On Healing Eve's Grief

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Referncias Simo, J. (2000). On Healing Eve'S Grief. Psychoanalytic Review, 87(2), 251-276. 
On Healing Eve'S Grief Joseph Simo, PHD, Member of NPAP. He is a past president of the Council of Psychoanalytic Psychotherapists and of the Society for Psychoanalytic Education and Training. He publishes, teaches, and supervises in the U.S., Latin America, and Europe; 18 East 8V St. 5B New York, NY 10028 Ever since Anna O defined the psychoanalytic treatment as a talking cure, the method of psychoanalysis has been identified with this suggestive description. Freud and Breuer (1893) enriched it further: Language serves as a substitute for action; by its help, an affect can be !abreacted" (p. 8). We know that language-the exchanges that we know as free associations and interpretations-plays a major role in the psychoanalytic treatment. Language is the psychic vessel that the invisible argonauts we call internal objects use to travel from our mind to the Other, the outer world, in order to explore it and to interact with whatever they encounter in it. This fact still fills me with wonderment: Images, thoughts, and affects can leave one's mind and journey on the wing of tiny bits of sound. Even more wondrous, they can be sent into another mind, a mind that can read these thoughts, feel these affects, and register foreign fantasies and be changed by them without even being conscious of it. We are used to speaking and listening, so we take for granted the amazing fact that language links the minds and the hearts of two separate individuals and allows them to exchange meanings. I have been a student of the role played by language in structuring human knowledge and communication, and for years I have been puzzled by many unsolved questions about how the meanings of one individual penetrate the psyche of another, that is, how these meanings make sense to him or her and how they elicit responses. Klein's concept of projective identification, enlarged and redefined by Bion as communication,
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helped me to solve aspects of this puzzle. It clarified that projective identification is the engine that opens the channels to interpsychic penetration, activating the capacity of the mind to receive and respond to the thoughts and affects emanating from an Other. Following Bion's conceptualization, I consider that projective identification is the complex mechanism that frees our potential for meaningful communication, if the listener-mother, father, or analyst-is in turn willing to be penetrated and transformed by the demands, conscious and unconscious, inserted in him or her by a desiring Other. A positive reception of the child's projective identification elicits empathy and concern and reinforces the maternal desire for further interpersonal rapport. On the other hand, a maternal fear of being touched and transformed by the child's demands can mobilize envy and hateful feelings in the child's tender mind against both intrapsychic and interpersonal links. This is what Bion defined as attacks on linking. It is safe to assert that the child acquires a meaningful mastery of language at the time that corresponds, roughly, with the height of the oedipal period. This means that the essential signifiers in the early exchanges between the child and the nurturing adults are of a preverbal nature. Bion (1963) redefined projective identification as the communicative and transformational relation of container/contained. I shall state the theory first in terms of a model, as follows: The infant suffering pangs of hunger and fear that it is dying, wracked by guilt and anxiety, and impelled by greed, Messes itself and cries. The mother picks it up, feeds it and comforts it, and eventually the infant sleeps. Reforming the model to represent the feelings of the infant we have the following version: the infant, filled with painful lumps of faeces, guilt, fears of impending death, chunks of greed, Meanness and urine, evacuates these bad objects into the breast that is not there. As it does so, the good object turns the no-breast (mouth) into a breast, the faeces and urine into milk, the fears of impending death and anxiety into vitality and confidence, the greed and meanness into feelings of love and generosity and the infant sucks its bad property, now translated into goodness, back again. As an abstraction to match this model, I propose an apparatus for dealing with these primitive categories of I, that consists of a container and the contained . The mechanism is implicit in the theory of projective identification in which Melanie Klein formulated her discoveries of infant mentality (p. 31). This transformational capacity of the mother is designated by Bion as the capacity for reverie. Ogden (1997) includes in his definition of reverie the most mundane, quotidian, unobtrusive thoughts, feelings, fantasies, ruminations, daydreams, bodily sensations and so on that usually feel utterly disconnected from what the patient is saying and doing at the moment (p. 721). Metabolic reverie is found in the psychic area of dreams and myths, just below the level of consciousness. Much as the manifest content of dreams, reverie is a form of conscious experience
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closely connected with unconscious experience. We could say that it is a privileged road that unconscious experience follows in its becoming conscious. At the base of the development of the personality there are experiences made up of rough sensory impressions and raw emotions that through alpha function-Bion's concept-are transformed into dream thought, that is, into psychological matter. In the absence of alpha function, these raw impressions of inner and outer stimuli just sit in the personality, as things to be evacuated or to be used as weapons in characteristically psychotic attacks on linking (beta elements). Alpha function becomes consolidated in the psyche if the infant's mother is able to contain the anxiety and the projections of the child. The mother's aptness for reverie is a must in order for her to become a metabolic container. In this optimal case the infant introjects the good container and incorporates this essential metabolic function into his or her psychic apparatus. Alpha function can be damaged by powerful envy, the engine that mobilizes harmful attacks on linking. Analysis can restore damaged alpha function if the analyst can contain his or her own fear and is capable of reverie, that is, if he or she can function as a good enough remedial mother at this very archaic level. Good enough is defined in a variety of ways by different authors. Meltzer (1967) defines it as the reparative capacity of the good internal combined parents. What happens when the mother, perceived first by the child as a combined parent, is unfit to be a good container and to metabolize the child's unwanted emotions? What happens when the combined parent is intojected as object(s) who fight viciously or who contemptuously debase each other? Then the child experiences his or her raw, unmetabolized emotions as terrifying things that these internalized parents put inside of him or her and tries frantically to cut off all contact with them. As a result, the baby ejects these threatening things-bad, unwanted parts of his or her psyche-into deformed pseudo-objects. These manic projections can damage the capacity for introspection and for an objective experience of the Other. The Other, perceived through the distorting lens of these hateful projections, later in life will become the unfulfilling partners who psychically are the contemporary external containers for the endless feuds of bad internal parents. This psychic scenario was enacted in the difficult impasse described in the clinical vignette that follows. In the worst cases this frantic projective/destructive activity ends in the formation of bizarre objects that are the products of psychotic functioning. When dependence on the metabolic capacity of the internal objects has been badly damaged, only an external object, the analyst, can restore transferentially the reparative vitality of these exhausted internal objects-if the analyst can become the bearer of the mother's breast and the creative coitus of the archaic parents. Clinical Vignette: Eve Bion reminded us that the analytic experience cannot be transmitted in its essence to a third person. This vignette can convey only a limited view of what really happened to each of us, the analysand and myself, in that segment of the analysis. Eve was in analysis for seven years, at a frequency of five sessions a week. The analysis was a
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successful experience because Eve did repair considerably a damaged inner world and improved dramatically most aspects of her life. She became a self-employed professional, and her capacity for understanding, her positive self-image, and her maturing internal and external object relations truly blossomed during the analytic process. When we started the analysis she was a sad, depressed young woman who felt compelled to wear an obviously false but permanently smiling Self. She appeared as the ultimate Winnicottian patient. From the first day I felt a gulf between her pleasant exterior and deeply buried depressive affect, stashed away from her conscious reach. However, she had become so adept at wearing her smiling Self that relatives and friends thought of her as a happy young woman. A female analyst she consulted before she and I met told her that she did not need therapy. Her first analytic contact was registered by her as being with a mother who, again, had been unable to recognize her deep grief. When Eve came to see me she was almost 30, and she strongly impressed me as a ragged virgin. Obviously she did not pay any attention to her appearance despite the fact that she could be pretty if she wanted to. She did not look well kept or feminine at all. Her appearance was an intriguing text that suggested thick darkness lurking behind the sunny exterior. My first countertransferential response to the external presentation of herself was thinking of her as a football player: a defensive tackle. What was she defending against? Why did she identify so blatantly with big aggressive males? Why was she vilifying in such a way her femininity? Was the exiled female she wore a public statement about her mother? What did she say about the relationship between her internal parents? Eve did not manifest any interest in men or in live sex. Instead, she enjoyed having fun with two of her girlfriends. They behaved like manic adolescents, talking endlessly or being naughty girls who giggled while watching male gay pornographic movies-an interesting polysemic icon wherein the woman is absent and only boys play sexual games. What was Eve saying about her parents" sexuality? Was she denouncing her father as a closet homosexual? What kept Eve from being sexually active? Was her mother frigid, asexual? Did she feel like a castrated male? Soon after we started she was throwing in my lap a myriad of questions whose answers lay buried behind the barricades formed by her forced smile. Professionally, Eve roamed a wasteland of jobs below her intellectual ability, jobs that barely paid for her rent and her food. Living an apathetic and depressed life, she was driving herself to nowhere. However, a sign of strength followed the onset of the treatment as a good omen. She looked for, and got, a better job in order to pay for the analysis, when she accepted that her fatherwho bought football sweatshirts for her as presents -would not pay for it as she had hoped. Her fantasies about his paying to restore a femininity buried underneath her sad exterior were soon deflated. Eve's father was definitely not interested in repairing her damaged femininity. Deflated fantasies, we know, are reinflated in the transference. What kind of reparation did she expect from
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her father? What had been his sin? Why did this avid churchgoer and thriving entrepreneur treat his only daughter as a boy? What did link Eve's father to gay pornography? I was being presented with an intriguing cast of characters who were forecasting an interesting and challenging analysis ahead of me. Little did I know how interesting it was going to become. Eve's life changed dramatically during the analysis. If I were to show pictures of her marked then and now, the charming and elegant woman of the end of the analysis would not look at all like the bizarre male impersonator of the beginning. Her living quarters, love life, and social and professional status are light years away from the old Eve. A specialist in public relations, she now owns her own business. This business is a symbol of her having taken control of her internal relations and going public as her own Self, a feminine Self that found authentic expression away from her father's and mother's struggles. We coincide in thinking that her analysis was a very successful venture. Nevertheless, a very disturbing event happened toward the end of the middle phase of the analysis, clouding what had been a positive and easy to manage therapeutic picture. All of a sudden a reservoir of affects related to early traumatic events burst open and flooded the treatment. I had already begun to outline in the horizon a possible termination, so this disconcerting material hit me like a ton of bricks. I had missed many things that I could have seen had I ventured beyond her dutiful improving of the aspects of her life that she thought I expected her to improve. It was a shock to face that paralyzing affect, as unstoppable as a garden weed that covered every path I tried toward a working through. I was not even sure what we were working through. Rage, sadness, and overwhelming depression that we had not felt before appeared like bolts of lightning spitting dense darkness on a clear summer sky. The compliant Eve had mutated into a bitter prosecutor: I wanted her to be alone, to be a nun, not to have any relationship. Beyond the oedipal meaning at the surface of these accusations (her outrage at my not showing a sexual interest in her), I was puzzled by the desperate sense of isolation carried by her words, and especially by the poisonous misogyny that she expelled in these outbursts. In her real daily life she was more feminine and sexual than she had ever been, yet in an archaic area of psychic reality that she had suddenly reactivated, she was relating to someone whom she hated and who, in turn, hated feminine and sexual women. Her external life was becoming a success, yet she related to me as a cold, rejecting, and depriving object. It was not clear what I was depriving her of, but it was related to an unbearable sense of loneliness and her incapacity to communicate whatever tormented her. Suddenly her panic of being doomed to an excruciating isolation had buried a smiling treatment beneath what felt like an unmovable mountain. Further confusing my puzzled mind, Eve was sexually active for the first time in her life, and she had had two reasonably satisfying relationships already. She had enjoyed them, even if they revealed her tendency to become panicky and somewhat manic when she got
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close to these men, who were less sophisticated intellectually, psychically, and emotionally than she was. The laws of transference dynamics tell us that Eve had energized an uncharted area of early psychic reality that released toxic elements of her past. These elements, without warning (or after warnings that I had been unable to heed), were suddenly reactivated in the transference. She was linking and reuniting elements previously kept apart, such as her body and soft feminine clothing, Male genitals and her own female genital, yet she was behaving internally as if a disaster of catastrophic dimensions was about to happen to her. She listened without resistance or interest to my attempts at connecting what I insisted in seeing as a transfer of archaic oedipal conflicts awakened by her sexual activity. However, her apathetic reception of my words was followed by uncharacteristic accusations of my uselessness in helping her to understand what was happening to her. It slowly dawned on me that my insistence in exploring oedipal meanings (in order to control the analysis), expressed my failure at being an appropriate metabolic container. Frightened by her intense anguish and by my lack of understanding, I defended from Eve's despair by unleashing my own attacks on linking and by applying theory rigidly, robotically, instead of truly listening to Eve. When that storm was over, a sentence found in Symington (1986) expressed my struggle: When I was interpreting according to theory I was not in reverie, I had held on to the theory to protect myself from the horrific screams of a suffering child (p. 293). Furthermore I resented Eve for forcing me to reassess the role of my countertransference on the progress of the analysis. Eve's intense despair at that stage of the game was something new to me, and I was not sure if I could not grasp it or if-judging it too big for my shoulders-I refused to accept and contain it. Early in my life as a psychoanalyst I had thought of countertransference reactions as inadequate responses, the result of failures in technique, due to the immaturity of the novice at keeping the desired analytic neutrality. Thus, depending on what I read during a particular week, I fantasized my future maturity as a modern-day knight armed with either an imaginary stoic immutability (my own version of the analytic blank screen) or with an abstract Zen compassion. These were odd mixtures of hard and romantic views of countertransference, softened later by a more mature perception of the role of empathy in opening one's Self to a patient's communications. I viewed empathy not as self-congratulatory sentimentality, but as the result of an arduous reaching deeper into the recesses of one's soul that are activated by the patient's projections. At the time when the events described in this vignette were taking place, Bion's work, especially a lengthy meditation on his Notes on Memory and Desire (1967), had shattered my belief in these naive perceptions of the clinical role of countertransference reactions. It had become painfully obvious that Eve, an excellent patient, felt gripped by despair when dealing with a dreadful panic, not yet metabolized as remembrances of things past. An outcome of my encounter with Bion's work was the growing conviction that, rather than insisting in forcing useless
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theoretical interpretations down Eve's throat, I had to be there for her, something far more difficult to do than to say. To break out of this impasse I had to accept and contain unconditionally whatever she needed to bring to me, in whatever form she brought it in, and let it ferment inside of me naturally, instead of rejecting it and giving back to her a piece of bookish theory, as meager compensation. A state of reverie means essentially that the analyst, like a good enough mother, is willing and open to be changed internally by the needs of the patient. I had to accept that I resisted being pushed too far into unknown grounds by my patients. Like the most resistant of my supervisees, I wished to believe that I had done most of the changing I needed to do in my training analysis, and that I took care of bits of changing that were needed in my self-analysis and in my dutiful reading of the latest in the psychoanalytic literature on countertransference. I had not only been far from a state of reverie in relating to Eve's distress but I had unconsciously identified with and acted out her absent mother by not being emotionally there for her when she reentered her darkest side. When interpreting correctly to her I identified with Eve's father, who had an image of whom she should be and expected her to accept as her own his image of her. For him, she had to become a lawyer and a boy. For me, at that junction of the analysis, she had to become a nonresistant oedipal patient. I had not been there for her, and for this absence of mine I blame a nameless fear that pushed me to adopt an intellectual approach. However, labeling my behavior intellectual is a misnomer, for I was aware of the rigidity and dullness of my thinking at that crucial time. The absence of libidinization of thought processes indicates that something in the transferential interaction is imperceptibly turning a psychoanalytic quest into a Grand Inquisition. We both were gripped by paralyzing forces: she by panic, I by an irrational search for sinners to condemn and burn at a theoretical stake. Nevertheless, I look upon partial identifications of the analyst with aspects of the analysand's faulty internal objects not only as a harmful obstacle to the analysis, but also as a potentially helpful step in metabolizing very early trauma. If identification is the silent language of the unconscious, we must listen to its communications in order to hear that which cannot be said with words. It is necessary to accept the emergence of these disturbing identifications with flawed aspects of primary objects in order to heed the unfulfilled needs, desires, and nameless dread that were ignored or rejected when they were projected onto these primary objects. This awareness alerts us to our defenses against hearing in the analysand that which is too disturbing to our own Self. As a result of a narcissistic idealization of Bion's work, I felt a desire to become a good Bionian analyst, a desire that wandered in the no-man's-land separating the ego ideal from the false Self. In order to think of myself as an inviting Bionian analyst I needed to know reverie, yet I did not know what reverie was in real experience. I fantasized that reverie was something that females experience naturally, which is a disturbing idea fed by concepts such as Winnicott's (1956) primary maternal preoccupation or Andre Green's (1975) maternal madness. If reverie was a close relative of primary maternal preoccupation and maternal madness, then there was little hope that I would ever experience this wonderful female thing and be a good Bionian analyst. (I
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disregarded the fact that Bion was a man.) It took much frustration with Eve's painful impasse to allow myself to be aware of how much jealousy I had always felt for that female thing and to admit that, having been analyzed in a period dominated by uncontested theoretical male points of view, there were aspects of my affective universe (such as envy of female things-womb, breast) that were not seriously dealt with in my training analysis. Eve's internalized misogyny insisted on an alliance with my own against a devalued womanmother. This presented me with the most difficult bit of self-analysis that I had ever faced. At the manifest level, Eve's father's discourse about women and my own were at opposite ends. But the deeper I went into my own imagos, unpleasant symmetries began to appear, which forced me to admit a mortifying twinship with a man who represented the worst qualities of insensitive males. These symmetries did shatter painfully big chunks of the narcissistic crust of my welldefined ego. After what amounted to a bit of unexpected surgery without anesthetic, I felt more at ease with my humbled understanding of how to listen to countertransference reactions. That meant that I could relax my anxious control over my psyche in order to make more of myself available-beyond memory and desire, as Bion would say-to receive Eve's projections. There was not much else that I felt I should do, besides accepting the despair expelled in Eve's accusations of incompetence directed at the barren mother and at her internal uncoupled parents, who attacked each other with no truce or compassion. Her indictment of the inadequate mothering and of the paternal contempt constituted the onset of Eve's working through of that traumatic stretch of the analysis. Whatever my flaws as an analyst were at the time, and there were more than I wanted to believe, these accusations were mostly addressed to the primary objects who had ignored Eve's requests. Eve's mother was not good enough as a mother. A weak, highly vulnerable woman, she panicked when Eve, her first baby, was born. Eve's grandmother had to be flown into town to teach her incompetent daughter how to feed her child (obviously, Eve's mother had not internalized an efficient mother). Ever since she could remember, Eve's mind had been riding a frantic merry-goround of questions about her parents that she was forbidden to ask. How could her mother, who was unable to feed her first baby, cope with two, then three? Was father aware of the difficulties that mother had with the children? Did he even care about her mother or about her? To Eve's unanswered questions I was adding my own. Was Eve's devotion to her youngest brother a repair of the harm she had inflicted, in fantasy, to the one who followed her? Why did her father ignore her and her mother's difficulties? Obviously, her fun-loving parents of the opening phase were not as well coupled nor as fun as she had wanted us to believe. Hate was emerging in the picture for the first time. Early in the analysis she had reported facts, supplied without much feeling and accented with self-deprecating jokes that hid Eve's belief that no one would comfort her unbearable distress. It was obvious that in the impasse where the analysis was stuck at this point, we had to deal with the following:
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1. A combined parent, internalized early in life, Motivated by hate and masochistic submission; 2. Her rejection by mother, perceived as a damaged container for her intolerable feelings; 3. The unbearable loneliness that followed the abandonment by the incapable mother; 4. Her fear of further harming the agonizing internal mother by verbalizing her sadness, her loneliness, and her nameless dread; and 5. The fantasy, distilled by a ferocious superego, of containing in her something bad and damaging to all her objects, something with which she harmed her good mother early in life. Her evidence was her father's lack of interest in the girls. Eve fantasized herself as containing something that turned her into an emotional leper who could infect whoever got near her with a deadly depression. We must consider that a likely outcome of a maternal lack of metabolic capacity is the fossilization of a bad combined parent in the psyche, in effect, a hardening that could be followed by an omnipotent idealization of destructive parts of the self. Rosenfeld (1971) outlined the pernicious effects of such an event. A destructive fury is turned blindly against all positive libidinal aspects of the self that experience the need for an object and the desire to depend on it. Defusing Eve's unconscious idealization of her destructive power and its deadly effect on desired objects became the most complex and laborious task that we had to face in the analysis. It appeared that she had given genders to these split-off parts of the self. The omnipotent destructive power was assigned to father and the big boys-to their penises which she desired. Weakness, which she hated, to mother's lack (her depression) and to all castrated girls. Her puzzling look at the beginning of the analysis now spoke more eloquently to me. Eve, in her analytic regression, was sinking into an old well of hopeless dread. She tortured herself with fantasies that she would never leave her somber dungeon. In session she felt paralyzed by the fear that she was incapable of getting close to anyone. She talked dejectedly about having to accept the likelihood of becoming professionally and socially successful, and an old spinster. It was an odd, disjointed discourse because her social, professional, and love lives were more successful than she ever imagined they could be, while another part of her was sinking into a bottomless well of despair. I felt pity for her suffering and humbled by this riddle that slipped like an eel through the bits of theory I managed to put together, but I did not feel useless. Even in the darkness of processes which I could not apprehend with theorizations, I felt confident. A metabolic process was in motion in my office, although I could not say honestly what, nor when, where, how, or why this process-operating below my conscious control-was taking place. Despite my desire to be helpful, My failed attempts at easing Eve's torturing feelings worsened her frustration. She fully experienced me as the insensitive and inept early mother. Indeed, I did feel often like a grossly incompetent analyst-mother and thought that perhaps Eve's intense pain was
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too huge for my expertise. In any case Eve could finally project unwanted fragments of her earliest experiences into the container of the analyst as a paradoxical bad/good enough mother. Luckily for both of us, I was stronger than her mother had been and less defended against my growing awareness of being too narcissistically invested in my own flaws and lack of understanding. I accepted myself as a man who despite a successful career was still learning about human processes, learning that cannot be found in books or in past experience refurbished with theory. To Eve, who scrutinized each psychic move I made with the sharp eyes of her unconscious, I became a flawed analyst-mother who accepted the narcissistic wounds inflicted on inflated selfimages as part and parcel of his own growth. Being able to change myself, able to remodel my psychic space by slowly overcoming jealousies and defenses, allowed me to hold Eve's wounds and hopes that had not found metabolic containment as yet. In the midst of that tornado of dark clouds that made me thirst for understanding, one day I felt an interesting reverie while in session. At first, I had difficulties naming that experience. Oniric vision, although linked to acceptable dream processes, sounded too mystical to my ears, still not weaned from reassuring orthodoxy. Waking dream did not please me, either, because-deep as I was in a psychic and clinical remodeling that I did not fully understand yet-it sounded like a confusing oxymoron. Hallucination was even more incorrect. For the clear image in the reverie had appeared inside of my mind, not as something alien. What was so difficult to describe is that it felt like a memory for it had that quality of familiarity, of dj vu, that memories have. But it felt also like somebody else's memory, which made it highly unusual and, I must say, Made me feel uncomfortable. It is possible to rationalize remembering somebody else's memories because we do file in our minds the bits and pieces of the picture-and-affect puzzle that the analysand transmits to us. We try to fit these pieces into clear pictures and to bring them close to their original affects, in what sounds like a borrowed remembrance. But like a timorous sailor, I was gripped by the ominous feeling of foolishly abandoning solid theoretical ground in order to enter a foreign ocean of uncertain depths and limits. I had desired so much to have reveries that the gods punished me by granting my wish. As happens often, at first I did not know what to do with the gift. What I saw and felt in that portion of my psyche that metabolized the experience was a very sad little girl, no older than two, playing dejectedly with a doll in the corner of a bare room. A most interesting feature of that construct was its astounding visual clarity, Mixed with a deep sadness, affection, and strong compassion that I felt seeing her. That girl was not part of my history. Could it have been that I had, once, experienced that dejection while playing alone in the corner of a bare room, and I was now awakening buried old feelings of mine as if they were hers? I deeply felt the futility of her trying to get her feelings through an impenetrable wall. Was I reexperiencing attempts of my own, lost in oblivion, at getting to an apathetic (real or imaginary) mother? I suspected that the image of the girl was related to Eve's early traumas and that the feelings that I experienced were active metabolic agents of the grief that she had been unable to heal. My agreeing to contain that grief, disturbing as it was, opened a new door to my understanding of empathy. The analyst as a little girl cut off from effective contact with his analysand is left to sit by himself and to play
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dejectedly with his doll (his theories about a patient whom he wants to reach but cannot). A fearful Hansel, hidden in a niche of my unconscious, could join a sad Gretel, a partner in feeling, in a healing project that helped both of us to break out of old and isolating loneliness. In a most precious moment of psychoanalytic satori I under stood some truth that, perhaps, Bion tried to convey in his writings. Clarity constructed not with belief or theory but with a deeply felt gut feeling. I am aware that I have to signify it with words in order to convey some of its quality, so I will say that it was akin to an inner sense of free floating liberty (from the Latin Libertus, a freedman). The root Liber designates as well the Roman god of growth. Thus, the closest that I can get to giving a name to that experience is to say that it felt like a combination of freedom and growth: a freedom, unknown until then, to grow emotionally in my clinical work. I communicated the image of that little girl to Eve. I did not try to drain my words of the intense affect that I was experiencing in my reverie as I had done a thousand times in the past. Without a word she started to sob uncontrollably, which she did for a long time. Every now and then she managed to say through her tears that although no memory came to mind, the image of the little girl felt right to her. Witnessing how the tears of mourning were taking the place previously occupied by futile manic efforts at expelling unbearable affect was a moving event. The links set up between our inner worlds had as much of a healing effect on me as it had on her. As I write, I know that trying to give theoretical descriptions of my experience will fail at conveying the richness of this event. Not even enlightened Zen teachers have been able to describe their experience. I am afraid I will come up with an insipid definition such as this: The analyst-as-good enough parent gave a name and an image-a container-to little Eve's grief, and to his own theoretical and clinical liberation. By bringing missing aspects of the maternal function to deep layers of Eve's psychic structure, he freed the operation of his own maternal containing function, in harmony with a paternal function, which previously had been oddly dissociated in his Self as well as in Eve's psyche. This is not a wrong description, but certainly a poor one. It was a far richer event than what appears on my computer screen: She and I-by sharing our repairing of our male and female identifications-established a new set of links between genders, links that were missing in her inner Self and repudiated in myself. Her watching male gay pornography was now illuminated by a brighter light. An essential filament in that new light bulb was the delayed acceptance of the feminine in my own self. Although I had been a supporter of feminism for as long as I can remember, My support had a high level of patronizing macho content and was mostly intellectual. I relegated the feminine (equated with stereotypes: soft, gentle, delicate, sensitive) to women. I could laud the value of feminine qualities in both male and females, but I had kept them at arm's length in my conscious daily life, despite my many years of analysis (or perhaps because of the unquestioning male quality of my analysis). To move closer to the real Eve I had to accept the risk of experiencing myself as Other-deeper, softer, and more complex-than the narrow and stereotyped me that I had always identified myself with.
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The burning showers of archaic affect did not disappear at once, but diminished in intensity and frequency. They were also acquiring a neurotic flavor, the quality of a search for a solution that progressively was replacing the hopeless despair that Eve conveyed when these bolts of lightning first appeared in the treatment. We did share a feeling of things falling into place, as Eve was internalizing the analyst as a good enough mother at last at peace with a good enough phallic father. The relationships in her inner world were altered in a way that modified her relationships in the outside world. Eve renewed the contact with the real mother, who she had avoided for a long time. Her mother was severely depressed and had been hospitalized during Eve's analysis. Reasonably free of the confusion of her inner and outer worlds, and much less afraid of hurting a mother who barely kept an unstable emotional balance, Eve talked to her about that which until then had been unspeakable. Eve, who now incorporated the functions of the analytic parent, could contain her mother's distress and be a mother to her mother. She was a better mother than the one she had been forced to be since she was a child, and a better one than she had ever been to herself. Her mother felt soothed by talking about the events surrounding the birth of Eve's brother, an event that had been experienced by little Eve as catastrophic for her and for her mother. Mother remembered little Eve's growing sense of being a family prior to the arrival of the new baby. Eve was begin ning to speak clearly and loved to say excitedly: Mummy, daddy, and me. Eve felt successful because of what she experienced as a bond between the relevant people in her life: Mummy, daddy, and me. This happy bonding soon was to turn Eve's success into a psychic catastrophe that brutally severed these tender links. Reintegrating her objects in the analytic experience, although rewarding, had renewed the terrifying unconscious promise of another ominous disaster. Her mother felt comforted by admitting that she abandoned Eve emotionally. If Eve had been abandoned by her mother, as well as devalued and not invested by her father, as a girl (to vest means to clothe), then the absence of femaleness in her external appearance when we started her analysis and the absence of women in gay pornography did reveal their genetic origins and made sense. That which had been unspeakable and unmetabolizable was being given form and finally verbalized. Words and imaged memories were gathering the scattered fragments of her emotional life-from anger to a new sense of filial piety-that until then had been orbiting chaotically her disjointed inner world. Their unsaid story could now be told and owned by both Eve and her mother. The latter abandoned Eve by sending her to her grandparents at the time of the delivery of her second baby. We know the anxieties that plagued her when nurturing Eve as a newborn. She wanted to be free of Eve for a few weeks in order to cope with the new child. Thus, when Eve got home from her visit, instead of the desired open arms of her mother, she found a bitter surprise: She had been replaced in those arms by a baby boy. She had lost her mother to another baby and her father to a
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real boy. Inexplicably, she had not been told of the new baby's impending arrival and her own unconscious had buried a knowledge too painful and confusing to uphold. Adding fuel to the fire ignited by this trauma, shortly after the birth they moved from their small apartment to a bigger one in a more elegant part of town, also without warning. Suddenly Eve lost all the familiar spaces she had known in her short life: the precarious emotional container, her mother, to that rival baby; the physical container, her home, to a strange neighborhood; and her father, the strong parent, to a boy. They moved because her father had been promoted to a desired executive position and wanted a better address to foster his social status. Those traumatic losses were only the first ones. Soon, they became a way of life. Eve was abandoned, again, when she was not yet four years old because she needed to have minor eye surgery, which required that she spend four days in the hospital. Eve remembered getting out of her crib at night and wandering in the hospital corridors looking for a mother who was not there for her and who instead was pregnant again with another boy. They kept moving to better apartments until they reached father's dreamed Shangri-la: a house in the suburbs, the symbol that clearly indicated that he had made it and that he could play with the big boys, as he repeatedly told them. This verbal image refers us, again, to hidden signifiers in the pornographic movies that fascinated Eve, where the big boys played pleasurable games, as well as to a rigid separation of parents and genders: father with the big boys and mother with the defeated little girl. If male homosexuality was a boisterous, pleasurable, and joyful game, women's sexuality was a lonely and dreary experience geared to the manufacturing of children who, one hoped, would be boys. She fantasized that I-father hid boy-brothers behind the private doors of my office, My closet, waiting to play sexual games with them after she left. To Eve, all men were wrestlers, that is, homosexual. In her still infantile version of sexuality-as-wrestling there were two kinds of homosexuals: the open wrestlers of the gay movies, and the closeted ones who wrestle with women. Obviously, she suspected the men she had a sexual relationship with of being gay; these suspicions were fed by the avowals of these men that they indeed had had homosexual experiences, either as adolescents or as bisexuals. It made sense that she had remained a virgin until her thirties. She had to understand the expulsion of femaleness from her life and to recouple her reconciled analytic parents in order to value her gender-her sexuality-and to become the female that she was not allowed to be. Feeling unable to cope with two young babies, her mother expected an impossible self-sufficiency in the little girl and consciously avoided Eve's competitive demands for her attention. In one of their talks her mother confessed her crushing guilt for experiencing Eve as a huge load she had to carry alone. She blamed herself for the unbearable grief that she saw in Eve's eyes when at eighteen months of age Eve sat for hours, all by herself, at the bottom of the stairs of their new duplex. It was not clear if in gluing together the pieces that Eve brought to me over the years I had remembered Eve's repressed memory, her mother's, or a construct that they had elaborated
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between them, long before it achieved psychic and emotional significance in my mind. In my reverie, I had given psychic and emotional space not only to Eve's distress, but to her mother's as well. By doing this, I-father was joining boys and girls in my mind. I was intrigued by the asymmetry between the little girl of my reverie who played with a doll and the one in her mother's memory, who held her head in her empty little hands. I had no doubt that my psyche was recording events and affects long buried in the depths of Eve's psyche but now active in mine. Thus, the doll in my reverie meant that we were dealing with events not yet metabolized, turned into thought, and verbalized by Eve, by her mother, or by her father who, to her astonishment, had joined this group task. One day Eve said, literally, I feel that I am unifying my father and mother. By talking to him and bringing him in the reconstruction of my history, I am reuniting them inside of me. Her father's contributions added essential pieces to this puzzle, such as the image of Eve struggling to climb into the new tot's crib, desperately trying to regain a lost space in her mother's soul by placing herself inside the object that embodied the privileges she had lost forever. Her mother, overwhelmed by her guilt over Eve's grief, tried to assuage it by sitting her in her lap and putting the little brother in the unhappy arms of the two-year-old girl. The doll she played with in my reverie finally appeared in the narrative and revealed its identity. It gave sense as well to the nature of the burden that Eve felt but could not identify, when she repeated often: I lost myself when I was young and I became a little mother. We knew that she had always felt forced to act maternally toward her brother, to compensate for her mother's deficiencies. The meaning of the separation be tween boys and girls was also clearer. The girls-Eve and mother-were there to serve the boys, to look after them until the day when they join the big boys and play exciting wrestling games. Then the girls should admire and envy them. Eve was now cognizant of the intrapsychic and interpersonal roots of the anger she always felt toward her father for his open misogyny and for his patronizing antifeminist opinions which she had ascribed to the conservative politics that he favored. Once we had built, inside of my psyche, some of these new pieces into a coherent picture, Eve said: It's amazing, I feel safe and secure. Bion defined security as a state of mind characterized by eased anxiety and a feeling of freedom from dangers that follows the discovery of the selected fact, akin, I like to think, to the free floating liberty that I had felt. A selected fact is an emotion or an idea that gives coherence to what previously was fragmented and dispersed, and introduces order into existing disorder. It effects a reorganization of the relationships of the internal parents who, finally, cooperate in a far more benign superego instead of fighting each other viciously. New information appeared about the anxiety-ridden attempts of Eve's mother to toilet train her before she was nine months old, for example. New pieces that revealed, time after time, the unrealistic expectations of that unhappy woman for an illusory degree of self-sufficiency in the little girl. In Eve's mother's guilty mind these memories were cruel self-reproaches that she tearfully confessed to Eve, as evidence of the many failures that damned her as a mother.
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Shortly after these memories had been reconstructed with the help of the dialogue between her internal, her analytic, and her real parents, Eve strayed for the first time from her rigid observance of the analytic rules and brought to session a photograph album. Consciously, she wanted to show me how sad she looked when she was about two years old (when mother sat her baby brother on Eve's lap). Indeed, there was grief overflowing from those big, sad eyes frozen in the old family photographs. But the communication that she obviously intended was to show me a real picture of her mother back then. Eve had reported that mother had always been thin and that the two of them had struggled throughout adolescence with Eve's weight gains, and her mother's attempts to counteract them with all kinds of diets and treatments. It was startling for Eve to confirm the evidence that the pictures revealed: There was no doubt that her mother, at the time the photographs were taken, was anorexic. Eve recalled how everyone in her family was amazed at how thin mother had always been, yet no one had seen the symptomatic origin of her aberrant thinness and the need for therapeutic action that this womanchild begged with her emaciated body. The most primitive aspect of projective identification is the attempt to get back into the object, to become undifferentiated and mindless in order to avoid all pain. Eve had desired to get back into her mother and to get rid of all the feelings and sensations that menaced her. But it was sadly obvious that there had not been, anywhere, an open space for Eve to get back to. Her mother was far too weak to contain whatever Eve needed to project into her and, in order to protect herself, had sealed the door of her agonized soul. Furthermore, the awareness of her mother's emaciated body had ignited Eve's guilt for damaging with her insatiable greed her much-needed mother. We found again the specter of the greedy girls: Weak and destructive, incapable of feeding each other, they fight bitterly instead, raging with their envy of the boys who play exciting oral, anal, and genital games. More stories emerged, encouraged by the creation of new containing space where a transformation of her mother's painful raw memories, as the other lonely little girl, was taking place. One of these stories was especially bizarre, for it told about mother walking, alone, the few blocks from home to the hospital, in order to have labor induced, because Eve was two weeks late in arriving to our world. They had to move from the university town where Eve's father had finished his studies to the apartment they abandoned when the second child was born. Eve's delayed arrival was interfering with the clear-cut plans of her father-to-be. He could not take his wife to the hospital because he was already in New York interviewing for the corporate job he so much coveted. Thus, the image of little Eve sadly playing by herself in the corner of a room had a genetic, and no less sad, precedent in the image of the frightened woman-child walking alone to deliver the baby she carried inside her. The baby was experienced as a huge responsibility that she felt incapable of shouldering, but that she had to carry alone-no mother and father to hold her trembling hand, no husband, either, as he was too much in love with his desire to play in the corporate world of the big boys. Eve's watching gay pornography reveals itself as an escape from her mother's crushing loneliness
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and depression. In her imagination the boys" world is exciting because they play pleasurable games. Her father liked to wrestle playfully with her brothers and with her, before puberty, when he treated her as another boy. She had been expelled from that exciting world and limited to watching and providing an admiring audience for the boy's exhibitionism ever since puberty, when she officially became a girl. This was a forced voyeurism that she had to extend beyond the family's living room to the adult male world: from gay pornography, to her transferential displays of admiration in order to appease what she believed to be my insatiable narcissism as another exhibitionistic boy. It all had to be fun, as her father wished the family time to be: fun, the time spent watching her brothers; fun, looking with her envious girlfriends at the boys having sex; and, for years, fun, the analytic time watching me. Many things finally began to make sense to Eve, things that she could talk freely about, as well as feel in liberty: Her mother's anorexia of body and soul, which rendered her unable to feed either her babies or herself, when Eve was a young child. Her mother's huge depression, which made her unable to cope with two babies (it was going to be worse with the arrival of the third), with no help from her husband. Her mother's emotional isolation and her living motherhood as an intolerable burden. The significance of her ongoing battle with her mother over thinness and weight. Her sense of being fatefully tied to her mother, unable to do anything to escape her (their) tragic destiny. Eve understood her fear of being thin as a response to persecutory fantasies. Her mother's isolation and unfulfilled needs would deprive Eve of everything that she needed and desired. She would be left hungry and empty. Not too far from consciousness Eve had carried the fantasy that mother had infected her with her deadly emotional anorexia. Eve confessed that, upon hearing my voice for the first time in my answering machine, My accent made her think of me as Dracula, and she felt a huge wave of anxiety flooding her. Her first transference projection onto a disembodied voice was a starved combined parent: Dracula is an ambiguous figure, who violently empties the Other of its essential vitality, a terrifying killer who condemns his victims to eternal hunger and loneliness. It is interesting to note that following the reconciliation of Eve's internal parents and the renewed dialogue with mother in the real world, her mother separated from her father and, shortly after, divorced him despite the fact that he had become much more available. Eve's mother, following Eve's lead, began to heal her own emotional anorexia, hoping that she had become strong enough to try to live by herself and with herself.
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We still had a few burning showers to go through but, as a rainy season came to an end, they diminished in frequency and intensity. A sunny period of analysis opened up, in which Eve began to relate her emerging new self to good enough parents. Periodically, she gave in to regressive tendencies and kept going back to her friends of the nun and gay periods, as if she could not, or should not, keep inside of her the good things she was acquiring. These friends were copies of her mother in many respects, especially in their obsessional talk about their failed relationships with men. They displayed infantile features, and their ages (in their mid-forties) and perpetual dating status (they were either single or divorced, usually abandoned by men) indicated that, like Eve's mother, they felt great ambivalence toward their desired dependency. They tended to see men as no more than remedial good mother figures. Eve finally was able to express in dreams many of her symbiotic conflicts, instead of acting them out. Alpha function transforms raw sensory stuff into dream thoughts, said Bion. In one dream Eve's bearded grandmother, an obvious combined parent, was taken away from her by her mother. In another dream, her mother-still anorexically thin and pregnant-was in bed with Eve's current, Most mature boyfriend. In that dream Eve, rationally and patiently, explained to her mother that she could not keep taking away from Eve her desired love objects or her needed parental figures. A belated, true analytic honeymoon followed that most exhausting turbulence. Eve, comfortable for the first time in her female self, found pleasure in the analytic work that she could take deeply inside. At times she felt like scolding me playfully for wanting her to work instead of allowing myself to play with her and delight in the narrative of aspects of her current life that made her feel so good. At other times she collapsed on the couch and announced that she was naughty, that she didn't want to do anything, and that she expected me to pick her up. I have to point out the importance of this play beyond its oedipal significance. This healing ludic activity had roots in older, Much deeper unfulfilled desires. Early in life, she had to play as a boy. Besides her envy of the boy's privileges, she had to fulfill her father's pathological denial of her gender in order to escape her mother's deadly depression. Thus, she built her Winnicottian false self (which I interpret as an asphyxiating identification with the imaginary child of the desired or feared parent) and tried to clone in herself the son of her father's pathological desire. An identification actualized in her football look that-even if narcisistically mortifying-was less painful to her than the emotional starvation promised by her mother's anorexia. Needless to say, during the analysis she thought that she should become an analyst, in order to become the imaginary son of what she perceived as a misogynystic analyst-father. For this emotionally battered child, a desire to play as a girl signified that aspects of her forgotten true self were being restored. This belated analytic honeymoon signaled as well the emergence of authentic oedipal desire, directed to a father who delighted in her charming femininity, instead of despising it, as had been the case during her period of butch virginity. At times she felt like an adolescent who has found a best friend and adviser in the analyst as mother and girlfriend. Once,
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when she was talking about dating two men, sex, and body odors, I pointed this out to her. She replied: It's amazing that you'd say this. Last night I had a dream that I was in session with you, but you were a woman. A nice, kind, intelligent and large woman analyst. It was you, but as a woman. Isn't it amazing how much in sync we are? I like you now. Yes, it was amazing to be so much in sync. Amazing as well was her joyous response to my own feminine transformation, amazing to be reunited again in a place where neither of us had been before, especially after having lost sight of each other, if we truly had ever seen each other before. Her professional life had become quite successful. Once her internal parents had reached a peaceful modus vivendi, she could internalize aspects of her father, who had been successful in business. She began a relationship with a man more generous and more compatible with her emotionally, intellectually, and sexually than the men she had previously dated. This man, despite being suspected by Eve of being a latent wrestler, was a much better container for good combined parents than the initial ones, who sounded like stereotypical childish male chauvinists. Most importantly, she felt confident in herself and open to new challenges and to the new people she met. I shall close this case study with the text of a dream Eve had a few months after these events had been elaborated and worked through to a considerable extent. The dream closed that phase of the analysis and opened the path toward termination: I am coming to my session and I am surprised to see my friend Vera [a friend of the nun period] in the waiting room with another woman. All of a sudden, I understand that she is now your patient but I am not sure if she is in analysis, or in group therapy. I feel that, from now on, I will not be seeing her, so as not to interfere with her treatment, or she with mine. I am thinking all of this while I am walking into the consultation room. There, I have an even bigger surprise when I realize that it has changed into a colorful playground, with a sand box and all kinds of play things. The contrast between Eve's weak mother taking all her (maternal) men from her and Eve's leaving her, in a sense, in my waiting room, indicates a significant shift in her internal world. But the contrast between the little girl playing, sadly, by herself and the big girl entering into an inviting and colorful playground, where she was free of the suffering mother and the suffering self that she left to my care, speaks more eloquently than any additional discourse that I could attempt. To me, the contrast between the somewhat rigid and naive analyst who started Eve's analysis, and the softer, gentler, and more mature one who terminated it is, at least, as remarkable. References 1 Bion , W. (1963). Elements of psycho-analysis. London: Karnac Books . (ZBK.004.0001A)
2
Bion , W. (1967). Notes on memory and desire. Psychoanal. Forum, 2 : 271-280.
Breuer , J. , & Freud , S. (1893). Studies on hysteria. In J. Strachey , ed. and trans., The standard edition of the complete psychological works of Sigmund Freud, 24 volumes. London:
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Hogarth Press , 1953-1974 . 2 : 1-251. (SE.002.0001A)

4
Green , A. (1968). On private madness. Madison, CT: International Universities Press . Meltzer , D. (1967). The psycho-analytical process. Perthshire, England: Clunie Press . Ogden , T. (1997). Reverie and metaphor. Int. J. Psycho-Anal., 78 : 719-732. (IJP.078.0719A)
Rosenfeld , H. (1971). A clinical approach to the psychoanalytic theory of the life and death instincts. Int. J. Psycho-Anal., 52 : 169-178. (IJP.052.0169A)
8
Symington , N. (1986). The analytic experience. New York: St. Martin's Press .
Winnicott , D. W. (1990). The maturational processes and the facilitating environment. London: Karnac Books . (Originally published 1956 ) (IPL.064.0001)
This publication is protected by US and international copyright lawsand its content may not be copied without the copyright holder's express written permission except for the print or download capabilities of the retrieval software used for access. This content is intended solely for the use of the individual user. Psychoanalytic Review, 2000; v.87 (2), p251 (26pp.) PSAR.087.0251A
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On Healing Eve's Grief

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Bion , W. (1967). Notes on memory and desire. Psychoanal. Forum, 2 : 271-280.

Hogarth Press , 1953-1974 . 2 : 1-251. (SE.002.0001A)

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On Healing Eve&#39;s Grief

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Bion , W. (1967). Notes on memory and desire. Psychoanal. Forum, 2 : 271-280.

Hogarth Press , 1953-1974 . 2 : 1-251. (SE.002.0001A)

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On Healing Eve's Grief

On Healing Eve's Grief