if I had said waking or waiting? I noted this misunderstanding and went on to suggest that his preoccupation with his wife’s attacks and persecution gave him something to occupy his mind while he was waiting.
I added that there was something anal in the way he controlled his objects during the waiting and I linked this with his preoccupation with money.
The patient responded by describing an incident a few days previously where he had waited for his wife upstairs at the theatre. He was sure she was late and doubted if she would come at all after her anger with him in
The patient responded by describing an incident a few days previously where he had waited for his wife upstairs at the theatre. He was sure she was late and doubted if she would come at all after her anger with him in