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As informaes de link a seguir fornecem um link permanente para o artigo solicitado. Link permanente para este registro: o link a seguir o levar ao incio do artigo ou da citao. Recortar e colar: para colocar links de artigo em um documento da Web externo, basta copiar e colar o HTML a seguir, "<a href" Para continuar, no Internet Explorer, selecione ARQUIVO e SALVAR COMO na barra de ferramentas do seu navegador acima. No se esquea de salvar como arquivo de texto simples (.txt) ou como arquivo 'Web Page, HTML only' (.html). No FireFox, selecione ARQUIVO e SALVAR ARQUIVO COMO na barra de ferramentas do seu navegador acima. No Chrome, selecione com o clique direito (do mouse) nesta pgina e selecione SALVAR COMO Registro: 1 Ttulo: Symbolic attitude and reverie: Problems of symbolization in children and adolescents Link permanente para este http://search.ebscohost.com/login.aspx? registro (Permalink): direct=true&db=pph&AN=JOAP.047.0241A&lang=pt-br&site=ehostlive&scope=site Recortar e colar: <A href="http://search.ebscohost.com/login.aspx? direct=true&db=pph&AN=JOAP.047.0241A&lang=pt-br&site=ehostlive&scope=site">Symbolic attitude and reverie: Problems of symbolization in children and adolescents</A> Base de dados: PEP Archive

Symbolic attitude and reverie: Problems of symbolization in children and adolescents1

Gustav Bovensiepen, MD, author, Editor-in-chief of Analytische Psychologie, chair of the Conference of Training Analysts of the German Society of Analytical Psychology (DGAP), is an analyst in private practice (children and adults) in Cologne and a training and supervising analyst in the adult and child programme of the Institute for Psychoanalysis und Psychotherapy im Rheinland (DGPT). Scientific interests include clinical aspects of adolescence, treatment techniques in the severely disturbed and unconscious group fantasies in the media and German politics. He is co-editor with Mara Sidoli of Incest Fantasies & Selfdestructive Acts. Jungian and Post-Jungian Psychotherapy with Adolescents (1995).; Dieringhauser Strasse 21, D-51109 Kln, Germany Email: APBov@aol.com In comparison to the 1970s and 1980s, we now treat more children and adolescents who, because they have had traumatic experiences of violence, child abuse, deprivation or chronic physical illness, are not able to adequately use their symbolizing function. The question is which qualities and which analytical attitude we should and can offer in analysis to help a child regain his or her capacity to symbolize, irrespective of how poorly developed or blocked this capacity may be. In contrast to Jung and some Jungians, the author argues that although the transcendent function is a !natural process" and hence
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archetypally grounded as Jung maintained, the transcendent function does not work spontaneously. Rather it requires a matrix based on the child's earliest relationship, which can later be re-enacted in treatment. Jung's general concept of a !symbolic attitude" can be complemented and focused in a specific way through the use of Bion's concept of !reverie", which contributes in a fundamental way to symbol formation within the transference/countertransference. This idea is illustrated by clinical material from a nine-year-old boy who suffered from a severe congenital intestinal disease and was blocked in his capacity to symbolize. From the perspective of treatment technique, the author shows how the drawing of !comic book" narratives in a reciprocal exchange was brought into the treatment. The drawings evolved in a way that he understood as a modified form of active imagination with children. The drawing process helped the boy gradually to develop a symbolic space in the therapy and to contain a psychic space in his mind. Introduction Symbols play a key role in analytical psychology. Jung sketched his ideas about the transformative function of the symbols of libido for the first time in 1912 in Symbols of Transformation, the work that caused the professional split between Jung and Freud. In analytical psychology, a symbol expresses a psychological function, which Jung later referred to as the transcendent function. This function mediates between opposites and effects transitions between, and transformations of, different psychic states. For Jung, this was the most important psychological function, and he writes: It is a natural process, a manifestation of the energy that springs from the tension of opposites and it consists in a series of fantasy-occurrences which appear spontaneously in dreams and visions. (Jung 1916/1928, para. 121; author's italics) Jung considered this psychological function of symbol formation to be goal-oriented and prospective. He was less interested in how it developed in the infant psyche and how it worked. When we look at the specific issue of symbolization in children and adolescents, we are thus confronted with the general question of how the transcendent function develops. It has only been since the 1950 s and hence comparatively late that Jungians have turned their attention to the perspective of developmental psychology. Erich Neumann in Israel (1963) and Michael Fordham (1985) in London were the pioneers of a post-Jungian Developmental School (Samuels 1985). It does not surprise me that those Jungians working within the framework of developmental psychology, that is, with infantile conflict and early object relations, or, to put it in another way, with the inner child in the intersubjective practice of transference and countertransference, are the most involved with other psychoanalytic traditions. There is, for example, a large group of Jungians who have taken a closer look at Kohut's psychology of the self and at current infant research (Jacoby 1999). There is also the work of Michael Fordham in London, which has been strongly influenced by post-Kleinian views, particularly those of W. R. Bion.

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Twenty-five years ago in Berlin, I myself did my analytical training at an institution housing both a postFreudian and a Jungian institute. Even today, several of my Jungian colleagues and I frequently experience a certain gap between Jung's topical theoretical conceptions of the unconscious and transformability of the psyche and his lack of theory for analytic technique. This gap is acutely visible in the realm of symbols and symbol formation, an area which, ironically, has been thoroughly researched by Jungians. Or perhaps, to express it more poetically, Jungians like ourselves too often have our heads in the clouds, and we can learn from psychoanalytical treatment technique to bring us back down to earth. In comparison with the past, we now treat more children and adolescents who, because they have had traumatic experiences of violence, child abuse, deprivation or chronic physical illness, are not able to adequately use their symbolizing function. There is a consensus among most child analysts and child psychotherapists, irrespective of their theoretical tradition, that the usual method of treating children which was developed from working with neurotic children, is not always appropriate for heavily traumatized children. One reason for this is that these children frequently lack the ability to play. To use Hanna Segal's term for it, they have not managed to create an adequately functioning psychic space during the course of their development (Segal 1991). Psychic space and the transcendent function are the conceptual background of this paper. Within this framework, I shall concentrate on two issues. The first of these is the symbol and the ability to symbolize, as they are used in the Jungian tradition. Secondly, with an eye to treatment technique, I am interested in determining which qualities and which analytic attitude we should and can offer in analysis, in order to help a child regain his or her capacity to symbolize, irrespective of how poorly developed or blocked this capacity may be. I treated a boy who had suffered from a traumatic colon disease since birth. As a result, he had not been able to develop enough psychic space or make adequate use of the transcendent function in symbolizing. I shall draw on this material to illustrate my hypothesis. I shall investigate Jung's claim that the transcendent function can only unfold if we succeed in assuming the analytical attitude that he called the !symbolic attitude". This is one of the few of Jung's concepts from which he explicitly deduced a treatment technique, that of active imagination. Since the prerequisite of active imagination is a differentiated and stable ego, it is not, in my opinion, an appropriate technique for patients who are structurally disturbed at an early developmental level. I believe that the gap between Jung's fundamental, but very general concept of the analyst's symbolic attitude and the analysand's inability to symbolize can be bridged by Bion's concept of !reverie" within the container-contained relationship. I include the earliest, mostly nonverbal exchanges between mother and infant in what Jung referred to as the !symbolic attitude". I therefore propose that, although Jung assumes it is a !natural process" and hence archetypally grounded, the transcendent function does not work spontaneously, but requires a matrix, which is based on the child's earliest experience of a relationship and which can later be re-enacted in treatment. Tom: I don't need to be understood - container/contained and reverie Before I address some of the theoretical aspects of my subject, I should like to describe the early stage of
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the treatment of the ten-year-old boy, whom I shall call Tom. I will fill in more clinical material from this case later in the paper. From the first session onwards, Tom was intent on making me understand that he could survive perfectly well without being emotionally understood, and that he did not need empathic sympathy or an understanding of sense and meaning as !nourishment", in order to thrive psychologically. In our sessions, he was primarily preoccupied with inventing guessing games, like those on a quiz show, which he had to win. When I could not come up with either a question or an answer fast enough, he got very angry, derided me, jumped up and down on the couch or around the room, threw pillows at me, and tried to involve me in violent boxing and biting matches. After such eruptions, which were rife with lust, aggression, and agitation, he would lie down on the couch or roll around in the bean-bag chair. He seemed to be in a bad mood and apathetic; he seemed, above all, to be completely drained and absentminded. After a while, just when I was able to start thinking about our being together, he would greedily and tyrannically challenge me to come up with a new game at once. If I did not give in to his demands immediately, but instead said something like, !Now you feel completely empty and you think you would feel better if I made something up for you", he did not reply with words, but instead moaned loudly and squeezed his buttocks together as if having a bowel movement, and farted with abandon. Or he would swallow air and belch saying, !That's your punishment!" I should like to use this episode to briefly introduce some of Bion's concepts in order to relate them to Jung's conception of symbols. It is typical in treatment that children first fight against the verbal formulation of the analyst's thoughts. Tom's farting and belching, his !replies" to my efforts to understand him and his extremely dictatorial quizzes, struck me as rather desperate and omnipotent attempts to destroy my ability to think about him with emotional sympathy, my capacity to contain. In other words, he wanted to destroy my ability to absorb his emotional emptiness and his fears, contain them within me and work through them to the extent that he himself would then be able to make use of my expressed understanding. He wanted to force me to match him perfectly. In my view, his eruptions represented an expression of his defences of the self, as Fordham has described them, as a way of protecting his self against psychic breakdown (Fordham 1985). The tyrannical question-and-answer game is a typical product of the initial stages of treatment, when the child and the therapist are trying to work out what the other is thinking. O'Shaughnessy emphasizes how much time is taken up in treatment by the patient's anxiety that the analyst will not understand him or her. She writes, At depth this is anxiety about the analyst's capacity for !reverie", in Bion's sense. A patient wants understanding based on actual events of emotional containment, he wants his analyst to be open to his first mode of thinking - viz, to communication by projective identification. Can the analyst receive primitive projected states and know what they are? (O'Shaughnessy 1988, p. 187) One could interpret the belching and the farting simply as the oral-aggressive and anal-aggressive venting of drives void of any symbolic meaning. In the language of Bion's theory of thinking, they are beta-elements, that is to say, raw elements of perception cast as sensual and emotional experiences,
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which, however, cannot be represented. With the help of a psychological function, to which Bion has given the abstract term of !alpha-function", they can be turned into alpha-elements, which means that they are endowed with psychic meaning. Bion writes: In contrast with the alpha-elements the beta-elements are not felt to be phenomena, but things in themselves (author's italics) Beta-elements are not amenable to use in dream thoughts but are suited for use in projective identification They are objects that can be evacuated Beta-elements are stored but differ from alpha-elements in that they are not so much memories as undigested facts, whereas the alpha-elements have been digested by alpha-function and thus made available for thought. It is important to distinguish between memories and undigested facts - beta-elements. (Bion 1962, pp. 6-7) Apparently, Tom had to free himself from what were for him unbearable, !indigestible" physical and emotional experiences that had surfaced in the transference. In the countertransference, I found him to be rather unbearable at these moments. At the same time, however, I could not possibly evade him. In terms of treatment technique, the problem was how I could put my alpha-function at Tom's disposal and achieve a condition of reverie, in order to gain a !thinking space" for myself in which I could assume a symbolic attitude and prepare a symbolic space between us. In this context, Bion used the earliest mother-child relationship as a model for his concept of reverie. Given sufficient affect attunement, the mother intuitively puts her own psyche at the infant's disposal, !lending" a container into which the infant can project his or her unbearable affects, fears, and psychosomatic sensations. Through her loving understanding, the mother turns these into tolerable experiences by naming them and endowing them with subjective meaning or sense, which can then be re-introjected. As we have learned through infant observation, there are catastrophic consequences when an infant retains no personal space in the parents" fantasy and psyche, as when some parents talk about their infant as if it were an inanimate object. When everything goes well, however, a mother consistently and continuously endows the events of everyday life with meaning, including the behaviour of her infant. In doing so, she is adopting a symbolic attitude. At this stage, Tom hardly ever communicated in a symbolic fashion but relied on projective identification. He did this by forcing beta-elements, the farting and the belching, into me. In the light of his early lack of containment, emotional experiences were apparently too painful for him, so that he could not use his capacity for understanding and assigning meaning to them. His transcendent function did not work. Hence, a tyrannical wish to achieve total consensus dominated him: just as on a quiz show, there was only right or wrong. Nevertheless, was there not some communicative meaning in his farting and belching? Was it an expression of an unconscious fantasy or did it retain a meaning that only revealed itself from a prospective point of view, not from a defensive one? I should like to make some observations about the symbol and the symbolic attitude, which I shall then relate to those ideas of Bion that I have already discussed.

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The symbol, the symbolic attitude and symbolic space Jung's understanding of symbols occupies a central place in his thought. His ideas on this topic vary greatly throughout his writings, however, and are by no means uncontradictory. That said, the symbol is also perhaps the only concept that is directly relevant to the theory and technique of treatment, apart from his 1946 article on !The psychology of the transference". In symbolization, the effect of the transcendent function manifests itself. Jung writes that the transcendent function expresses itself in !this remarkable capacity of the human psyche for change " (Jung 1917/1942, para. 360); it mediates between the body and the psyche. The symbol combines conscious and unconscious contents and mediates the transition from the ego to the unconscious (Jung 1916/1958, para. 131). In other words, individual unconscious fantasies express themselves in symbols in the same way as archetypal fantasies do. The symbol not only leads to intellectual understanding, but also to what Jung calls !understanding through experience" (Jung 1916/1928, para. 184). In his article !The psychology of the child archetype", Jung locates the origin of the symbol in the body when he writes: The symbols of the self arise in the depths of the body and they express its materiality every bit as much as the structure of the perceiving consciousness. The symbol is thus a living body, corpus et anima The more archaic and !deeper," that is the more physiological, the symbol is, the more collective and universal, the more !material" it is. (Jung 1940) For Jung a true symbol is a !living symbol". Another characteristic of a true symbol is a surplus of meaning. All of its possible meanings can never be fully understood, and much remains hidden. Together with the assumption of a transcendent function, Jung's conception of the symbol results in an analytic attitude, the so-called symbolic attitude. In 1921, Jung defined this as follows: The attitude that takes a given phenomenon as symbolic may be called, for short, the symbolic attitude. It is only partially justified by the actual behaviour of things; for the rest, it is the outcome of a definite view of the world which assigns meaning to events, whether great or small, and attaches to this meaning a greater value than to bare facts. (Jung 1937, para. 899) I believe that Bion, with his concept of beta-elements, which he also called the !thing in itself", thought of something comparable to Jung's !bare facts". Jung's conception of a symbolic attitude means that we endow events with sense or meaning in analysis when we succeed in establishing a link between inner reality and the outside world and between personal and collective experience. I believe that human beings are equipped with an innate need for sense and meaning, and that this need enables them to create a link between objects, just as do the drives, particularly those of love and hate. This need for meaning which, even in children and adolescents, amounts to a search for sense, resembles Melanie Klein's !epistemophilic instinct" or Bion's !K-links". The symbolic attitude is not the same as these
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concepts, however, because it possesses a prospective and teleological quality and because it is archetypally grounded. In treatment, the experience of a true symbol can lead to a deep feeling of being understood and being connected. In contrast to Freud, Jung not only regarded the formation of symbols as the psychic representation of the instincts, he also believed that symbolic activity reshaped and transformed the psyche (Jung 1912). In the struggle between the ego and the unconscious, Jung considered symbol formation to be !the production of a third" (Jung 1916/1958, para. 181) against the background of the transference/countertransference (Jung ibid., paras. 145-6). An individual's striving to differentiate between the symbolized and the symbol, between the !bare facts" and the !meaning and sense", is a triangulating attitude, which, in turn, leads to the creation of an internal psychic space and a symbolic space in the analytic framework. Referring to the Oedipal situation, Britton (1998) has called the psychic space a triangular space. In the analytic situation everything which happens can or should be perceived with a symbolic attitude. In this context, symbolization takes place not solely in the semantic or in the iconographic realm, which is important to bear in mind, since people often regard only words and images as true symbolizations. In my understanding the analysis in its totality is a symbolic space par excellence. In relation to the transformative activity of the psyche, Jung's !transcendent function" bears a certain resemblance to Bion's !alpha-function", which turns beta-elements into alpha-elements. As we have seen, Jung regards a surplus of meaning to be one of the most important characteristics of a true symbol. Similarly, Bion uses the metaphor !unsaturated", derived from chemistry, to describe alpha-elements. In other words, alpha-elements are open for any number of possible relationships and meanings. From Tom's treatment: the creation of a symbolic space Prologue Let us now return to Tom. There were surprising parallels between his chronic physical illness and his psychological functioning. He suffered from a congenital megacolon or enlarged colon. This condition, which is hereditary, is a disease of the intestines. Here, several sections of the intestines, particularly of the colon, do not have autonomous nerve ganglia. As a result, no peristaltic bowel movement can occur in these sections; to all intents and purposes, they are shut down. Consequently, parts of the intestines are massively bloated while others are constricted. Soon after birth, children with this disease begin to suffer from diarrhoea and vomiting alternating with constipation. Although food enters the system, it leaves it again immediately, without being sufficiently digested or absorbed. If the illness is not diagnosed early enough, heavy bacterial inflammations can occur coupled with catastrophic diarrhoea, which can even lead to death. Usually, treatment consists of removing the affected sections of the intestines during infancy but the remaining scars often lead to a re-constriction of the intestines. Patients have to avoid certain foods, such as sweets, fats, and fruit, for their entire lives, if they do not want to be plagued by chronic diarrhoea and flatulence. Tom was sent to me by a colleague who was treating Tom's half-brother, who was two and a half years older. My colleague got the impression that Tom required immediate help. Tom's parents told me that he
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was very restless, that he constantly dropped things and that he never listened. He was said to be chaotic and forgot everything immediately. His mother sounded extremely angry and desperate when she said, !If you tell him something, it goes in one ear and out the other". Being strict or punishing him had been to no avail. His father complained, above all, about his !extreme untidiness". His mother was also worried because he frequently seemed so absent-minded, as though he was lost in his thoughts. She was afraid that he might be run over by a car. She added that there was a great deal of jealousy between Tom and his half-brother, who frequently threatened him and entered his room without being asked, actions against which Tom could not adequately defend himself. Tom also wet his bed. He wore nappies at night until just a short time before treatment began, and he still wet the bed about once or twice a week. Tom was not a planned child. During the difficult divorce from her second husband, his mother, who comes from Denmark, became pregnant by her future, third husband, a management employee in an industrial company. She said that, physically, she had been in !great shape", but that psychologically, she felt overburdened. She had tried to breastfeed Tom, but he threw up immediately and began to suffer from acute diarrhoea soon after birth. After a few days, his mother said, her milk dried up !from one day to the next". After ten days, Tom had to go to the hospital, where his intestinal disease was diagnosed. He spent most of the first year of his life in the hospital, and his intestines were operated on repeatedly. Between the ages of one and three years, Tom must have experienced his relationship with his mother as sadistically intrusive, since she had to push metal pins up his rectum three to four times a day, in the hope that this procedure would widen the constricted sections there. Tom had little contact with children of his own age and frequently spent hours by himself playing with Lego or doing puzzles. He repeatedly suffered from indigestion with heavy flatulence, or from diarrhoea. Although he acted up at school, he still managed to be a good student. While his mother told me this terrible story in a hectic, intrusive and determined fashion, I was never able to establish any real emotional contact with her. The father remained silent for most of the time. Despite the abundance of facts, everything she said remained strangely flat and empty and two-dimensional. I could, however, detect some feelings of guilt because his parents suspected that, as a result of his many stays in hospital, Tom may have felt that they had pushed him away. Tom was not yet ten when I met him for the first time. I was surprised by how tall and heavy he was and by how vital he seemed. During our first meeting, he bombarded me with tales of his life and his problems. Everything sounded rather terrible but he recounted it in an emotionless, manic, and often boastful and over intimate manner, as if he wanted to tell me that none of this mattered to him. I had the impression that internally he was in chaos, like his dissected and deformed intestines. He ignored or rejected any remark of mine offering emotional understanding. There were brief moments when I glimpsed a deep forlornness, but for the most part, Tom struck me as being filled from bottom to top with a desperate anger. Towards the end of our initial interview he spoke of becoming a policeman when he grew up, and he drew a picture of a little black policeman who !shoots dragons and pours fire over them".

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I was a little surprised by the twist that it was the policeman who !pours fire" instead of the dragon spewing fire, and I thought that both of them actually looked quite friendly. This picture awakened my sympathy for Tom, which I had not really felt before. In the picture, a strong red arc of fire connected the head of the little, black policeman to the nostrils of the mighty, green dragon, whose body was riddled with black bullet holes. I sensed that the dragon and the policeman were also connected in a strongly libidinous way, with the dragon perhaps personifying the entire dangerous and unintelligible chaos of Tom's intestines. The black bullet holes in the dragon's body made me think of the many intestinal operations Tom had undergone. I did not voice this suspicion, however. Tom then left, with the assurance that he would like to return. Excerpts from treatment Tom came to treatment twice a week. I would have preferred it if he had come three times, but I could not convince his parents. As I have already mentioned, Tom tried to control and dominate me in a very omnipotent and intrusive fashion right from the outset. He made it very difficult for me to assume a symbolic attitude or one of reverie, or to develop my own !thinking space" in order to understand and consider what he was telling me. The situation escalated over the next months as Tom became increasingly aggressive and chaotic. During one session when he was in the process of getting violent again and threatened to throw a chair at me, I told him in an uncompromising tone of voice to stop. I also reminded him that we had agreed that there would not be any physical fights and that neither of us wanted to get hurt. In a more conciliatory tone, like a referee, I added, !that's against the rules here". He stopped immediately and threw himself on the bean-bag chair with a growl. I suggested that he draw what he would like to do to me on the blackboard. He accepted the proposition and spent the rest of the session drawing, in a rather aggressive manner, nuclear missile attacks on the !Bovensiepen-Zombie". In our next session, he enthusiastically continued this activity, but without any direct physical attacks. There were no physical attacks in the sessions that followed, but the emotional atmosphere of tyranny, a desire for destruction and total control, through which Tom wanted to enforce my complete submission, intensified accordingly. I told him that I thought he wanted to make me feel how he actually felt when he had a fight with his elder brother who forced his way into Tom's room, namely helpless and defeated because he had no way of defending himself. He confirmed my suspicion. For the very first time, he accepted an intervention that conveyed an understanding of his emotional state, and he began to express something of himself in words. He spoke about his grandmother, whom he always visited on those weekends when his half-brother went to see his own father. Tom told me that he liked being at his grandmother's because she was not strict about following his dietary regime. Then, however, he unexpectedly recalled that she had once knocked out one of his teeth. I had the feeling that he was only half-joking when he told me this, and I must have looked somewhat incredulous while, at the same time, expressing my empathy. He apparently interpreted my mixed reaction to mean that I either did not believe him, or at least did not correctly understand him,
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or that I could not distinguish between a lie and the truth, or - what was even worse - that I suspected that he could not tell the difference and that I myself was lying when I commiserated with him! He reacted by growing very impatient and angry, farting constantly, and saying that he now had to go on a !revenge crusade" against his grandmother. I did not attempt to interpret his angry eruption as a grandmother or mother transference, but instead suggested that he tried to depict this !revenge crusade" as a picture story in a comic strip. He immediately took me up on my suggestion, but insisted that I had to begin. He then went to his personal box for the first time in therapy, fetched a sketch pad and crayons, and divided a piece of paper into twelve squares by drawing one vertical and five horizontal lines. When he had finished, he pushed the piece of paper over to me and said, !Come on, get going". I hesitated for a moment since I was unsure about offering something of myself when I did not really know what he needed. I had the impression that he used his farting as an anal-aggressive attack to fend off his fear of the !bad" non-understanding and intrusive maternal object, and that he felt I was turning into the mother who was penetrating his anus when I tried to talk to and understand him. On the other hand, I wondered whether his triumphantly and omnipotently employed !ability" to fart at any time was actually a concrete expression of his deeply rooted conviction that he could only produce foul-smelling air in his chaotic psyche, which he had to communicate to me through projective identification. I also asked myself whether he was dominated by the unconscious fantasy of a destructive parental primal scene, the only product of which could be senseless thoughts, foul-smelling air, or a zombie baby that had to be expelled. Be that as it may, I sensed that it was crucial for him at this moment that we could find a way to name his state of mind, entering into an exchange of thoughts in the form of a pictorial dialogue. It was crucial that I offered him something living of myself; he needed something that would give him a spark of hope, even if this did not necessarily signify understanding yet. So, I drew a relatively motherly, portly figure who greeted Tom, and he then drew his grandmother being riddled with bullets. !You're the grandma!" he exclaimed triumphantly. He then added in a friendlier tone: !But you're not bad, we're only acting as if". He continued working on the picture story until the end of our session. It was an interactive game. He drew a scene to which I had to react by drawing another scene, to which he reacted by drawing another picture, and so on. The story primarily revolved around the grandma being pursued and having to be annihilated, and she could only save herself by changing into another figure. Mercilessly and sadistically, Tom employed every possible means to annihilate her, while I had to come up with ideas about how I/the grandma could survive, which I repeatedly tried to accomplish with the help of a transformation spell. Our session ended when the grandma retreated into an atomic bomb shelter because she was being threatened by nuclear missiles. Tom really enjoyed drawing these stories. For me, it was not the content that was important, but the fact that this activity represented a nascent possibility that we might be able to create a symbolic space, however temporary, in which an intersubjective exchange of fantasies could occur without the emptying of undigested emotional experiences and physical sensations: !we're acting as if". Tom kept returning to these picture stories during the course of treatment and we continued to work with them. They became a consistent and safe part of his inner world. Even though his therapy box was
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overflowing with chaotic sketches and papers or plasticine figures, and he threw everything out every few months, he took great care of his collection of picture stories, which had to be filed and given titles. He frequently tested me to see if I remembered certain characters and scenes or the names of the different stories. In this way, a process of working through the anxieties and their defences could unfold as they were enacted in the stories. For him, the stories seemed to represent an object that gave him hope of not losing the mind-to-mind contact with the therapist; metaphorically one could say Tom suffered from a !psychic diarrhoea". Slowly he began to feel how painful the experience of loss is, and that his problems had something to do with being able to master his nameless anxieties and chronic depression. After about a year and a half of treatment, a relatively safe symbolic space had been established within Tom. This was evident from the fact that he only rarely tried in his tyrannical fashion to force me to submit, that he started voicing his interest in my thoughts, that he was curious to find out more about my private life, and that he wanted to know whether my colleague in the practice was also my wife, whether I had children and so on. He also started thinking about what might be going on inside his father when the latter was having one of his frequent fights with Tom's brother. Increasingly he was able to assume an observing position, evidenced by the fact that his intrusive sadism, born out of despair, was frequently replaced by an intrusive humour. He wondered, for example, why so many random letters of the alphabet were printed nonsensically on the back of the sheets of paper that I provided for him to use in such quantity. I told him that my personal computer had spewed out a large number of misprints. In response, he said with amusement, !Your computer must have been thinking, I'm going to bug the old man!" His ability to explore himself, to understand himself, and to achieve this by other means than mere externalization developed very slowly. He no longer reacted to my verbal interventions physically but instead answered in kind, with verbal commentary. To my interpretations he frequently answered, for example, that I obviously wanted !to intrude upon his private sphere", or, !my dear Mr Bovensiepen is one-hundred-percent gay!" Nevertheless, for a long time, the scope of his denial of a basic emotional need for dependence and his defences against a relationship based on understanding and meaning remained frightening. He sensed this and although he continued to be unhappy and depressed, this was an important step forward in his development. Discussion Tom is an example of a child who does not possess the capacity to contain and is thus seriously impaired in his ability to symbolize. Although Jung may have believed that symbolization is a !natural process" based on the transcendent function, I would like to modify this assumption, since, in clinical situations, we are frequently confronted by patients who cannot symbolize at first. If we understand Tom's problems with symbolization as analogous to his problems of digestion, we can say that digestion is a natural process, but it can also be impaired. Following Jung, Verena Kast has argued that the complexes spontaneously unfold in symbols (Kast 1990). This may hold true for many neurotic patients, but not for those with an undifferentiated ego-structure. Furthermore, this assumption focuses too heavily on the
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contents of the fantasies or symbols. We should, I believe, place much more emphasis on the process of developing a symbolic space, which results from the matrix of the transference/countertransference and which, like the early mother-child relationship, can lead to a transformation of emotional experience in a dyadic relationship. I think that this concept fits well with Jung's idea of the !symbolic attitude", which a mother also assumes when she succeeds in creating a place for her child within her psyche. With Tom, the most striking problem was his lack of containment: he showed extreme and rigid splitting and !everything went into one ear and out the other". If the symbolic attitude is primarily understood as a relational process instead of an intellectual amplification of symbolic contents, this understanding would expand our treatment options for patients who are, above all, plagued by difficulties with symbolization. I believe that the symbolic process, a !natural process" according to Jung, can only !naturally" unfold in treatment if the therapist assumes an attitude that is as open and as receptive to his own fears and fantasies as to the patient's fears and fantasies. This is an attitude that I believe is best expressed in Bion's conception of reverie. I would like to comment on an important aspect of Tom's fantasies/picture stories because it expresses facets of the transference/countertransference. For a long time, the stories revolved around the idea that the persecutor and the persecuted could only save themselves by constantly transforming themselves. This is an archetypal motif that we know from many fairy tales: the hero, who has been an apprentice to a sorcerer or a sorceress, for example, can only free himself at the next stage of development by using the tools of his trade to magically transform himself and escape. With his pictures, Tom showed how he was identified with the !magical" power of his mother complex as a part object and needed to distance himself from this identification by means of an escape through transformation. It took a great deal of time in therapy for him to work through his identification with a powerful, intrusive mother introject. My introduction of drawing picture stories can be understood as a modified form of active imagination. For a while, drawing was my form of reverie, which I had attempted at first to offer as the verbal reverie that Tom attacked so violently at the start of treatment in order to master his anxieties. In contrast to !classic" active imagination, in which the patient unfolds his or her fantasies, here, I had to become active first and had to offer something prospective of myself. One could argue that he intrusively compelled me to offer something. But this was obviously the right !food", !served" in the form of a living and enlivening symbolized object relation, because Tom was able to accept it and develop it further. I think the method also turned out to be the right one because it enabled Tom to make his unconscious thoughts thinkable in order to satisfy his need for sense and meaning. In my view, Jung's prospective function of the living symbol, which he stressed repeatedly, corresponds to the above-mentioned need for a living object maintaining the mind-to-mind-contact with Tom and the need for meaning in Jung's" sense or for !knowledge" as Bion puts it. Hence, the primary issue with severely disturbed patients is not so much to interpret the defensive meaning of the symbolism in relation to a lack or loss, but to help them to create the hope of being able to think about lack or loss, being able to imagine before seeking means to overcome lack or loss. This is what I understand as the prospective function of the symbol. Anne Alvarez from the Tavistock Clinic, who has made so many significant
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contributions to the treatment of severely disturbed children, put it poetically, if you like, in a Jungian way, when she wrote, !We need symbols for sunset, but also for a new morning" (1992, p. 168). Footnotes 1 I would like to dedicate this paper to the memory of two Jungian colleagues from London: Jane Bunster and Mara Sidoli, who died far too early and to whom I am personally as well as professionally indebted. In the late 1980s, Jane Bunster worked in Berlin for two years as our supervisor in the observation of infants, which followed Esther Bick's method. Mara Sidoli and I founded the International Workshop for Analytical Psychology in Childhood and Adolescence in 1984. We cooperated closely for many years, and I learned a great deal from her. Not least she and the other London colleagues of the SAP were instrumental in introducing me to Michael Fordham's concept of the self in childhood and to the ideas of W. R. Bion, whose thought is intimately related to some of Jung's own ideas. References 1 Alvarez , A. (1992). Live Company. Psychoanalytic Psychotherapy with Autistic, Borderline, Deprived and Abused Children. London: Routledge .
2

Bion , W. R. (1962). Learning from Experience. London: William Heinemann Medical Books . Reprinted 1984 : Karnac Books . (ZBK.003.0001A)
3

Britton , R. (1998). !Subjectivity, objectivity and triangular space". In Belief and Imagination. Explorations in Psychoanalysis. London: Routledge .
4

Fordham , M. (1985). Explorations into the Self. The Library of Analytical Psychology, Vol. 7 . London: Academic Press .
5

Jacoby , M. (1999). Jungian psychotherapy and contemporary infant research: Basic patterns of emotional exchange. London: Routledge .
6

Jung , C. G. (1912). Symbols of Transformation. CW 5 .

Jung , C. G. (1916/1928). Relationship between the Ego and the unconsciousness. Two essays in Analytical Psychology. CW 7 .
8

Jung , C. G. (1916/1958): !The transcendent function". CW 8 .

Jung , C. G. (1917/1942). !The psychology of the unconsciousness". In Two essays in Analytical Psychology. CW 7 .
10

Jung , C. G. (1937). !Definitions". In Psychological Types. CW 6 .

11

Jung , C. G. (1940). !The psychology of the child archetype". In The Archetypes and the Collective Unconsciousness. CW 9i .
12
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12

Jung , C. G. (1946). !The psychology of transference". In The Practice of Psychotherapy. CW 16 .

13

Kast , V. (1990). Die Dynamik der Symbole. Olten: Walter Verlag . ( The Dynamics of Symbols: Fundamentals of Jungian Psychotherapy. New York: Fromm International , 1992 .)
14

Neumann , E. (1963). Das Kind. Struktur und Dynamik der werdenden Persnlichkeit. Zrich: RheinVerlag . ( The Child. Structures and Dynamics of the Nascent Personality. London: Hodder & Stoughton , 1973 .)
15

O'Shaughnessy , E. (1988): !Bion's theory of thinking and new techniques in child analysis". In Melanie Klein Today. Developments in theory and practice. Vol. 2: Mainly Practice, ed. Elizabeth Bott Spillius. London: Tavistock/Routledge .
16

Samuels , A. (1985). Jung and the Post-Jungians. London: Routledge .

17

Segal , H. (1981). The Work of Melanie Klein. A Kleinian Approach to Clinical Practice. London: Aronson .
18

Segal , H. (1991). Dream, Phantasy and Art. London: Routledge .

Acknowledgement I would like to thank Elisabeth Adametz and Miranda Davies for their thoughtful and helpful comments on this manuscript.

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. Journal of Analytical Psychology, 2002; v.47 (2), p241 (17pp.) JOAP.047.0241A

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