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Annie Reiner
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First published 2009 by

Karnac Books Ltd
118 Finchley Road, London NW3 5HT

Copyright © 2009 Annie Reiner

The right of Annie Reiner to be identified as the author of this work has
been asserted in accordance with §§ 77 and 78 of the Copyright Design and
Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored

in a retrieval system, or transmitted, in any form or by any means,
electronic, mechanical, photocopying, recording, or otherwise, without the
prior written permission of the publisher.

British Library Cataloguing in Publication Data

A C.I.P. for this book is available from the British Library

ISBN: 978 1 85575 705 9

Edited, designed and produced by The Studio Publishing Services Ltd

e-mail: studio@publishingservicesuk.co.uk

Printed in Great Britain

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FOREWORD by James S. Grotstein xi



Philosophical and psychoanalytic background 3

The true self and psychological birth 11

The spiritual perspective in psychoanalysis 23

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Theories of conscience 49


Clinical examples 73

Summary and conclusions 123

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I am grateful for permission to use material from the following
Leopardi, Giacomo, Leopardi: Selected Poems. Reprinted by permis-
sion of Princeton University Press.
Laing, R.D., Knots. Reprinted by permission of Tavistock Publications.

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Annie Reiner, PhD, PsyD, LCSW, is a member and associate faculty

member of The Psychoanalytic Center of California (PCC) in Los
Angeles, and a Fellow of the International Psychoanalytic Associ-
ation. Her work was profoundly influenced by the ideas of Wilfred
Bion, with whom she studied in the 1970s. Her psychoanalytic writ-
ings have been published in various journals and anthologies. In
addition to her work and writings as a psychoanalyst, Dr Reiner is
an accomplished playwright, poet, and painter. She is the author of
four books of poems, a book of short stories, and four children’s
books, which she also illustrated. She maintains a private practice
in Beverly Hills, California.

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Dedicated to the memory of Estelle Reiner

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James S. Grotstein

In this remarkable work, Dr Annie Reiner explores a hitherto

unthought-of perspective on man’s moral endowment, and, in so
doing, reclaims its lost innocence and positive value for man. After
reading the work, one realizes that psychoanalysis had to wait for
Bion to shed new light on the numinous or transcendent significance
of conscience as opposed to superego. One of the rewards one acquires
when reading this book is receiving a profound and extensive survey
of Bion’s contributions. Reiner explores the mysterious space between
what has ordinarily been meant by “conscience” and the evolved
achievement related to “consciousness” and “conscientiousness”, and
how that difference impacts the birth (or death) of the mind.
In the author’s words, “A primary aim of this book is to distin-
guish clearly between that primitive state of mind [of a moralistic
superego] [parentheses added] and a more developed conscience,
based on a more subtle and complex emotional understanding of
good and bad and the relationship between them in the mind . . .
The Quest for Conscience and the Birth of the Mind highlight[s] the idea
of conscience as an as yet unrealized potential, although one
toward which we are naturally driven.” That was the author’s
intent, and the text elegantly lives up to her promise.

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By rediscovering the all but forgotten idea of the “conscience”

and distinguishing it from, as well as connecting it with, “super-
ego”, she reminds us that “superego” has become intimately asso-
ciated with psychopathology, while its positive aspects have been
marginalized. The conventional understanding of the superego
(Freudian view) is that it is superimposed on the infant’s code of
behaviour during the phallic–Oedipal phase of development and
consists of the establishment of moral values from the intimate
(parental) as well as cultural background. Further, it designates the
smashing of the Oedipus complex (omnipotence) (Freud, 1923b).
Upon discovering both the importance of aggression in infantile
mental life and the clinical ramifications of projective identification,
Klein (1927, 1930, 1946) added yet another theory about the origin
of the archaic superego in the oral stage of development. Her theory,
in brief, is as follows: the infant splits off and projects unwanted
affects, e.g., anger, in addition to infantile omnipotence, into (its
image of) his mother, who thereupon becomes transformed in the
infant’s eyes as a hateful mother. The infant internalizes this image,
whereupon it becomes installed on a gradient in the ego as a criti-
cal superego, vis à vis the infant’s own ego. Her theory implies that
this phenomenon occurs in the infant’s unconscious phantasy. Dr
Reiner helps us to comprehend how Klein’s phantasy-driven model
becomes fatefully amplified by a rearing environment in which
parental projections into the child, or other problems in the con-
taining environment, become emotionally intolerable to the child
(Fairbairn’s model). The child is then faced with a moral dilemma
that impels him to make himself bad in order to preserve the par-
ent’s goodness in his mind. Reiner quotes Fairbairn’s description
of the child’s untenable moral position, “It is better to be evil in a
good world than to be good in an evil world”. The result of this
dilemma is the creation of a pathological superego, that is, a pun-
ishing conscience based on an identification with bad internal
objects designed to control the child’s dangerous negative feelings
toward the parent. The feelings, and soon all feelings, felt to be bad,
are split off at the behest of that harsh and omnipotent internal
authority. Thus, she links the onset of the pathological superego to
failures in the child’s attachment to the mother, and what the infant
makes of it in phantasy. She contrasts this with, in her terms, a “con-
science capable of maturation”. The latter, born of an emotional
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background characterized by good enough containment and affect

attunement, facilitates the development of an authentic self which,
Reiner asserts, is the foundation of a healthy conscience. Thus, she
connects the primitive pathological superego to the infant’s inter-
nalization of, and identification with, his mother’s “badness”, those
often unwitting projections of uncontained or unthought emotional
aspects of her personality that the child’s mind cannot process. For
the infant, the lack of maternal mental containment provokes a
failure to be able to go on being. This situation, along with the
child’s need for, and dependence upon, this mother, gives rise to an
essential confusion between good and bad that obstructs the devel-
opment of a healthy conscience. In the second half of the book,
Reiner presents detailed clinical work to illustrate these ideas, and,
through the patients’ dreams, shows the development of an authen-
tic self through a psychological birth, necessary to a mature con-
If I read her correctly, the author, thus, interestingly suggests
that the superego and this kind of conscience have different origins.
Freud’s as well as Klein’s theories of the superego predicate that it
is superimposed on the infant’s mind either from the parental and
cultural environment and/or from the infant’s unconscious phan-
tasy (splitting plus projective identification  introjective identifi-
cation), in either case post natally and environment-inspired to one
degree or another. Yet, Freud (1914c) himself actually postulated
that the ego ideal, which he referred to before he theorized about
the superego, differentiated from the ego soon after birth and
became located in a gradient of the ego, thus suggesting the possi-
bility that it qualifies as an inherent potential.
Dr Reiner postulates clearly that the potential for a mature con-
science, as differentiated from the superego, is an inherent given. I
understand this to mean that conscience (and maybe even the ego
ideal as well as the ideal ego [Freud, 1914c]) may constitute a
Kantian primary category or a noumenon (or Ideal Form, inherent
preconception), that it has a developmental line and constitutes an
ever-potential state waiting to be realized. I should like to support
her thesis with the concept of “entelechy”, Aristotle’s term for the
activation of one’s inherent potential. The adult human being, for
instance, is the entelechy of the embryo, and, unconsciously, we
sense our destiny to achieve this ever-evolving state.
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Reiner looks at these ideas in terms of Bion’s theories of think-

ing, his idea of an inherent need for truth and his concept of O. In
examining what she views as prerequisites for the development of
a healthy conscience, she makes the point that a capacity for con-
tact with O—the numinous realm described by Bion as “absolute
truth, ultimate reality, the godhead”—is a necessary foundation for
the development of an authentic self, without which the develop-
ment of a healthy conscience is obstructed. Without truth, and, in
particular, the truth about inner emotional life, there can be no con-
sciousness and no conscience. She examines the experience of O,
contact with which requires access to primitive states of mind in
conjunction with more sophisticated capacities for thinking. She
views the state of mind associated with O as a spiritual perspective
which Bion introduced as central to psychoanalytic thinking and
practice. Making a careful distinction between this spiritual per-
spective and an institutionalized religious perspective, she presents
evidence that this development in Bion’s theories represents a new
analytic perspective which was not yet accessible in Freud’s way of
thinking or his theories.
Reiner sees both the capacity to think and the capacity for con-
science as mental potentials not yet realized, but which may be
helped toward a process of becoming through analytic work.
I wish to mention another of Bion’s ideas to emphasize the con-
trast the author makes between a pathological superego and a nor-
mal conscience. Bion (1962a) formulated the concept of container–
contained from his experience in analysing psychotic patients. He
came to realize that they were victims, not of projecting too much,
but of having been deprived of a sufficient maternal containment
for the projections of their emotional anguish. The result was the
creation of an “obstructive object, a pathological “super” ego which
attacks the infant’s positive links with his objects, an internal object
which is hyper-moral in its judgement of the infant, and yet lacks a
sense of true morality (Bion, 1959).
Morality, simply put, is the capacity to distinguish good from
bad, but this, as Reiner reminds us, is not a simple matter. She refers
to Nietzsche’s idea of a morality “beyond good and evil” to eluci-
date a state of mind akin to O, a mind with the freedom to think
beyond the strictures of social convention. It is a new way of think-
ing, beyond the primitive superego which attacks thinking and
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truth. This new way of thinking is the provenance of a healthy con-

science. Reiner’s ideas also connect conscience with Nietzsche’s
“das Übermensch” (1884), the man who is true to himself, and
whose conscience is therefore true to and for him. This is the man
capable of that new way of thinking. Nietzsche’s “das Übermen-
sch” is commonly translated as “Superman”. Literally, I think it
should be translated as “Overman”, which I reinterpret as “Higher
Man”, and which, I believe, may have been Nietzsche’s intent.
“Higher Man” functions by Kant’s categorical imperative and by
the beacons of his own beliefs, having freed himself from the cul-
turally imposed superego. I should like to append Kant’s concept
of the “categorical imperative” to amplify the nature of “das Über-
mensch”. Kant (1785), in Groundwork for the Metaphysics of Morals,
states it as follows: “Act only according to that maxim whereby you
can at the same time will that it should become a universal law”.
I take these injunctions to mean that conscience constitutes a
transcendental (inborn) entity that serves two masters: our accep-
tance of our truths that we have gleaned for ourselves, and the
truths we must apply to our relationship to others. The potential for
conscience, Reiner upholds, is a function of that universal law
which is realized in the individual capable of contact with his
authentic emotional self, which allows for genuine contact with an
Other. In brief, man must pursue truth and always aim to achieve
his conscientious self, his ever-evolving conscience. In her masterful,
articulate, and convincing work, Reiner gives an extraordinarily
textured examination of these ideas and a hidden theme in psycho-
analysis: the distinction between conscience and superego.
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Kant referred to conscience as analogous to “the starry heavens”, a

masterpiece of creation felt to be the highest achievement of the
human mind (Freud, 1933a, p. 61). This exalted view may at first
seem to be at odds with Freud’s estimation that, “God has done an
uneven piece of work [when it comes to conscience], for a large
majority of men have brought with them only a modest amount of
it or scarcely enough to be worth mentioning” (ibid.). Both state-
ments may be accurate, however, if they are viewed in terms of the
development, or what I posit to be the lack of development, of this
inherent human attribute. I will consider conscience from that per-
spective, that is, of a largely unrealized mental potential, if it is
defined in terms of what I will here describe as a “mature con-
science”, or a conscience in the process of maturation. A distinction
will be made between this kind of mature conscience and that
which we are used to thinking of as the superego, two aspects of
conscience which, I hypothesize, may actually develop along dif-
ferent lines.
Whether from Kant’s or Freud’s perspective, however, one
might expect the examination of conscience and morality to have
had a central role in psychoanalytic investigations of mental life.

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Surprisingly, this has not been the case, despite Freud’s view of its
critical importance as an area of study. “The problems which the
unconscious sense of guilt has opened up, its connections with
morality, education, crime and delinquency, are at present the pre-
ferred field of work for psychoanalysts” (Freud, 1933a). Although
increasing attention has been paid to the subject more recently by
numerous prominent analysts (Britton, 2003; Grotstein, 2004, 2007;
Paul, 1997; Symington, 2004), there has been relatively little exami-
nation of conscience overall. Two of the rare earlier psychoanalytic
books devoted exclusively to conscience and superego were written
in 1948 and 1989 by Bergler, who echoed Freud’s statement, saying,
“The unconscious conscience, although the key to the theory of
therapy and neurosis, has been grossly underestimated” (Bergler,
1989, p. vii).
The Quest for Conscience and the Birth of the Mind is an examina-
tion of a mature conscience as an unrealized human potential,
including an examination of the obstacles to its realization. If we
consider conscience as a higher mental function, or even, as Kant
suggested, the highest mental function, it seems evident that its real-
ization would require the fulfilment of all the preceding develop-
mental steps that form its foundation. The following is an overview
of those prerequisites to the development of conscience and the
ideas upon which they are based, all of which will be discussed in
more detail in Chapter Two.
Several questions seem essential to a psychoanalytic under-
standing of conscience. To begin with, what constitutes a mature
conscience? How does it relate to, or differ from, Freud’s and others’
theories of the superego? What are the obstacles to conscience and
what facilitates its development? These complicated and far-reach-
ing questions will be examined in relation to several hypotheses.
First, that a mature conscience is predicated on an “authentic”
or “true self”. As a corollary to this, the development of a true self
may, and perhaps in most cases does, require a psychological or
mental birth, by which process the individual can begin to experi-
ence buried, unrealized, or unborn aspects of the personality. These
derive from unconscious experiences and unthought thoughts that
reflect early proto-mental states (Bion, 1977a). Split off and hidden
from conscious awareness, these become the foundation of a false
self. Access to or “resurrection” of those unmentalized states
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(Mitrani, 1995) facilitates the process of mental birth into awareness

of one’s true self, a process that, from this perspective, is always a
factor in the development of conscience.
The second hypothesis, very much related to the first, reflects
the direct relationship between mental birth and the development
of the capacity to think, the development of higher mental functions
that is dependent upon the capacity to contain primitive emotional
states (Bion, 1962a, 1970). The capacities for contact with an authen-
tic emotional self, the capacity to think, and the capacity for a true
conscience are, therefore, seen as necessary to each other and con-
stantly linked. As this kind of emotional containment is a function
of conscious awareness, I hope to show that conscience is a by-
product of consciousness, in particular the capacity to contain emo-
tional reality. The latter has its source in the mother’s capacity to
contain the child’s unconscious states of mind (Bion, 1962a).
Third, that these kinds of conscious mental functions are associ-
ated with a state of mind concordant with Bion’s concept of O, rep-
resenting absolute truth, ultimate reality, the infinite, or the
godhead (Bion, 1970). This state of mind will be examined with ref-
erence to a spiritual or religious perspective. It becomes critical,
however, clearly to differentiate this kind of spiritual perspective
from the ideological, dogmatic, and reified definitions of God often
reflective of organized religion, ideas that here are seen as antithet-
ical to thinking in the terms Bion describes. “Spiritual” is, therefore,
simply meant to convey that which is of the mind or spirit, in con-
trast to that which is associated with sensuous, material, or physi-
cal reality: noumena as opposed to phenomena. The word “spirit”
represents an animating or vital principle, the breath of life, from
the Latin, spiritus, meaning soul, vigour, breath, and is related to spi-
rare—to breathe; it is not meant to represent any reified or anthro-
pomorphized version of the concepts we use to describe these
mental states.

Spirit and body

The failure to make this critical distinction may have helped con-
tribute to a virtual taboo in psychoanalysis against the discussion
of religion and spirituality as an aspect of mental life. However,
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there have been changes in this regard in the works of eminent psy-
choanalysts (Bion, 1970; Jones, 1991; Symington, 2004). Questions
about the existence of God have first of all to do with how one
defines God, which is related to this distinction. Symington makes
the distinction between what he calls “mature religion” and “prim-
itive religion”, a distinction that relates to what he later defines as
the difference between a true or a false god (Symington, 1994, 2004).
These reflect perspectives at different levels of mental development.
The term “false god” represents traditional religious ideas of the
concretized or anthropomorphized God, an idea which has more in
common with Freud’s (1912–1913) theory of God as the child’s rep-
resentation of the father. Symington’s notion of a “true god”, on the
other hand, reflects the process of a mind in pursuit of contact with
ultimate reality, absolute truth, the infinite—again, what Bion calls
O. The distinction, in other words, has to do with the development
of a capacity to think vs. a primitive level of mental functioning
which serves as a substitute for real thought.
Since Freud’s ideas about religion have greatly affected, and in
many ways determined, the psychoanalytic perspective, I will
examine how his views on the subject relate to prevailing psycho-
analytic ideas about the mind, and how these differ from Bion’s.
Much of what has been written about the superego describes a
primitive aspect of conscience which has not developed into what
is variously referred to here as a “mature”, “healthy”, or “true” con-
science, linked to higher mental functions. Indeed, it is possible that
they cannot mature into a healthy conscience, and, therefore, I put
forward the hypothesis that these represent two separate lines of men-
tal development. While both have their basis in an innate potential for
conscience, the classical notion of superego seems often to represent
a derailment of that natural potential.
Finally, and derived from the previous idea, I will explore
whether the usual understanding of the superego as described by
Freud and others may represent a pathological form of conscience
rather than a stage of normal development that leads toward a
mature conscience.
The importance of these questions is based on the idea that
problems of conscience and morality underlie many, perhaps even
most, pathological mental states. This statement may seem reduc-
tionist, but is more understandable if we consider the fundamental
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nature of morality. The laws of morality in the internal world, the

assessments of good and bad, form the central core of the person-
ality, for it is conscience that directs us either toward or away from
life, love, and attachment. The centrality of this issue is expressed
symbolically in the myth of the Garden of Eden, where the tree of
knowledge of good and evil is situated in the centre of the Garden
(Genesis, 3: 3). One taste of its fruit set humanity on a course of
struggle towards this knowledge, towards consciousness and con-
science, and the painful reckoning with the realities of life. I will
illustrate, through detailed clinical examples, how conscious aware-
ness of this kind is dependent upon the birth of an authentic self.
Given its central importance, it is worth examining why such little
attention has been devoted to conscience and superego in the psy-
choanalytic literature.
The root of the word, “conscience”, from Old French, borrows
from the Latin “conscientia”, meaning knowledge or consciousness,
and from the Greek, “syneidisys”, literally meaning, “with know-
ledge”. Freud pointed out this connection as well, noting that the
words can barely be distinguished in some languages, and that con-
science “is related to that of which one is most certainly conscious”
(1912–1913, p. 68). While psychoanalysis is not expressly intended
to be engaged in moral development, as a means of gaining know-
ledge at this fundamental level of the mind it may play such a role.
Certainly, there is a danger that this may be confused with a moral-
istic stance in line with the demands of an unconscious conscience,
a primitive and oppressive superego antithetical to thinking and to
development of any kind. This kind of discussion of good and evil
always runs the risk of such confusion and of exciting the paranoia
of that primitive conscience or punitive superego that, as Bion
(1962a) described it, is moralistic but lacks any real sense of moral-
ity. It is necessary to differentiate these two fundamentally different
experiences. A primary aim of this book is to distinguish clearly
between that primitive state of mind and a more developed con-
science based on a more subtle and complex emotional under-
standing of good and bad and the relationship between them in the
mind. It is based, that is, on knowledge and the desire for truth.
Bion often pointed out that mankind is in its infancy, with lan-
guage, which provides an essential tool for thought, a mere 5,000
years old. “Thinking”, he wrote, “in the sense of engaging in that
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activity which is concerned with the use of thoughts, is embryonic

even in the adult and has yet to be developed fully by the race”
(Bion, 1962a, p. 85). This developmental limitation proves to be
problematic in terms of conscience, since thinking, in particular the
capacity to think about one’s emotional life, provides the founda-
tion for conscience. In this regard, I have used the title, The Quest
for Conscience and the Birth of the Mind, to highlight the idea of con-
science as an as yet unrealized potential, although one toward
which we are naturally driven. There are powerful obstacles to this
goal, however, both external and internal, which often cause us
unwittingly to be driven toward the very opposite of conscience
and morality. It will be necessary to understand these obstacles, and
their often ferocious conflicts with other aspects of the mind which
thirst for truth.
The idea of psychological or mental birth is described by
Piontelli as “. . . the capacity to live mentally and emotionally in the
outside world once outside the narrow boundaries of the womb”
(1988, p. 73). Chapters Two and Three include an investigation into
the process of psychological birth, which is further examined with
reference to detailed clinical material in Chapter Five. It is impor-
tant to recognize that although we are talking about unconscious
memories of intrauterine life, they are reconstructed through psy-
choanalytic investigation. These “imaginative conjectures”, as Bion
called them, are not amenable to strict scientific evidence, so that
which is being discussed here is not necessarily a memory, and
should not necessarily be viewed as such clinically. Whether they
are memories or not, the analyst must deal with the enduring
unconscious phantasies related to an often idealized prenatal expe-
rience. These idealizations are meant to protect the infant’s unde-
veloped psyche against unbearable mental states, which often
result from early trauma or failure in the containing environment.
Early trauma, then, becomes a factor in the derailment of con-
science. The notion of mental birth, or psychological birth, exam-
ined by Bion (1977a), Tustin (1981), Paul (1981, 1997) and others,
represents the process by which unmentalized states are brought to
consciousness to facilitate contact with an authentic and essential
The notion of a real or authentic self, discussed in Chapter One,
relates to Winnicott’s idea of the True self, the denial of which gives
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rise to a False self (1960a), to that which Deutsch called the “as if
personality” (1965) and Reich called “character armour” (1949).
This alienation from the self shares aspects as well with Steiner’s
concept of a psychic retreat (1993); on an even more primitive level
it is also at the heart of Tustin’s concept of the autistic enclave, an
attempt at deep protection against the pain of emotional contact.
The true self presupposes contact with emotional life and attach-
ment to an object; the false self exists in a walled-off state, the phan-
tasy of a safe, yet isolated, womb-like environment characterized by
anaesthetization of feelings, detachment from objects, and an inabil-
ity to think (Paul, 1997). Its essential aim, to greater or lesser
degrees, depending on the individual, is a state of mental death.
Once these ideas are more fully outlined, they will be further
explored through detailed clinical material that will demonstrate
the notion that the obstacles to the development of the true self also
obstruct the development of conscience. It is these obstructions that,
I believe, account for the truth in Freud’s observation of the “mod-
est amount of conscience” among the majority of people.
As Freud (1911b) described in “Formulations on the two princi-
ples of mental functioning”, the infant’s frustrated needs are first
satisfied through hallucinatory gratification under the sway of the
pleasure principle. The eventual realization of the failure of hallu-
cination to satisfy these needs ultimately leads to the reality princi-
ple. This new mode of mental functioning requires the infant to
bring attention to the outside world in search of ways to mediate
his environment and so satisfy his needs in reality. Problems in the
environment, early trauma, including the failure of a containing
mother, or an inability otherwise to bear the feelings and frustra-
tions associated with reality, may cause the child to continue to
resort to this evasion of reality through hallucinatory wish fulfil-
ment. This takes the place of feeling and thinking, so, while devel-
opment may appear to progress normally, the persistence of that
primitive mode of mental functioning gives rise to a split in the self.
The development of a mature conscience represents a triumph over
these psychological obstacles to contact with one’s true self, a vic-
tory garnered through painstaking emotional awareness and know-
ledge of inner life.
Finally, like the mind itself, what we are really looking at is an
ongoing process of development. As I learned in the course of this
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study, it is, therefore, more accurate to refer to this natural moral

potential for conscience as a process of maturation. It is related to
Bion’s supposition of an innate epistemophilic instinct as a central
factor in the personality. With his views that truth serves as nour-
ishment for the mind and, conversely, that the absence of truth or
the presence of lies poisons the mind, he introduces into psycho-
analysis a focus on that which constitutes mental health as well as
pathology. This innate drive toward truth impels the individual
toward growth, which, as Bion (1970) points out, is synonymous
with life and health. The capacity to think and the capacity for con-
science function mentally in a way analogous to the liver in the
body; that is, they help to cleanse the mind of poisonous toxins, in
this case through the capacity to bring truth and thought to bear on
otherwise unknown experiences of mental life. These “toxins” are
the undigested, outmoded thoughts and beliefs that function as lies
to poison the mind, distorting one’s perceptions of internal and
external reality. In trying to understand more about conscience, The
Quest for Conscience and the Birth of the Mind also tries to bring atten-
tion to the developmental steps that lead toward mental health.
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“The problems which the unconscious sense of guilt has

opened up, its connections with morality, education, crime
and delinquency, are at present the preferred field of work
for psychoanalysts.”
(Freud, 1933a)

“I feel bad because I am bad

I am bad because [my mother] does not love me
She does not love me because I am bad.”
(Laing, 1970)
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Philosophical and psychoanalytic


“I will put my law in their minds, and write it on their

(Jeremiah, 31: 33)

The unconscious conscience

onscience is a function of an individuated mind. However,
primitive fears of abandonment and psychic disintegration
in the absence of the mother present impediments to the
awareness of separateness, which may lead to encapsulated,
entombed, or “en-wombed” states of mind. This kind of retreat into
a phantasy of a safe haven, though on the one hand self-protective
in its intention, also represents an unconscious attack on the self
and on the object. This gives rise to unconscious guilt and confu-
sion, which become impediments to the development of conscience.
From the perspective of the prevailing societal view, conscience
is commonly seen as a conscious ability to distinguish right from

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wrong, good from evil: intentioned moral judgements based on

learnt behaviour. This differs greatly from Freud’s idea of an uncon-
scious conscience, which includes the idea of inner life, unconscious
mental states which, though unknown, none the less affect the indi-
vidual’s moral actions and thoughts. In addition, popular notions
of conscience focus on social behaviour toward others and rarely
include an awareness of damage to the self. However, these appar-
ent acts against the self also reflect problems of conscience, for, with
these unconscious forces at work, and from the point of view of
object relations, acts against the self may reflect unconscious attacks
on internalized objects, mental representations of others toward
whom one may consciously believe oneself to be lovingly disposed.
The failure to develop a mature conscience derives from this funda-
mental confusion of affects. It is a state of mind which confounds
love and hate, described by Rosenfeld (1987) in his discussion of
confusional states, and which Fairbairn (1952) clearly outlines in his
concept of the “moral defence”, examined in detail below.
In the grip of the “unconscious conscience”, or “unconscious
sense of guilt”, an individual may regard himself as guilty “even
when a person has not actually done the bad thing but has only
recognized in himself an intention to do it” (Freud, 1930a, p. 124).
This recognition may also remain unconscious, however, so that
one feels he has done wrong despite the absence of any physical
The following brief vignette illustrates the idea of unconscious
guilt. The patient, Mr A, exhibits severe schizoid qualities and is at
times almost completely withdrawn from society. His emotional
detachment from his parents began at an early age, in part in reac-
tion to a narcissistic mother, but complicated by the birth of a
brother when he was sixteen months old, before he himself had
been weaned. This left him with a feeling of abandonment and
distrust from which he never recovered. After three months in
analysis, he reported this dream.

A man had killed a woman. I was trying to help him cover it up; I kept
washing the patio even though there wasn’t any blood.

The patient explained repeatedly that he did not know the man
and could not understand why he would risk himself to help him.
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I was reminded of Lady Macbeth: “Out, out damned spot!”, a

hallucinatory manifestation of unconscious guilt which, in this
case, seemed to me to reflect the patient’s murderous rage at his
mother. There was no blood, of course, for he had killed “only” his
love for her, and his emotional connection to her in his mind. The
“unknown man” seemed to represent the patient himself, a destruc-
tive, split-off aspect of his personality with which he was unfamil-
iar. In Mr A’s short time in analysis, feelings of connection toward
me had already been awakened, all unconscious, for these also had
to be killed, along with me and the analysis itself. These emotional
“crimes”, implemented through severe splitting, were often mani-
fested in the session by arrogant verbal posturing meant to keep me
at a distance. He experienced no conscious sense of wanting or
needing to see me, although he continued to come, always on time,
behaviour he was at a loss to explain. His question in the dream and
other association as to why he would want to help someone he did
not know were relevant to this and to his treatment in general, for,
although he experienced terrible guilt and feelings of self-hatred for
which he was constantly being punished internally, both his trans-
gressions and his guilt were unconscious. All that remained as
evidence was his disturbingly insular life, a kind of self-imposed
exile or imprisonment. His real feelings and real self were hermeti-
cally sealed off behind the bravado of a false persona, and so he
could not consciously understand why he was having these
sessions with me to try to help someone he did not experience or
recognize as himself.
Freud noted that “bad intentions are equated with bad actions”
(1930a, p. 128). Long before Freud’s concept of the superego, how-
ever, this correspondence of thought and deed were expressed in
the New Testament.

You have heard how it was said to our ancestors: You must not kill;
and if anyone does kill he must answer for it before the court. But
I say this to you: whosoever is angry with his brother without cause
will have to answer for it before the court. [Matthew, 5: 21–22]

If we view the court as one’s own unconscious conscience, it is

oneself to whom one must answer. This idea of responsibility for
one’s thoughts as well as one’s actions was seen as a new and
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higher standard, meant to fulfil the spirit of the existing religious

law (Matthew, 5: 17–20).
Nietzsche (1886) describes a similar course of moral develop-
ment in Beyond Good and Evil. He refers first to a “pre-moral period
of mankind [in which] the imperative ‘know thyself’ was as yet
unknown” (p. 44). He goes on to say that only in the last ten thou-
sand years have there been signs of “a period that one may call
moral”. This, he says, constitutes a reversal of man’s entire perspec-
tive, in which the value of an action is judged not only by its conse-
quences but also by its intentions. However, Nietzsche indicates the
need for a further shift.

We stand at the threshold of a period which should be designated

. . . as extra-moral. After all, today at least we immoralists have the
suspicion that the decisive value of an action lies precisely in that
which is unintentional in it . . . In short, we believe that the inten-
tion is merely a sign and symptom that still requires interpretation.

Nietzsche’s ironic reference to himself as an “immoralist” implies

someone at odds with a prevailing moral system that, in his opin-
ion, is not really moral. The true higher morality lies in the search
for the underlying and unknown intention. He views the traditional
sense of morality, the morality of known (or conscious) intentions,
as a kind of provisional morality, but one by which society contin-
ues to be guided.

The overcoming of [traditional] morality . . . let this be the name for

that long secret work which has been saved up for the finest and
most honest, also the most malicious, consciences of today, as living
touchstones of the soul. [ibid., p. 45]

This “immoralist” is one whose assessment of vice or virtue is

not based on conventional notions of good or evil, but on a reality
more difficult to apprehend, as it requires an understanding of
unconscious motives. These judgements made by the “finest and
most honest . . . consciences” and based on long and difficult work,
require contact with an authentic self beyond the dictates of social
convention. This is one characteristic of the “living touchstones of
the soul” to which he refers, a capacity related to Bion’s (1970) ideas
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about the mystic, the gifted or extraordinary person with direct

access to knowledge of the “soul” or mind denied to “ordinary”
people. Nietzsche’s conjunction between the “most honest” and the
“most malicious consciences” also warrants comparison to Bion’s
description of the mystic as someone dangerous to the society or
group of which he is a member, whose role as a harbinger of
truth and an instrument of change may prove destructive to group
The need to interpret underlying, unknown intentions presages
Freud’s theory of the unconscious, and Freud’s recognition and
admiration of Nietzsche’s thinking is clear. “In my youth,” Freud
writes, “[Nietzsche] signified an ability which I could not attain”
(Jones, 1957, p. 460). The development of psychoanalysis and the
psychoanalytic method, however, can be seen as a form of “that
long and secret work” which addresses this level of unconscious
intentions, and calls attention to an idea of conscience that depends
on the development of a capacity to think in a new way. It is occu-
pied with the task of uncovering the provisional morality of
presumed good intentions to make known the hidden intentions
beneath the surface, and, in this way, is, in Nietzsche’s terms,
“extra-moral”. The assessments of good and evil, of vice and virtue,
become blurred, for accepted ideas of goodness may, from the
perspective of conventional thought, represent the denial of deeper
To give a common clinical example, if the patient’s anger is kept
buried by a harsh superego designed to split off or anaesthetize
emotion, any awareness or expression of that anger, while conven-
tionally felt to be bad, from a psychoanalytic perspective is good,
for it reflects the patient’s co-operation in the analysis in the service
of emotional growth. This conflict becomes central to the develop-
ment of a true self if the reality of the family group is destructive to
the child’s inner reality. So-called “bad” aggressive impulses which
arise from such a situation are then actually attempts to protect the
true self, leading to a profound confusion between good and bad,
or loving and aggressive, impulses.
Nietzsche’s most scathing indictment of small-minded, tradi-
tional morality is aimed at the stultifying false piety of Christianity,
and yet his idea of responsibility for one’s unknown thoughts
echoes Christ’s dictum quoted above. This seeming contradiction
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reflects Nietzsche’s distinction between essential religious know-

ledge and the use to which this knowledge has been put through
concretized and institutionalized thinking. It is analogous to
Symington’s (1994) distinction between the true and false god, but it
also reflects Bion’s (1970) reference to “the Establishment” as a force
against the threat of the new—or messianic—idea.
The awareness that one’s intentions are unknown to oneself
brings the additional awareness that one’s judgements, perhaps all
of one’s thinking, may be based on false premises. This places the
individual in a terrifying position, for the very foundation of his
beliefs must be reassessed and each experience considered accord-
ing to his own, perhaps new, ideas. This requires one to know his
ideas, which, in turn, requires the difficult work of thinking and the
awareness of inner life. The individual is deprived of the false secu-
rity of a known, dependable, and externally prescribed code of
moral behaviour that is antithetical to thinking. The fear generated
by having to know one’s mind, to have a mind and to think, ushers
in the terrifying fears associated with a mental birth.
Along these lines, Bion points out that any thought already
contained within the container of a mind is false, for it is not an
evolution of O or absolute truth. He says, “. . . all thought as it is
ordinarily known, that is, as an attribute of the human being, is
false, the problem being the degree and nature of the falsity” (Bion,
1970, p. 117). It is an idea also suggested in this vivid image by the
poet, T. E. Hulme, “Prose is a museum in which all the old weapons
of poetry are kept” (Hughes, 1960, p. 21). It suggests the kind of
struggle involved in thinking a new thought as distinct from musty
old ideas to which Bion (1970) referred as the elements of a mind
saturated with old ideas and associations.
Bion’s idea of “the thought without a thinker” relates to his
discussion of the messianic idea, for both “. . . represent O at the
point at which its evolution and the evolution of the thinker inter-
sect” (ibid., p. 117). One is called upon to traverse feelings of uncer-
tainty and doubt, which arouse primitive paranoid–schizoid
anxieties. If one can bear it, Bion says, one is rewarded with the
momentary security of an experience of truth. He symbolizes this
journey from patience to security as Ps↔D, a later, more evolved
version of the infant’s primitive states of mind.
In Nietzsche’s terms:
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To recognize untruth as a condition of life: that, to be sure, means

to resist customary value sentiments in a dangerous fashion; and a
philosophy which ventures to do so places itself, by that act alone,
beyond good and evil. [Nietzsche, 1886, p. 12]

Nietzsche’s reference to “untruth” refers not only to the lies told to

shield ourselves from the difficult challenge of facing the natural
laws of reality, but to the idea of our always flawed human attempts
to reach an ultimately unreachable absolute truth. Given this, one
needs to recognize the continuous need to assess good and evil
anew. They are not static, learnt moral laws, but change according
to an understanding of the dual nature of that realm, the indivisi-
ble wholeness of life. He asks, “Did you ever say yes to one joy? O
my friend, then you have said yes to all woe as well” (Nietzsche,
1888, p. 12). The capacity to think toward this inclusive unified
view of a realm of higher truth also underlies Bion’s theories about
thinking and contact with the transcendent infinite reality, O, ulti-
mate reality, absolute truth, or the godhead. The capacity to think,
and the capacity for morality that is a function of thinking, depends
upon this deeper knowledge.
The clinical material in Chapter Five indicates that the primary
obstacle to moral development is a fundamental and unconscious
confusion which makes it impossible to distinguish between behav-
iour that is good for oneself or others and behaviour that is harm-
ful. All behaviours which are unhealthy for oneself or others,
addictions to drugs, alcohol, food, sex, etc., reflect a problem of
conscience, a fundamental inability to distinguish, with sufficient
conviction, “this is good for me” from “this is bad for me.” This
confusion requires within the self a fundamental understanding of
the concepts of good and evil and the relationship between them,
without which both the development of conscience and higher
consciousness are obstructed. Without the ability consciously to
distinguish good from bad, one cannot wage war effectively against
one’s unconscious identifications with forces of ignorance, cruelty,
or confusion in oneself or in others.
On a societal level, there seems to be an increasing reluctance to
make clear distinctions such as between “good” and “evil”, distinc-
tions which may become confused with moralistic values felt to be
politically incorrect, reactionary, or unenlightened. However, this
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reflects confusion between a primitive superego and a more mature

conscience, a problem in thinking which confuses being judgemental
and being capable of making judgements. The former—based on prej-
udice and preconceptions—is antithetical to thinking while the
latter—based on observation and knowledge—is a necessary factor
in the capacity to think.
Centuries before psychoanalysis, Rumi described the uncon-
scious conscience from a perspective we can now recognize as
informed by object relations.

A thief carrying off someone’s property

feels a twinge of conscience.
“What’s this?” he asks. Tell him,
“It’s the hurt of the one you’ve hurt,
hurting you” [Rumi, 1991, p. 43]

These unrecognizable “twinges of conscience” exist within the

labyrinth of a mind in the complex identifications, introjections, and
reintrojections that make up the world of internal objects. The
unconscious inner wars to which they often give rise will be elabo-
rated in Chapter Three, with reference to Fairbairn’s ideas about
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The true self and

psychological birth

The true self and the false self

t is important to look more deeply into the development of the
true self, upon which the development of conscience depends.
“At an early age,” Bion writes, “we have already learnt . . . not
to be ourselves . . . But the facts continue to exist” (F. Bion, 1980,
p. 12). This true self, in other words, continues to exist despite the
forces working against it or the phantasies of the self one believes
oneself to be. Furthermore, this real self is an internal “fact”, a real-
ity of psychical existence, though its existence may remain
unknown to the individual and those who know him. In speaking
of his own childhood, Bion refers to himself and his sister as “an
accomplished pair of liars, smooth and quick to see what our
betters expected of us and to provide accordingly” (F. Bion, 1982,
p. 28). These lies, if unconscious, go to make up a false self.
Winnicott’s idea of the false self describes a premature defensive
organization established at the very earliest object relations, and
which represents the death of the self. He writes, “When the
mother’s adaptation is not good enough at the start the infant
might be expected to die physically, because cathexis of an external

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object is not initiated . . . But in practice the infant lives, but lives
falsely” (1960a, p. 146). “The False Self,” he goes on to say, “has one
positive and very important function: to hide the True Self, which
it does by compliance with environmental demands” (ibid., pp. 146–
147). He makes it clear that “only the True Self can be creative and
. . . feel real” (ibid., p. 148).
Bion (1962a) describes the psychodynamics of a severely patho-
logical kind of mental escape from the self dominated by psychotic
processes and a primitive conscience. The infant develops a system
of morality based on an archaic superego, a moralistic “superior
[internal] object which asserts its superiority by finding fault with
everything” (ibid., p. 98). It does not aim at understanding of behav-
iour but is, rather, an “envious assertion of moral superiority with-
out any morals” (ibid., p. 97). Its aim is the destruction of contact
with the object, with reality and with truth. Such patients exist in
what Bion calls minus K (K), a state of mind (or mindlessness) in
which no mental space exists for abstract thinking. Thoughts, felt to
be concrete things-in-themselves, are stripped of meaning.
A brief clinical example vividly demonstrates this destructive
state. Mrs M finds fault with everything, starting with herself. She
admits that she hates herself, although only after elaborate and
circuitous discussions which aim to negate this internal fact and,
indeed, all of her emotional life. She upholds sweetly that she has
no quarrel with me, and yet she criticizes and ultimately disagrees
with everything I say. In wondering why she continues to come
talk to me, since she finds no value in my interpretations, I finally
realized that she comes precisely because I am, in her eyes, always
wrong. Having been emotionally dropped by her mother in favour
of an older brother, she fears being dependent on anyone and
is determined not to be hurt again. Each interpretation she dis-
misses is an attempt to prove to herself that she does not need me.
From this perspective, our relationship is defined by what she does
not get from me, which is just as she wants it. In this perverse plea-
sure, she deprives herself of help and devalues me, ensuring her
emotional isolation. She is dependent only on her need not to be
dependent. Of course, this does not exactly work, for in addition to
keeping her paralysed in her emotional life, her moralistic super-
ego continues cruelly and constantly to punish her. This extreme
example of a false self, almost completely detached from real
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feelings and meaning, also leaves her in a state of confusion, unable

to think.
Winnicott talks about the infant’s awareness of the object’s inde-
pendent existence as a part of a developmental process dependent
on a facilitating mother (1971, p. 89). In describing the capacities
necessary to facilitate the infant’s mental growth, Winnicott rede-
fines the meaning of early trauma to include the failures in the envi-
ronment and maternal care. He speaks of the basis of the true self
as a “continuity of being” between psyche and soma, a “psyche–
soma” which depends on minimum disruptive impingements from
the environment. This allows the infant protection from premature
awareness of the loss of the stable environment of the womb. If the
mother can safeguard this illusion, the infant’s chance for natural
self-development is maximized. If, however, there is a disturbance
to the sense of perfect mothering, the infant is burdened by preco-
cious consciousness, attempts at thinking which stimulate the need
to take over the functions of the mother (Winnicott, 1965). Similarly,
Tustin describes “an agony of consciousness” when the infant, too
early forced to face the world, shrinks from the light of premature
awareness of existence outside the womb, or outside the emotion-
ally containing “womb” of mother’s mind (1981, pp. 106–107). The
trauma of that premature awareness of separateness disrupts the
illusion of unity, often resulting in anxiety states of hyper-vigilance
and premature sense of responsibility for the self and one’s objects.
Fairbairn’s theories also call attention to environmental failure in
the development of a false self, and Rosenfeld (1987) cites the
mother’s projections into the baby, possibly even in utero, as a cause
of the infant’s turning away from the mother in narcissistic states.
Paul also points to the mother’s projections as a source of trauma
that causes the development of an as-if personality capable of imita-
tions of communicative speech, which masks “a capsular life of
induced affect and a barrier to contact” (2002, pp. 202–203). Vestiges
of the infant’s unconscious sense of having turned against his true
self remain in what Bion described as a proto-mental realm, pre-
verbal and incapable of being thought.
The false self develops in isolation from emotional life, provid-
ing an escape from frustration as well as from truth and the mind’s
capacity to apprehend it. This flight from a self capable of growth
and development is a kind of death of the self or mind, which may
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appear as drugged or stuporous states, a personality denuded of its

contents, of feelings, thoughts and phantasies, which are walled off
beyond conscious awareness. Rosenfeld, Tustin, and Steiner des-
cribe various states of encapsulation and detachment from the
object. Though Tustin’s ideas generally address more severe
degrees of disengagement at a more primitive level of develop-
ment, all of these theories address the defences against the pain of
emotional reality, resulting in varying levels of isolation from inter-
nal and external reality. Steiner (1993) refers to this avoidance of
contact with reality as a “psychic retreat”, which

serves as an area of the mind where reality does not need to be

faced, where phantasy and omnipotence can exist unchecked . . .
This feature is often what makes the retreat so attractive to the
patient and commonly involves the use of perverse psychotic
mechanisms. [ibid., p. 3]

For the infant faced with early trauma, confusion develops

between life and death. In the absence of maternal containment, the
terror of birth and separateness of life itself is experienced as so
painful that the infant is moved to anaesthetize his feelings and so
embrace a kind of mental death. Although the destruction of the
mind’s capacity to contain a reality too painful to endure is a means
of survival, as contact with emotional life is severed, so is the
survival of what Winnicott called the true self. The idea of the true
self is also referred to throughout this work as a real, authentic, or
essential self, and is related to what Fairbairn called the “central
ego” (1952, p. 85).

The death of the true self

“Birth was the death of him” (Beckett, 1979, p. 425). This haunting
line from a dramatic piece by Samuel Beckett expresses succinctly
the idea of the early death of this essential self, an idea also dis-
cussed in a poem by Leopardi, a nineteenth century Italian poet
who was plagued by loneliness and depression all his life. The
poem, entitled “Dream”, illustrates the death of the true self, and
the effect of trauma on the early attachment to the mother.
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It was morning and through tight shutters

The first faint glimmer of sunlight slipped
Into my darkened bedroom. [Leopardi, 1997, p. 11]

In these first lines, the scene is set in infancy, the morning of life, so
to speak, as well as the mind, the first dawn of awareness. As the
poem continues, the poet sees “the girl who first taught me what
love is / And then left me grieving. She didn’t / seem dead, but
downcast, like a lost soul” (ibid.). We see at first the glimmer of
hope, and of love, followed immediately by loss. These dynamics
are similar to those Green (1986) describes in “The dead mother”, a
split in the self which occurs as a result of the pain of a depressed
mother. He speaks of a simultaneous identification with the dead
mother and an emotional de-cathexis of the mother, which he calls
“a psychical murder of the object” (ibid., pp. 150–151). The connec-
tion between self and object is broken, but so is the internal rela-
tionship to the self and to love. So, when the girl in Leopardi’s
poem asks him, “Are you still alive? Do you remember me at all?”
(Leopardi, 1997, p. 11), she represents not only the lost mother, but
also the mental detachment from the internal mother and those lost
aspects of his self. She says:

I died early when life is sweet, before

One knows all human hope is vain.
It doesn’t take long for mortal misery
To learn to call upon death itself
As its sovereign cure; but there can be
No consolation when children die,
And nothing could know a crueler fate
Than that hope buried in an early grave.
It isn’t any good for the innocent young
To see into Nature’s hidden secrets,
And random suffering cancels all
Such raw unripened knowledge . . .
Our future’s been wiped away. [ibid., pp. 11–13]

In these few lines, the poem also illuminates Meltzer’s con-

cept of the aesthetic conflict (Meltzer & Harris, 1988) and Tustin’s
idea (1981) of the infant’s premature “agony of consciousness”.
The body is left alive but dis-spirited, disembodied, in a mental
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state between sleep and wakefulness. The individual is left with

a false self that stands in for the real self, really the death of the
personality, as the future and all hope of real knowledge dies. This
false self is a bully which guards the door to the emotional self,
like a bouncer who ejects anyone and anything which might cause
pain. Ultimately, it ejects life, reality, and the mind’s capacity
to attend to its own mental states—the foundation for consci-
ous thought. With no way to distinguish the once protective, but
now destructive, false self from one’s true self, the individual
fiercely protects the “bouncer”, a powerful force which erects a
rigid wall as a shield against reality. In this unconscious valua-
tion of death over mental life, the individual seems to enter into
a pact with the devil. Although emotional death is promised,
the individual is paradoxically subject to the punishments of a
brutalizing unconscious conscience for this intuited transgression
against the self and against truth. Good and evil are hopelessly
What I have here called the “bouncer” is well defined by Rosen-
feld (1978) in his ideas about a brutalizing internal gang that begins
as protection against intolerable trauma but becomes a bully in the
service of schizoid detachment and psychotic defences against life.
This confusion between life and death, and between what is good
or bad in terms of mental survival, may become an intractable
impediment to emotional development, and the development of a
true conscience. However, to view it analytically as an “evil” force,
or only in terms of envious attacks on the self or object, simplifies
a complex issue, and this analytic perspective can, at times, become
aligned in the patient’s mind with the bullying superego designed
to destroy contact. It is, therefore, necessary to distinguish the posi-
tive function this “bouncer” originally served in the personality as
a defence against the terrors of annihilation, fragmentation, and
psychosis in the face of unbearable realities. Bion said that we owe
a great deal to our infant self, who was forced to resort to these
drastic defences of projecting one’s entire mind, knowing that,
without that choice, we would not have survived. In Bion’s view,
gratitude to that otherwise unprotected infant self contributes to the
adult’s later willingness to contain that early pain, which is revis-
ited as those primitive defences are stripped away (Alexander,
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Mental birth, conscience, and the capacity to think

Winnicott sees the sense of oneness with the mother as a normal

developmental state in which, psychically, there is no baby and no
mother, but a combined infant–mother, indistinguishable in the
baby’s mind (1960b, p. 45). In the absence of this necessary step in
the development of a secure attachment to the mother, pathological
defences, which often arise in response to overt trauma, arise
against the fear generated by this precocious awareness of sepa-
rateness. Even the less dramatic, less visible effects of “ordinary”
life on the sensitive infant who lacks sufficient emotional contain-
ment are traumatic to the vulnerable psyche.
In talking about the transitions, whether from actual foetal life
to separate existence or, in the case of a mental birth, from an en-
wombed state of mind to an awareness of separate existence, it is
necessary to appreciate the exquisite vulnerability of neonatal expe-
rience. In his paper, “Caesura”, Bion gives expression to the possi-
bility of intrauterine mental life (Bion, 1977a), which he charac-
terizes as pre-verbal proto-mental states. His thoughts are based
first of all on Freud’s statement, “There is much more continuity
between intra-uterine life and earliest infancy than the impressive
caesura of the act of birth allows us to believe” (1926d, p. 138). Paul
illuminates the experience of the caesura in his discussion of emer-
gence into mental birth, outlining in detail the extremely painful
process of psychological birth from that encapsulated state and the
tenacious defences, autistic in nature, which are erected against
emotional contact (1981, pp. 552–570). This process is the founda-
tion upon which a mature conscience is built.
The splitting off of contact from emotional life leaves the true
self in a sort of waking dream state, the no-man’s land of the anaes-
thetized, encapsulated, walled-off state of mind. Nietzsche’s ideas
about dream thoughts provide a way to explore the difference
between conscious and unconscious thinking, between phantasy
and reality, a confusion instrumental in keeping one imprisoned in
that walled-off state. That which we assume to be wakeful
thoughts, he says, are derived from the thought processes of
dreams. He describes dreams as “a second real world”: real, that is,
from the point of view of the dreamer, for when things come to us
in dreams we tend to believe they are real (Nietzsche, 1878, p. 14).
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Nietzsche gives the example of incorporating the actual sound of a

bell into the content of one’s dream.

How does it come about that the dreamer’s mind always blunders
like this . . . that the first plausible hypothesis for explaining a
sensation that occurs to [the sleeper] is at once accepted as the truth.
(For in dreams we believe in the dream as though it were reality,
that is to say we regard our hypothesis as completely proved.) In
my opinion, the conclusion man still draws in dreams to the present
day for many millennia mankind also drew when awake, the first
causa that entered the mind as an explanation of anything that
required explaining satisfied it and was accounted truth . . . In the
dream this primeval piece of humanity continues to exercise itself,
for it is the basis upon which higher rationality evolved and contin-
ues to evolve in every human being; the dream takes us back again
to remote stages of human culture and provides us with a means of
understanding them better. We now find dream-thinking so easy
because it is in precisely this imaginative and agreeable form of
explanation by means of the first plausible idea that strikes us that
we have been so well drilled over such enormous periods of human
evolution, to this extent the dream is a relaxation for the brain,
which has had enough of the strenuous demands in the way of
thinking such as are imposed by our higher culture during the day.
[ibid., pp. 17–18]

In short, “dream thinking” is easy, wakeful thinking is hard. As

the Portuguese poet, Fernando Pessoa, wrote, “Thinking is a
discomfort” (1998, p. 45), and Bion similarly describes thinking as
a difficult and often hated task.

I have rarely failed to experience hatred of analysis . . . The human

animal has not ceased to be persecuted by his mind and the
thoughts usually associated with it . . . Refuge is sure to be sought
in mindlessness, sexualization, acting out, and degrees of stupor.
[1970, p. 126]

The pain of having a mind—of having to attend to inner reality,

tolerate one’s feelings, and distinguish them from external reality—
is felt to be worse than the pain brought about by the stuporous or
detached states Bion mentions, although they amount to attacks on
the mind, on thinking, and on truth.
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Bion views dreams as a form of unconscious thinking, a part of

alpha function, which is a critical factor in the capacity to digest
emotional experience and to think (Bion, 1962a). Nietzsche’s idea of
dreaming as “a relaxation for the brain” is related to alpha function
(Bion, 1962a), although alpha function describes a mental state in
which one is sufficiently but not overly “relaxed”. One must be
relaxed enough mentally to have access to the dream processes that
always exist beneath the awareness of the phenomenal world, and
yet not so relaxed that one is essentially asleep and, thus, incapable
of the attention required to think. This process is central in under-
standing mental birth as instrumental to the capacity to think, as
unborn emotional states emerge to be dreamt in order to be
Nietzsche’s ideas about dreams predate Freud’s but bear com-
parison to his idea of the origin of dreams in primary process think-
ing (Freud, 1916–1917). Perhaps Nietzsche gave modern man too
much credit, however, for these dream states help us understand
not only early human culture, but also primitive aspects of present
day waking thoughts, which persist at an unconscious level. It
helps us to understand problems in thinking, for we can observe
how, at this level, people may believe the first things which entered
their minds in the dream-like mental states of infancy, and then
continue to replay these “thoughts” as private phantasies all their
lives. Although they may be mistaken for rational thoughts, they
are actually belief systems based on primitive feelings, which are
unconscious and cannot be thought. Nietzsche expresses a sophis-
ticated idea about a primitive belief, that one’s feeling is the same
as external reality. This is an unconscious belief, more common,
perhaps, than we would like to think, a belief that results in confu-
sion between phantasy and reality and presents serious impedi-
ments to the development of thought.
To give an example of this from a patient’s session, Kristin’s
childhood experience with a violent father and an overwhelmed,
unfeeling mother often leads her to feel I am either attacking her or
not listening to her. In one session, she said angrily, “You don’t
understand what I’m saying!” While it is always possible that this
may be true, it was clear to me in this instance that she was in just
such a waking “dream” of her traumatic childhood. Her mother, a
hardened woman, readily admitted that she “hates feelings and
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will not talk about them”. As a result, Kristin had long ago erected
a barrier against her feelings and against contact that will admit no
one. In this session, she feels (or dreams) that I am her mother, who
could not listen to her or understand her feelings. Since she is not
psychotic, she knows that I am not, in reality, her mother, and, after
eight years of analysis, her experience also tells her that I am differ-
ent from her mother, that I do, in fact, listen very closely to what
she says. The problem is that she herself, like her mother, does not
listen to her experience. Rather, she keeps listening to the old feel-
ing she had as a child, which she mistakes for reality and which
now replays constantly in her mind in phantasy. Internally, she is
the mother who does not listen to her, which she now projects into
me. This is, of course, a description of transference, essentially a
dream state in which one’s past objects cannot be distinguished
from those people in one’s present. In any transference situation,
the individual is in a waking dream from which they cannot
awaken. Kristin’s anger at me in the session is anger at an imago of
her mother in her mind, beneath which lies the terror of that infant
who could not be heard and so is felt not to exist. That is the night-
mare from which she cannot awaken, and which she must play out
with me in my consulting room.
After a lifetime of these defences, upon which Kristin has come
to rely for protection from those terrifying nihilistic fears, it is in
large part the reality of our relationship and the fact that I do listen
to her which frightens and angers her. She knows by now that as I
penetrate the barrier erected so long ago against this unavailable
mother, the baby long sequestered behind the wall begins to feel the
terror and vulnerability of those old feelings. Therefore, she clings
desperately to that internalized mother imago, and to that protec-
tive wall, despite the obvious drawbacks.
As Freud said, “Hysterics [neurotics] suffer from reminiscences”
(Freud, 1893a, p. 7). Kristin ends up angry and misunderstood,
based on her old reminiscences and, more importantly, on her belief
that these reminiscences are real (Paul, 2007). This delusion repre-
sents a disorder in her thinking, which keeps her imprisoned in the
memory. She clings to the repetitive image and familiar pain of her
impenetrable mother, for it is within her mental control and so
seems preferable to the unknown and uncontrollable pain of real
feelings. Most disturbingly, she cannot distinguish the two.
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Entrenched in the mental grooves of her phantasies, Kristin can

neither attend to nor accurately perceive her current reality. There-
fore, she lacks the knowledge that her attacks on me (and others in
her life) are directed to a spectre of the past and so are unwarranted
in the present. Unconsciously, however, she does know, and is thus
at the mercy of a primitive and punishing unconscious conscious
which warns her cruelly against real contact and bedevils her with
brutal attacks on her character. We can see here how the impedi-
ments to thinking also impede the development of a mature
Bion’s idea that the capacity to think is not separate from
emotional life, but, rather, is a direct outgrowth of it is described by
Meltzer as a significant shift in perspective from Freud’s view of the
mind. “Bion’s model of the mind divides mental life into symbolic
and non-symbolic areas (alpha-function and beta elements) and
places its emphasis on the mind as an instrument for thinking about
emotional experiences” (Meltzer & Harris, 1988, p. 7). This shift
means that the ego, rather than the forces of the unconscious,
presents resistance to change and creative mental life. From this
perspective, anti-developmental forces are seen to be derived from
the conservative conscious mind rather than the repressed uncon-
scious, as Freud believed. This kind of repressive ego is synony-
mous with the false self, whose aim is to defend against the
authentic self and repress awareness of emotional truth.
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The spiritual perspective in


t seems difficult to discuss conscience and morality without
reference to theology and religion, but these have had little
place in psychoanalytic discourse. Bion noted this omission and
commented on the fact that religion, “one of the main departments
of mental activity”, was excluded from psychoanalytic investiga-
tion (1974, p. 15).

Psychoanalysts have been peculiarly blind to this topic of religion.

Anyone, recalling what they know about the history of the human
race, can recognize that activities which can be called religious are
at least as obtrusive as activities which can be called sexual . . . One
wonders on what grounds a mind or personality could be regarded
as a human personality or character if it had missing one of the
main departments of mental activity. [ibid.]

The prevailing analytic perspective has, to a great extent, been

influenced by Freud’s own atheism, and by his ideas of religion as
a “mass delusion” (Freud, 1927c, p. 85), “the universal obsessional
neurosis of humanity” (ibid., p. 43). This view, while an accurate
description of the restrictive role religious ideology has played in

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human history, addresses only what Symington referred to as the

“false god” (2004) or “primitive religion” (1994). Freud’s idea also
offers an accurate description of the child’s primitive experience of
the father (or, as we may now also say, of the mother) as an omnipo-
tent God, but it needs to be distinguished from the essential source
of these feelings in the capacity for contact with the infinite realm
of O. Freud (1930a) did, in fact, make this distinction between the
deepest sources of religious feeling and the common view of reli-
gion driven by that primitive state of mind; however, with Bion’s
contributions we get an idea of the importance of that religious feel-
ing as instrumental to the capacity to think.
The basis of this distinction is the idea of religious ideology as a
defensive reaction to that more primal source of religious feeling.
Bion’s concept of O calls attention to a spiritual function inherent in
the higher capacities of the mind. Grotstein referred to Bion as “the
first to establish the new ‘mystic science of psychoanalysis’”
(Grotstein, 2007, p. 24). As this spiritual aspect of the mind also
bears directly on the relationship of conscience to contact with an
authentic self, it will be examined here in depth.
Freud struggled between theism and materialism in his early
studies of philosophy and theology, and, at age seventeen, wrote,
“The bad part of it . . . for me lies in the fact that science of all things
seems to demand the existence of God” (Boehlich, 1990, p. 111).
Later on, he sought to frame psychoanalysis as a scientific endeav-
our, antithetical to religion. The notion that science and religion are
incompatible, however, is clearly rejected by many scientists,
including Einstein, who saw the scientist’s religious feeling as the
guiding principle of his life and his work. He noted that while
science was created only by those imbued with aspirations toward
truth and understanding, the source of that feeling:

springs from the sphere of religion . . . and the faith in the possibil-
ity . . . [of] a world . . . comprehensible to reason. I cannot conceive
of a genuine scientist without that profound faith . . . science with-
out religion is lame, religion without science is blind.” [Einstein,
1954, p. 55

A similar perspective can be found in Bion’s work, for he des-

cribes faith as analogous to a priori knowledge, calling it “a scientific
state of mind . . . [if] unstained by any element of memory or desire”
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(1970, p. 32). Faith, he says, is a necessary state of mind if one is to

have contact with O, representing absolute truth, the infinite, the
godhead, or the thing-in-itself, a reflection of a formless, unknow-
able, numinous essence beyond sensual reality. For Bion, as for
Einstein, faith is necessary to the idea that such a thing as truth and
ultimate reality exist. It becomes evident that Freud’s legacy vis à vis
religious experience is the basis for a fundamentally different view
of the mind than that of Bion, for whom the existence of O, or
absolute truth, “is as essential to science as to religion. The scientific
approach is as essential to religion as it is to science and is ineffectual
until a transformation from K ➝ O takes place” (ibid., p. 30). Bion also
addresses the differences in scientific and religious perspectives, and
the ways in which psychoanalysis encompasses them both.

The scientific approach, associated with a background of sense

impressions, for example the presence of the psycho-analyst and
his patient in the same room, may be regarded as having a base.
Insofar as it is associated with the ultimate reality of the personal-
ity, O, it is baseless. This does not mean that the psycho-analytic
method is unscientific, but that the term “science”, as it has been
commonly used hitherto to describe an attitude to objects of sense,
is not adequate to represent . . . those realities with which “psycho-
analytical science” has to deal. [ibid., p. 88]

The aspect of the personality with which psychoanalysis deals

cannot be represented through the usual scientific approach based
on data derived from sensuous phenomena. The analyst’s concern
is with O, the unknown and unknowable, so that a science of psy-
choanalysis needs to expand beyond the horizon of physical science
to include that which is metaphysical. “What is required is not a
base for psycho-analysis and its theories but a science that is not
restricted by its genesis in knowledge and sensuous background. It
must be a science of at-one-ment” (ibid., p. 89).
This is a revolutionary proposition in psychoanalysis. In order
to apprehend the infinite and unknowable realm of the mind with
which analysis is concerned, a different scientific perspective is
required of the analyst. This includes what may be considered to
be a spiritual view, because of its attention to an area beyond sen-
suous reality. The overtones of mysticism in Bion’s work are not
always acknowledged, and, although he disqualified himself from
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commenting on mysticism because of a lack of scientific evidence

(Bion, 1974, p. 105), his examination of O as a sort of cosmic intelli-
gence accessible, at least in part, to human thought, very much
includes it in the science of psychoanalysis. If it is religious, though,
it is in the sense defined by Einstein.

[The scientist’s] religious feeling takes the form of a rapturous

amazement at the harmony of natural law, which reveals an intel-
ligence of such superiority that, compared with it, all the system-
atic thinking and acting of human beings is an utterly insignificant
reflection. This feeling is the guiding principle of his life and work
. . . It is beyond question closely akin to that which has possessed
the religious geniuses of all ages. [Einstein, 1954, p. 50]

The concept of “God” is not seen as something supernatural, but as

a reflection of the natural mysteries of the universe. Bion echoes this
idea in his statement that to view faith as supernatural may simply
reflect “a lack of experience of the ‘natural’ to which it relates”
(1970, p. 48). He makes clear his belief in the central importance of
this experience. “[Newton’s] mystical and religious preoccupations
have been dismissed as an aberration when they should be consid-
ered as the matrix from which his mathematical formulations
evolved” (1970, p. 63).
Symington’s distinction between the concepts of the true and
false god is concordant with this view and sheds further light on it.

The realization of the true god in the personality is the product of

an inner creative act. This is in direct contrast to the presence of the
false god, which is through an act of submission in which the indi-
vidual psyche is crushed. The realization of the true god lays a
foundation in the personality for respect for the Self. [Symington,
2004, p. 119]

The “true god” represents an internal relationship to an experience

of O, an openness to the unknown which allows for curiosity and
so foments mental growth, unlike the placid acceptance of estab-
lished ideas which quashes the vitality of psychic life. Symington
sees the need in psychoanalytic work for a relationship or integra-
tion between religion, in this sense of the word, and science, stating
his view that “unless these two axes intersect then the process . . .
remains sterile” (ibid., p. 73).
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Richard Feynman, the physicist and Nobel Laureate, describes

the awe inspired by scientific facts. He refers to Man, for instance,
as “atoms with curiosity” (2003, p. 212), and contemplates the
mystery that this collection of atoms “. . . [can] look at itself and
wonder why it wonders” (ibid.). While some call this a religious
experience, Feynman makes clear his opinion that organized reli-
gion cannot contain the vastness of this experience, stating simply,
“The God of the Church isn’t big enough” (ibid.). Like Symington’s
false God, this God of the Church is seen as incapable of encom-
passing the depth, breadth, and vastness of the unknown and
unknowable domain of O. The reason for this centres around a
pivotal dichotomy, where the appreciation of the natural world is
associated with uncertainty, with questions, and the faith of church
dogma is associated with certainty, or answers (ibid., p. 214).
Nietzsche also presented two opposing perspectives on religion,
noting that it could be used as incitement toward higher spiritual-
ity, where conscience encompasses mankind’s overall development,
but that it also represented a sinister danger that has made man into
“a sublime miscarriage” (1886, p. 76). The latter suggests the kind
of mental distortion or abortive mental development occurring
when religion is used to palliate, thereby undermining knowledge
of its higher purpose; it is no longer used as a means of further
education but as sovereign in its own right. This distinction reflects
one of Nietzsche’s central ideas, the need for a new and courage-
ous state of mind, in his language, “a new species of philosopher”,
a new kind of thinker, or a “free spirit”. He calls them “friends of
Truth”, those who are unfettered by conventional ideas which mili-
tate against thinking (1886, p. 53). They are given the provisional
name of “attempters”, or experimenters, highlighting the idea of a
process, the aim of which is contact with the unknown (ibid., p. 52).
He relates this to the work of becoming one’s true self, a task, he
says, requiring a free spirit. “The expression ‘free spirit’ should here
be understood . . . [as] a spirit which has . . . seized possession of
itself” (Nietzsche, 1888, p. 89). Elsewhere, he connects this work of
developing one’s self with a moral imperative. “What does your
conscience say? You should become the person you are” (Nietzsche,
1887, p. 219). This is juxtaposed to the adherence to religious ideas,
which claim certain knowledge of that realm.
The intention in describing the schism between science and reli-
gion is not to demonize organized religion. We should note, in fact,
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that the official position of the Vatican allows for the importance of
scientific study, even when, as in the case of evolution, it contradicts
Biblical teaching. A 1950 headline in Italy’s conservative news-
paper, Il Giornale, read “Pope Says We May Descend From Mon-
keys” (Gould, 2003, p. 194). This statement referred to the ruling of
Pope Pius XII, who said that everything science determined about
the evolution of the body was acceptable to Catholics for it kept the
concerns of religion—the evolution of the soul—separate from the
concerns of science. The Pope used the term “non-overlapping
magisteria”, a term derived from the Latin, magister (meaning
teacher), to indicate why there was no conflict between science and
religion. His reasoning had to do with the legitimate magisterium, or
the proper teaching authorities, whether of science, whose domain
is empirical knowledge, or religion, whose domain is the assess-
ment of value and meaning. Pope John Paul believed, similarly,
that, according to this concept of non-overlapping magisteria, there
need be no conflict between the two realms. However, this delin-
eation becomes less clear in the case of psychoanalysis, a different
kind of science, which also concerns itself with the origin of mean-
ing and ethical behaviour. As Symington suggests and Bion’s writ-
ings imply, this requires integration between these two realms of
mental experience.

Container and contained: the new mind

The new, more courageous mode of inquiry that Nietzsche connects
with higher spirituality is defined more specifically in Bion’s theo-
ries of thinking. His theory of alpha function, for instance, as well
as the bi-modal theory of container and contained, speaks to a
dynamic process of mental integration, the capacity of thought to
contain and digest emotional experiences. Container and contained
() is a model of opposing functions which work together to
create a state of mental wholeness, which is the basis of vital and
creative thinking. It is a dynamic, ever-changing, and uncertain
state requiring the ongoing work of attention in order to remain
capable of change and growth. These qualities of being mentally
alive, however, may be experienced as fearsome instability.
None the less, this integrated state, born of a dynamic relationship
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between container and contained, is a cornerstone of Bion’s theory

of thinking, a precursor to the capacity for contact with the oceanic
experience of O.
Paradoxically, analyses of Bion’s work have often emphasized
one side of this equation of container and contained. The content of
his theories has been much more thoroughly explicated and under-
stood than the more amorphous function of a container, which is an
infinite unknowable mental universe. Perhaps the emphasis on
content is not surprising, then, as the function of that formless
mental container is more obviously difficult to conceptualize and
communicate than the mental contents of feelings and thoughts,
despite the fact that these psychical states are also intangible.
Theories about what seem to be more concrete mental contents, as
opposed to the formless background to those contents, may simply
be more misleading, as knowledge comes to be “possessed”, seen
as fixed as “pieces” of knowledge rather than part of the process of
becoming to which Bion refers. This ongoing process is inherent in
the theory of container and contained as the dynamic relationship
that creates the capacity for mental integration. It also provides the
container for a more accurate understanding of Bion’s contribution.
In Introduction to the Work of Bion, the authors acknowledge these
pitfalls regarding reification of Bion’s ideas. They make the point
that simply to clarify Bion’s theories can be deceptive, since the
realities these theories aim to illuminate are ambiguous and obscure
(Grinberg, Sor, & Bianchedi, 1977, p. xvi). None the less, they go on
to explain Bion’s theories, the “contained”, without much luck in
explaining the nature of the obscure new container Bion’s work
addresses. Since container and contained are each transformed by
its relationship to the other, an understanding of Bion’s model of
the mind requires an experience of the relationship between the two.
Without this, one is left with stale theories. The constant shifts in
that dynamic relationship form the basis of the experience of
mental birth, the emergence of the true self from the presumed
safety of its encapsulation.
This represents a sort of “catch-22” regarding our capacity to
think about or communicate about thinking. According to Bion
(1970), O is not attainable by K (his symbol for knowledge based on
sensual reality). In effect, this means that one cannot really distin-
guish between intellectual thought and the kind of creative process
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of thinking reflecting openness to O, unless one can already think

in this way. We might say that one cannot think without the means
to think, and one cannot develop the means to think using the
undeveloped apparatus which is often confused with thinking. Nor
can one tell the difference.
The realm of O is an immaterial realm of the mind, of thought
and feeling and spirit. An experience of it requires a shifting pers-
pective from unconscious to conscious modes of thinking, oscilla-
tions between paranoid–schizoid and depressive modes, from the
limitless, imaginative, and dream-like experience of reverie and
alpha function to the limiting attention and discriminatory powers
of rational and deductive systems. For a mind that is split and
unable to move freely between these two modes, the process of
psychological birth feels like a terrifying upheaval, full of uncer-
tainty, as one begins to experience these constantly shifting
dynamic movements in the mind. Access to deeper unconscious
awareness and integration with the emotional reality found there is
experienced by the individual as catastrophic, for it threatens one’s
entire existing system of beliefs, as well as the container which
holds them.
An ancient version of Bion’s (1970) idea of the catastrophic
danger posed by a new thought is expressed in the New Testament.
Jesus warns, “To put new wine in old wineskins is futile, for the
fermenting wine expands, the old brittle skins burst and both are
destroyed” (Matthew, 9:17). Like the brittle old skins, rigid mental
defences opposed to change are threatened by the expansiveness of
a new idea. The dynamic relationship between container and
contained, which threatens to destroy the containing function of the
mind, can also be seen as the “new wine” of Bion’s ideas, which
challenged existing psychoanalytic beliefs. However, it also
addresses the practical dilemma that faces the psychoanalyst in
every session, as any new idea can lead to the upheaval of growth
and mental birth, eliciting fear and resistance in the patient. The
problem is, the new idea cannot be effectively contained or thought
by the old mind, and yet the emergence of a new mind to accom-
modate it brings both analysand and analyst into contact with the
infinite Unknown, with “O”. One patient, “Allen”, whose case will
be illustrated at length in Chapter Five, described this experience
as feeling “. . . as if I’ve been de-constructed”. For him, it was a
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frightening feeling of dismantling the old mental system by which

he had lived his life, and yet the “old wine skins” of that fixed
system began to feel too rigid to hold his dynamic new thoughts
and feelings. Suddenly faced with the sense of an unfamiliar new
self, he felt like a stranger in his own world. He was caught
between two realities, feeling like a prisoner now in the old system,
and yet terrified of the uncertainty of change.
The mystic, genius, or exceptional person is someone who
claims “direct contact with O” (Bion, 1970, p. 117). Such a person,
unlike Allen (the patient mentioned above), is not imprisoned by
his own ideas but can experience the vastness of external and inter-
nal reality. This capacity is a function of a generative mind, vital
and creative, and Bion’s language suggests that this kind of mind—
a mental process, really, which allows for change, growth, and
creativity—is related to mystical experience. The mystic’s relation-
ship to truth through access to O differs from that of the individual
who knows that same truth only theoretically, through the kind of
knowledge represented by Bion as “K”. The latter engages “a
barrier against truth which is feared as annihilating to the container
or vice versa” (1970, p. 118). Behind that barrier lies the true self,
cloistered in a brittle unchanging container, a mental representation
of a finite womb in which there is no feeling, no growth, no life.
Like the old wine skins, that old, rigid, “petrified” self, frozen with
fear, cannot adapt to change or, in this case, mental growth or
expansion. The unborn self fears contact with all the realities of life:
birth, pain, time, death, “the slings and arrows of outrageous
fortune”, and all the forgotten, but endlessly relived, early
emotional realities “that makes calamity of so long life” (Shake-
speare, Hamlet, 3:1). The original “calamity” is the early trauma
that, replayed over and over in the mind, never really ends.

The “oceanic experience”

Freud’s religious orientation and his view of God as the child’s
image of an exalted father (1913–1913, pp. 149–152) has set the tone
for psychoanalysis. “Psycho-analysis,” Freud wrote, “infers that
[God] really is the father, with all the magnificence in which he once
appeared to the small child” (1933a, p.163). That definition of God
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addresses the early, idealized view of the parent, but does not
acknowledge any alternative view of an essential religious feeling
of the kind implicit in Bion’s theories of thinking. The latter repre-
sents a mind capable of integrating primitive modes of perception
with higher ego functions, a more developed mental level that facil-
itates contact with O. The child’s image of an omnipotent parent, on
the other hand, is a concrete view emblematic of a reified, anthro-
pomorphized God or deified Christ. This view, appropriately char-
acterized by Freud (1927c) as an illusion, is in line with religious
dogma to which religious institutions adhere. It reflects beliefs
based on sense data and a more primitive level of mental develop-
ment that does not distinguish, as Einstein did, between the God of
the “naive man” and the God of “the profounder sort of scientific
mind”. The former, corresponding to the exalted idealized father,
serves as a defence against the child’s feelings of helplessness; the
latter is a depiction of the dynamic and creative process which
incorporates those early helpless feelings. It underlies what Bion
refers to as “container and contained transformed”, a process of
mental integration which is necessary to scientific thinking, and
upon which apprehension of O depends (Bion, 1970, pp. 106–116).
In emphasizing this potential in the mind, Bion’s work brings atten-
tion to bear on that which comprises mental health and growth as
well as pathology. It aims at an understanding of the kind of func-
tion to which Einstein refers when he writes, “It is the most impor-
tant function of art and science to awaken [the cosmic religious]
feeling and keep it alive in those who are receptive to it” (Einstein,
1954, p. 48). However, psychoanalytic thought adds an important
idea to this discourse about the meaning of this cosmic religious
feeling, for it includes an understanding of its relationship to the
earliest emotional experience of the infant. As Bion sees it, the capa-
city for contact with O, related to that cosmic religious feeling, is a
necessary factor in the most complex functions of the mind, but has
its source in the most primitive functions of the mind. The relation-
ship between these two aspects of the mind is essential to the kind
of mental integration necessary for thinking and for creative work
of any kind, including scientific work, and is seen by Bion as essen-
tial to psychoanalytic work.
We might view Freud’s idea of conscience—as “God’s uneven
piece of work” (1933a, p. 61)—as a representation of the child’s
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anthropomorphic view of God as a parent, but one who has failed

the child. On the other hand, Kant’s view of conscience as the
mind’s most divine aspect reflects the inherent mental potential for
contact with “O”, the idea of the godhead as an expression of the
infinite and absolute truth.
Freud clearly alludes to such a distinction in his correspondence
with his friend, Romain Rolland, the celebrated French author.
Having written to Freud that he had liked The Future of An Illusion,
Rolland none the less expressed regret that Freud had not “properly
appreciated the true source of religious sentiments”. It was a feel-
ing, the writer added, which he himself was never without. In
response, Freud writes:

It is a feeling [my friend] would like to call a sensation of “eternity”,

a feeling as if of something limitless, unbounded—as it were,
“oceanic” . . . One may, he thinks, rightly call oneself religious on
the ground of this oceanic feeling alone, even if one rejects every
belief and every illusion. [Freud, 1930a, p. 64]

(Freud does not mention Rolland by name, but he is identified in a

letter published in Boehlich, 1992. See fn. 33.)
Freud was troubled by these views from someone he considered
to be “an exceptional man”, for he admitted he could discover no
such “oceanic” feeling in himself. Rolland saw religious feeling as
distinct from illusion and able to coexist with logic and reason. For
him, this oceanic feeling is not an article of faith, but a “subjective
fact” (Freud, 1930a, p. 64). Freud’s less transcendent views about
religion have had a lasting effect on psychoanalysis. Fear and
stigma exist around the subject because of its associations with the
primitive and sometimes pathological conceptions of God, without
making the distinctions from the spiritual essence to which Rolland
and Bion refer.
The relative neglect of the subject, which, for better or for worse,
has been central to human life, has a notable exception in Freud’s
later work, Moses and Monotheism (Freud, 1939a), which offers a
thoughtful discussion of Judeo-Christian philosophies about God
and its relationship to the capacity for abstract thought.
Rolland’s statement approximates to Bion’s idea of faith as a
scientific state of mind (Bion, 1970, p. 32). Both are describing an
experience that, like Kant’s “thing-in-itself”, is essentially unknown
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and unknowable. O, Bion writes, “does not fall in the domain of

knowledge . . . it can be ‘become’, but it cannot be ‘known’ “ (ibid.,
p. 27). Meltzer (Meltzer & Harris, 1988) describes O as the absolute
essence of an emotional situation, equivalent to the state of being in
love. Religious, spiritual, or mystical experience, like mental expe-
rience in general, is intangible, and so cannot be apprehended
through knowledge gained through sense impressions. It is
noumena, not phenomena, although it can become knowable as O
becomes manifest in phenomena. Although the analyst’s experience
of O—the patient’s essential reality—is not based on data derived
from the senses, it must evolve through that which can be observed
by the analyst: the patient’s words, dreams, associations, the tone
and timbre of his voice, his gestures, as well as the analyst’s
emotional experience of these things. The analyst is called upon to
become one with these experiences, bringing about what Bion calls
an “evolution in O” (1970, p. 27). By this process, the analyst is in a
position to bring thought to bear on these messengers from the infi-
nite unknown. It requires the analyst to let down his or her guard
in a way similar to how one does when asleep, so that one can dream
while awake one’s experience of the session and of the patient. This
state allows more direct contact with the moment and, as Bion
points out, can only be reached through the suspension of memory
and desire, a rigorous discipline of temporary abstention from
entertaining one’s hopes for the future or one’s reliance on what
one already knows.
For Bion, this experience of O is the basic psychoanalytic
perspective. If the analyst is to make contact with the patient’s
essential experience, he must “focus his attention on O—the
unknown and unknowable” (ibid., p. 89). The requirement for this
state of mind is what Rolland described as religious. Bion clearly
The idea of infinitude is prior to any idea of the finite. The finite is
“won from the dark and formless infinite”. Restating this more
concretely the human personality is aware of infinity, the “oceanic
feeling”. [Bion, 1967, p. 165]

Freud could not solve his dilemma about Rolland’s religious feel-
ing, for his friend’s statement about faith “fits in so badly with the
fabric of our psychology” (1930a, p. 65).
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Freud does relate the oceanic feeling to the infant’s experience

of oneness at the breast, a state in which the ego is still undifferen-
tiated, but he views its persistence in the personality as a sign of
neurosis, a regressive return to the “limitless narcissism” of that
early state (ibid., p. 72). This theory does not include the possibility
of an ego capable of developing to the point where it can encom-
pass both the capacity to differentiate self from object while also
retaining contact with that early mode of mental functioning.
Rather, the two states of mind were felt to be mutually exclusive,
with the developed, adult ego of necessity cut off from that primi-
tive state of mind as part of normal development. “Our present ego-
feeling is only a shrunken residue of a much more inclusive—
indeed all-embracing—feeling which corresponded to a more inti-
mate bond between the ego and the world about it” (ibid., p. 68).
The “shrunken residue” of the adult ego is implied to be an inevit-
able condition of normal mental development, while it may instead
represent the effect of a pathological defence, a self split off as
protection from contact with one’s own primitive mental states.
Winnicott addressed this idea of an inclusive ego, stating, “Id func-
tioning is normally not lost; it is collected together in all its aspects
and becomes ego-experience” (1962, p. 56). The distinction between
an inclusive ego-feeling or one which excludes primitive experience
also reflects the differences between Bion’s ideas of mental devel-
opment and those of Freud, and even Klein. Klein, like Freud, saw
the child’s relationship to the mother in terms of physical (eroge-
nous) zones, while Bion saw it as epistemological, based on a means
of learning and acquiring knowledge (Meltzer 1984a, pp. 51–70).
Mental development, in other words, is not viewed by Bion as
biologically determined, as Klein supposed. It is dependent instead
upon the relationship with a mother capable of particular mental
functions related to containment of the child’s emotional life.
Meltzer makes the point that while Freud’s and Klein’s theories are
essentially correct in that they describe what actually does take
place in the mind, Bion’s model builds on these. He describes Bion’s
epistemological theory of a mind as a “developmental process
[which] extrapolates toward wisdom, from ignorance to wisdom,
whereas Klein’s concept of development sees the mind as evolving
from disintegration to integration—a very structural concept”
(Meltzer, 1984a, p. 68).
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Grotstein (2004, 2007) writes about this “truth drive”, or “truth

instinct”, as a “hidden order that runs through the entirety of Bion’s
work” (2007, p. 52). Although the resistances to thinking and to
mental change and growth are balanced by this natural instinct
toward truth, the ego’s defence mechanisms, Grotstein says, are
engaged in an effort to obstruct the eruption of truth into conscious-
ness. I would suggest that this kind of ego is often a reflection of the
false self, whose aim it is to avoid contact with feelings.
Bion outlines the functions necessary for this development. First
of all, there is the mother’s capacity for reverie, or receptivity to the
infant’s projective identification, which, in this aspect, is viewed as
a means of pre-verbal communication. Related to this is her capa-
city for alpha function, whereby her mind can function as a sort of
mental womb, a containing function capable of dreaming for the
infant his or her as yet unthinkable feelings and thoughts. The
infant is then felt to introject these maternal mental functions of
reverie, containment, and alpha function, thus facilitating the
development of the infant’s own capacity to dream, digest emo-
tions, and, ultimately, to think. Without this containing mental rela-
tionship, those unthought feelings are projected, but never
received. Unable then to be processed or digested, either by the
mother’s or the child’s mind, the ego becomes impoverished, a
shrunken or empty version of a self divested of its emotional expe-
However, this ego does not remain merely shrunken; it grows,
but in pathological ways, to take on the attributes of a false self.
Genuine emotion is replaced by the “lies” which masquerade as
real, and the child becomes the “accomplished liar” to which Bion
(1980) referred. The real self, starved of truth, continues to shrink,
withering behind the barrier erected against emotional reality.
Freud’s (1930a) reference to the ego’s capacity for that earlier
“intimate bond” with the outside world represents the model for
the potential development of mental integration brought about by
real emotional connection to those early states of mind. Huxley
(1932) describes the oceanic feeling using different terms. He quotes
Goethe who, when speaking to someone suffering from a painful
toothache, advised him, “You must live in the All, then you would
be happy” (Huxley, 1932, p. 19). The “All”, Huxley says, is a feel-
ing of oneness with the world, a feeling, however, which is always
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fleeting, for one must also live in the world of bodies and separate-
ness and toothaches.

The all-feeling is brief and occasional; but . . . the great predomi-

nance in our lives of the not-all feelings [does not] necessarily inval-
idate an all-theory any more than a theory of molecular movement
is invalidated by our almost constant sense of the solidity and
stability of matter. [Huxley, 1932, p. 20]

Metaphysical reality, though unavailable to the senses, may still be

real, although, as Huxley points out, we do not know. Like O, it
remains part of a reality that is ultimately unknowable.
Freud’s notion of the shrunken ego seems to reflect the idea of
the imprisoned or encapsulated self cut off from its capacity to
experience the oceanic, the “All”, or O. It is a self unable to tran-
scend, even for that fleeting moment, the sense of separateness to
which all human beings are subject. It stands to reason that, with-
out the conscious awareness of separate existence, one cannot expe-
rience the oneness which transcends separateness. Paradoxically,
one remains in an undifferentiated state, a phantasy of oneness in
which neither oneness nor separateness is real.
One can describe this state as oceanic, as essence, as the All, as
religious, or as O, but, as Huxley points out, “The names are many,
but the experience, the state of awareness, is only one” (Huxley,
1932, p. 24). A differentiation does need to be made, however,
between the infant’s access to this state of mind before conscious
awareness of separateness and the mentally developed adult version
of O, or spiritual oneness, based upon an awareness of separateness. Just
as daytime realities distract from the ongoing state of dreaming that
is continuous throughout waking life (Bion, 1992), the infant has far
greater access to this state by virtue of a lack of ego capacities that
serve as distractions from contact with O. This represents a funda-
mental difference in these experience, which Bion represented in his
idea of an evolved version of Ps ↔ D
Obstructions to contact with O, the oceanic or religious feeling,
are often a function of the more detached “shrunken ego”. At
around the same time that Freud wrote what he did about the
shrunken ego, Brierley seemed aware of a developmental signifi-
cance to the infant’s primitive oceanic feeling in relation to the
object, for she referred to it as “the prototype of mystical experience”
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(1936, p. 265). Along these lines, many ancient Eastern philosophies

view the loss of the ego and the feeling of oneness with the universe
as the highest goal of enlightenment. Again, however, the infant’s
oneness at the breast clearly should not be confused with enlighten-
ment, for it is not contained within the capacity for thought,
which is dependent on the awareness of separateness. Still, it is the
contact with those early experiences, integrated with the capacity
to think about them, which forms the foundation of the true self
upon which consciousness or enlightenment depend.

Bion’s concept of faith

Bion remarked that, although Freud regarded “belief in religion as
an illusion, he had no doubt about the actual existence of the illu-
sion”. The apprehension of this, or any illusion, can become mani-
fest to the analyst only through a state of hallucinosis, which can
only be reached through an experience of faith: again, faith as a
scientific state of mind distinct from its usual religious meaning.
Bion (1970) differentiates this state of hallucinosis from pathologi-
cal hallucinations.

. . . I do not regard [hallucinosis] as an exaggeration of a patholog-

ical or even natural condition: I consider it rather to be a state
always present but overlaid by other phenomena which screen it. If
these other elements can be moderated or suspended hallucinosis
becomes demonstrable; its full depth and richness are accessible
only to “acts of faith” . . . to appreciate the experience of halluci-
nosis the analyst must participate in the state of hallucinosis . . . By
eschewing memories, desires, and the operations of memory he can
approach the domain of hallucinosis and of the “acts of faith”; by
which alone he can become at one with his patient’s hallucinations
and so effect transformations O  K. [1970, p. 36]

This “always present” state of mind is related to the primitive

oceanic experience, and to O. Bion explains that, since ultimate
reality or absolute truth cannot be directly known, one must
have faith that such a thing as truth exists, and so, for Bion, the
state of mind necessary for apprehension of O is faith. Faith is an
aspect of “patience”, which Bion relates to Keats’ idea of “Negative
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capability” (1970, pp. 124–125), a state of mind in which “. . . man

is capable of being in uncertainties, Mysteries, doubts, without any
irritable reaching after fact and reason” (Keats, 1818, p. 329). This
state of mind is the essence of listening in the analytic process, of
Freud’s “freely hovering attention”, and Bion’s suspension of
memory and desire. Although the analyst, while listening to a
patient, may find himself in the darkness and confusion of complex
and incomprehensible material, he or she requires faith that, by
waiting patiently without jumping to a known theory or premature
interpretation, and without searching desperately for an answer,
an answer will come. Bion (1970) describes the transition from
“patience” to “security” as a later development of the transition
from the paranoid–schizoid to the depressive position, distinguish-
ing it from the primitive level of development and pathological
usages of those terms. He goes on to express the critical importance
of this process. “I consider that no analyst is entitled to believe that
he has done the work required to give an interpretation unless he
has passed through both phases—’patience’ and ‘security’” (1970,
p. 124).
Bion makes it clear that this “act of faith” belongs to the system
of O and not to that of K (knowledge derived from sensually based
experience). “The ‘act of faith’ has no association with memory or
desire or sensation. It has a relationship to thought analogous to the
relationship of a priori knowledge to knowledge” (ibid., p. 35).

Desire, memory, and understanding are based on sensuous experi-

ence . . . Anxiety, depression, persecution are not . . . If the mind
is preoccupied with elements perceptible to sense it will be that
much less able to perceive elements that cannot be sensed. [ibid.,
pp. 41, 47]

Behind Nietzsche’s statement, “The religious person is an excep-

tion in every religion” (1887, p. 185), is an assumption, like Freud’s,
that the basis of most religions is illusion. Nietzsche distinguishes
this illusion, however, from his idea of a “new philosophy” based
on a process of free and creative thinking that continually questions
conventional judgements of good or bad derived from the more
primitive morality and faith in religious dogma. In Bion’s terms,
these belong to the system K, based in desires, sensations, and
memories of previous knowledge or experience. Freedom from
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conventional thought or judgement is necessary for contact with O,

and so Bion advocated for rigorous questioning of preconceived
notions of all that we believe we know. À propos of this, he advised
the analyst to “keep one’s questions in good repair” (Bion, 1978a).
He even questioned the assumption of psychoanalytic cure as good,
viewing unexamined assumptions about cure as determined by the
expectations of the patient, who may find it difficult to experience
the destruction of the self as “good”. He writes, “Too much of the
thinking about psychoanalysis precludes the possibility of regard-
ing as good a theory that would destroy the individual or the
group” (Bion, 1992, p. 378). We must be willing to include, in other
words, the possibility that a good psychoanalytic outcome would
be the destruction of the individual or the group, for destruction
may be in the service of a more authentic self. My patient who felt
he was being “de-constructed” in the course of our work (p. 30),
certainly did not experience this as good, and to an outside viewer
he may certainly have appeared to be getting worse. None the less,
he continued, as he could also recognize by then that he felt more
Like Nietzsche’s ideas about a higher state of mind beyond
good and evil, Bion’s view speaks to the need to discriminate
between ideas which protect mental or social stability to the detri-
ment of the mind’s vital health and capacity for truth. Bion writes,
“The patient has a breakup, or a breakdown, rather than a break-
through. Many a facade has been saved by the misfortune that had
made it a successful ruin” (1977a, p. 47). These “successful ruins”
are “cures” that may originate from the failure to question the
notion of cure, and that may instead simply shore up the defences
which reconstitute a false self. A “cure” based on an identification
with the analyst, for instance, may mirror the childhood “cure” of
identification with a parent, behind which the real self languishes
unknown. On the other hand, the mental birth and emergence of
that real self seems to spell disaster to the patient, for it brings with
it the deconstruction of the old shrunken self which has taken its
place, but to which the patient clings as the only self he has known.
The basis of a true conscience resides in the capacity for know-
ledge of, and contact with, the real self, the only aspect of the
personality able to imbue one’s actions with meaning, thereby
allowing the individual the means by which he can evaluate his
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own standards of good and bad beyond those learnt through iden-
tification with the parent and the demands of a primitive superego.
Freud, by his own admission, had little personal experience of
the oceanic feeling, that kind of mental experience viewed by Bion
as essential to a psychoanalytic perspective. This experience is also
essential to contact with the true self upon which conscience
depends. Bion’s notion of “at-one-ment with O” may be visualized
as oceanic, as if being awash in waves of a fluid unconscious
process of hallucinosis and other mental processes outside the
realm of the senses. The ability to tolerate and make use of this
experience is based on a dynamic relationship between container
and contained. This can be juxtaposed to the “shrunken ego”
described by Freud (1930a), whose capacities are limited to a more
intellectual understanding of unconscious processes characterized
by K, which might be visualized as looking at the waves of uncon-
scious experience from inside a boat or from the safe distance of the
shore. The former is a process of continuous and vital mental
energy; the latter, a concrete structure imagined to be contained
within the mind. This unconscious phantasy is an illusion of
certainty, control, and stasis designed to give solace by dispelling
the fearsome lack of control and painful vulnerability inherent in
any real experience of life.

Clinical vignette
A short vignette of two dreams from the analysis of a patient
(whose clinical material is discussed in depth in Chapter Five),
illustrates these states. “Grace” is a bright, intuitive, thirty-one-
year-old woman who, at the time of this session, was in law school.
She has problems with overeating, often binging on sweets, a tena-
cious and sometimes violent defence which obliterates her aware-
ness of separateness and need, along with her mind. She alternates
between unbearable neediness and fierce independence, a defence
she required early on in relation to a volatile and undependable
psychotic mother and an emotionally detached father. At the time
of these sessions, she had been feeling increasingly vulnerable and
sensitive to her primitive needs, as well as angry and resistant, for
she had been suffering for almost a year the painful process of
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emerging into her true self. Shortly after a week-long break she
reported this dream.

I was going to a school function and noticed urine stains on my skirt. I

saw Dr X there [a professor she doesn’t like]. I stopped at my parents’
house at the beach to wash my skirt, then saw outside a huge wave,
30–40 feet high. There were surfers trying to go over the wave and I
wanted to tell them, No! You need to dive through it! The wave crashed
. . . lifeguards were pulling bodies out to resuscitate them and I saw a
man who had died. I felt so sad.

Grace said she had been plagued by her desire to overeat during
the break and had ended up binging. For the purposes of this
vignette, I will not give a detailed account of her associations, but
this and her other thoughts led me to think that, in my absence over
the break, her primitive feelings of loss, anger, and need were too
much to contain, a sort of emotional incontinence represented by
the urine stains. Although she had tried valiantly to manage her
feelings by resorting to her old defences, identifying with an ideal
mother so she could clean herself up without my help, her huge
waves of feelings overwhelmed her mind’s capacity to bear the
frustration and await my return. I felt that what had died in this
flood of feeling was her connection to me, for, in my absence, I had
become like Dr X, someone she does not like and cannot trust. At
the same time, severing that connection to me also represented the
death of her connection to her own mind, that is, her capacity to
think about her feelings, which had also drowned under the unman-
ageable force of those feelings. Her belief that she could “clean
herself up” by relying on the phantasy of my (or mother’s) presence
(her binging as a representation of her possession of the breast)
dispenses with any possibility for real emotional contact. Her
efforts are, therefore, incompatible with the survival of a real self
based on awareness of her need for attachment, and so also incom-
patible with the development of thought.
The next day, Grace reported a fragment of a dream which,
interestingly, included a similar image.

Again there was a huge wave, but this time I felt the surfers would be OK.

Grace felt extremely anxious today. She noticed that the positive
feeling in this dream did not correspond to her conscious feeling.
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She explained how difficult it had been to wait to see me again, and
had wanted all day to binge on sweets. She had managed to control
those impulses and instead to focus on studying for a forthcoming
exam. Her ability to think, as well as her actions, indicated to me a
sufficient awareness of, and capacity to tolerate, the pain and frus-
tration of her feelings of need for and connection to me, so that they
did not have to drown. The discrepancy between her anxiety and
the positive outcome in the dream revealed that, in being able to
think about those feelings rather than take action to evade them,
she was now able to “suffer” the feelings, in the sense that Bion
used the word, as being able to feel the feeling rather than have it
act upon one unconsciously. In the latter case, the patient feels that
unconscious pain without knowing what it is. The patient, Bion
writes, “can feel the pain but not suffer it, and so cannot be said to
discover it” (1970, p. 9). Grace had “discovered” her feeling, and,
having mentally attended to it, she could think about it.
Bion’s idea also differentiates an internal experience of pain from
the sense of pain as something inflicted from without, and, in
Grace’s case, the previous session had put her in touch with her
feelings sufficiently to contain it, so that she not only had pain, but
could suffer it and so could become aware of it. Although she felt
worse, the integrity of her mind was protected by a capacity for
awareness, based on her ability to tolerate the pain and frustration
of having a feeling. It exemplifies Freud’s ideas about primary and
secondary process modes of thought in “Formulations on the two
principles of mental functioning” (1911b). Grace had substituted
thought for the action of binging, which, for her, represented a state
of hallucinatory wish fulfilment of possessing the breast, a more
primitive primary process “solution”. In the second dream, her
mind and her true self had, at least at this moment, survived the
tumultuous, primitive oceanic waves through the sophisticated
function of thinking. This facilitates contact with reality, her essen-
tial reality—the experience of O.

Freud’s view of mysticism

In another letter to Rolland, Freud alludes to his awareness that the
mystical perspective may reveal more of the soul than the so-called
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rational approach of analysis, and that descent into the emotional

experience of unconscious states may be less familiar to the analyst
than to the mystic, musician, or writer.

To me, mysticism is just as closed a book as music. I cannot imag-

ine reading all the literature . . . which you have studied. And yet,
it is easier for you than for us [psychoanalysts] to read the human
soul. [E. Freud, 1960, p. 389]

Freud concludes his argument concerning the oceanic feeling by

admitting that he is “not an out-and-out skeptic” (ibid., p. 393), but
expresses how difficult it is for him “to work with these almost
intangible quantities” (ibid., p. 72). Bion’s idea, however, is that the
fundamental requirement of analytic work is precisely the ability to
work with those intangible qualities: “. . . the psycho-analytic
vertex is O” (Bion, 1970, p. 27). Freud’s admission is, therefore, an
exceedingly important one, for what is at issue is a change not only
in the content of analytic theory, but the process of thinking that the
analyst employs to do his work. Bion’s image of “binocular vision”
expresses the idea that what is required is an oscillating perception
from both vertices, of rational linear thought and the oceanic back-
ground of emotional experience. The concept of container and
contained () is a model for this kind of integration.

The relationship between mother and infant described by Melanie

Klein as projective identification is internalized [by the infant] . . .
The activity that I have here described as shared by two individu-
als becomes introjected by the infant so that the [container/
contained]  apparatus becomes installed in the infant as part of
the apparatus of [thinking]”. [Bion, 1962a, p. 91]

The absence of a mother who can contain the infant’s early

projections of primitive feelings, whether those of anger, terror, or
love, therefore obstructs both the capacities for emotional aware-
ness and containment, and the capacity to think. The child’s capa-
city for a dynamic interchange between these dual functions of the
mind—container and contained—cannot develop, nor can the
conscious access to an authentic experience of the self. This idea of
the self or mind as an intangible process of dynamic energy, rather
than a fixed entity, was described by Groddeck as early as 1923. “I
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am by no means ‘I’ [ego],” he wrote, “but a changing form in which

the ‘It’ [id] displays itself, and the ‘I’ feeling is one of its tricks to
lead man astray” (1923, p. 238).
Though he was a student of Freud’s work, Groddeck’s ideas and
impressive intuition were also recognized and highly respected by
Freud, whose concepts of the ego and the id were influenced
by Groddeck (ibid., pp. v–vi). However, their theories diverged
in essential ways. While Freud saw the mind in terms of the two
halves of conscious and unconscious, with the ego as supreme,
Groddeck viewed the mind as an integrated whole which was a
function of an unknown force he called the “It”, described as “. . .
the sum total of a human being, physical, mental and spiritual”
(ibid., p. vi). This mysterious and autonomous function of the mind,
he felt, directed man’s thoughts and behaviour, and, while it was
the source of illness, he made it clear that this enigmatic force was
also the source of health. The ego, on the other hand, was seen as a
product of the “It”, a kind of mask imposed by the intellect. The
statement, “I live,” he said, more accurately means, “I am lived by
the It” (ibid., p. vi).
Like Bion’s concept of O, Groddeck’s “It”, unknown and
unknowable, is also a source of terror and awe. “About the It itself,”
Groddeck says, “we know nothing whatever” (ibid., p. 240). His is
a spiritual perspective, again distinguished from religious iconog-
raphy, with its concrete systems of belief, which distract one from
the essentially non-sensual aspect of the experience, and Groddeck
makes it clear that the “It” is not a thing but a tool to think about
mental experience. He was aware of how language can be used to
freeze ideas into what Bion (1970) would call “saturated” elements,
words or concepts so laden with associations that they become
meaningless in the mind and cease to be effective for use in think-
ing or learning. As Groddeck put it, “. . . any definite term destroys
the symbol” (1923, p. xix), and so, also like Bion, whose symbols
such as O, or “alpha” or “beta” elements, were intended to be
empty concepts, Groddeck intentionally uses a neutral term, “It”, in
order to retain its indefinite meaning and allow for creative use of
Fairbairn also stressed the relationship between the mind and its
contents as a process of dynamic energy: “Energy [is] inseparable
from structure” (1952, p. 149). His was an integrative model of
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dynamic relationships between internal objects that diverged

fundamentally from the more mechanistic approach of Freud’s
drive theory. Fairbairn’s view of object relations reflected the uncer-
tainty of modern science and quantum physics, and so differed
even from Klein’s perspective.

Because Klein remained dedicated to Freud’s drive theory even

while stressing the importance of object relations from the begin-
ning [of life] . . . her theory, like Freud’s, remained grounded in the
mould of nineteenth century mechanical physics . . . Fairbairn
altered his orientation fundamentally. [Scharff & Birtles, 1997,
p. 1086]

While Freud paints a picture of the individual divided against

his instincts internally and at odds with the external world, Fair-
bairn’s perspective is of a mind that is always relational, a “twenti-
eth century view . . . interactive and interdependent” (ibid., p. 1089–
1090). The capacity to apprehend what Freud called the “intangible
quantities of the mind” is the background of the true mind and
authentic self, from which conscience evolves.
The foregoing discussion on spirituality and religion is included
to make clear the idea that contact with that which is called a spir-
itual aspect of the mind is a factor in the function of thinking, without
which there can be no foundation for the true self, the foundation
as well for a mature conscience. Thinking is derived from the capa-
city to contain emotional experience, including those earliest prim-
itive mental states related to the infant’s oceanic experience. The
essence of a religious aspect of the mind is not, therefore, somehow
detached from, or on the fringes of, mental life, but has an inte-
grated place in it. Like Bion’s ideas about faith as a scientific state
of mind, this spiritual state differs fundamentally from religious
ideation or any particular religious faction, representing instead the
essence of religious feeling and its source in primitive emotional
life. The fear of stigma still exists in psychoanalysis around the
subject of religion, due to the failure to make this distinction, which
then makes it possible to be confused and associated with the dead-
ening effects upon the mind of institutionalized thinking. The
essence of religious or spiritual feeling to which Einstein and Bion
make reference is the wellspring of the awe and mystery at the
heart of the mystical experience, but, lacking integration with early
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emotional life in the form of thought, the meaning of these kinds of

experiences can and do degenerate into a purely emotional system
of beliefs based on the unmentalized (Mitrani, 1995) version of
those early states. It remains, that is, an unconscious primitive
emotional experience, which Freud described as an illusion, one by
which the individual is unconsciously ruled. Those dogmatic,
systemized, and formulaic views of morality dictated by the
conventions of organized religion are attempts to impose order on
the confusion of good and bad upon which consciousness has not
been brought to bear. But it is a false order, like the one imposed by
a primitive superego, which develops out of fear, before the devel-
opment of the capacity to think. It lacks, therefore, the necessary
foundation upon which the capacity for a healthy and mature
conscience rests.
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Theories of conscience

“God has done an uneven piece of work [when it comes to

conscience], for a large majority of men have brought with
them only a modest amount of it or scarcely enough to be
worth mentioning”
(Freud, 1933a, p. 61)

reud asserts that sexual life exists in the child from the begin-
ning, but that conscience does not (1933a, pp. 59–60). “Young
children are amoral, and the part which is later taken over by
the super-ego is played to begin with by an external power, by
parental authority” (ibid., p. 62).
Freud did not believe in the existence of “an original, as it were
natural capacity to distinguish good from bad” (1930a, p. 124). For
him, there is no universal moral law derived from an inner moral-
ity, the sort reflected in the Old Testament statement, “I will put my
law in their minds and write it on their hearts” (Jeremiah, 31: 33).
He does seem, at times, to contradict this, for, in a letter comment-
ing on religion and psychoanalysis, he clearly states his agreement
with the idea, “What is moral is self evident” (E. Freud, 1960,

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p. 308). However, in general, Freud upholds an empirical perspec-

tive. “There are no sources of knowledge of the universe other than
the intellectual working over of carefully scrutinized observations
. . . in other words, what we call research” (Freud, 1933a, p. 159).
According to him, what is bad in the beginning is the prospect of
loss of love, a learned “ ‘social’ anxiety” (1930a, pp. 124–125). He
describes “two origins of the sense of guilt: one arising from fear of
an authority, and the other, later on, arising from fear of the super-
ego” (ibid., p. 127). He distinguishes the terms conscience, guilt, and
superego as different aspects of the same thing, describing con-
science as “a function ascribed to the agency of the superego” (ibid.,
p. 136), which serves to censor the actions and intentions of the ego.
Conscience does not exist until the superego is present as an internal
structure, he says, but guilt predates conscience and superego. That
earlier sense of guilt comes from fear of external authority, while
conscience or superego is derived from fear of the internal author-
ity of the superego, based on the incorporation of, and identifica-
tion with, the parents. The sense of guilt, Freud says, “is at bottom
nothing else but a topographical variety of anxiety; in its later
phases it coincides completely with the fear of the super-ego” (ibid.,
p. 135). Conscience is seen to be driven by fear of punishment by
the loved object or its internal representative.
With the onset of the ego ideal, also based on the internalized
demands of parental figures, the individual “sets up an ideal by
which he measures his actual ego” (Freud, 1914c, p. 95). This
becomes the superego, which Freud equates with conscience, but
which, in its primitive aspect, places unrealistic, even violent
demands upon the self. He describes the superego as an observing
function of the ego resulting from a split in the ego. When this
observing function becomes sharply divided from the ego and
displaced on to external reality, it gives rise to a pathological super-
ego (Freud, 1933a, p. 59).
In Civilization and its Discontents Freud points to man’s instinc-
tual disposition to aggression as “the greatest impediment to
civilization” (1930a, p. 122). He defines civilization, whose purpose
is to combine single individuals into a larger unity of mankind, as
“a process in the service of Eros”, which is engaged in a struggle
with an instinct toward disunity, or death (ibid.). On an internal
level, conscience serves to mitigate the aggressive instinct, which is
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internalized and directed toward one’s own ego. A portion of the

ego then sets itself against another in the form of a superego, and
the struggle between these two forces gives rise to conscience (ibid.,
p. 123). Freud explains, however, that aggression toward the parent
is not renounced.

By means of identification [the individual] takes the unattackable

authority into himself. The authority now turns into his super-ego
and enters into possession of all the aggressiveness which a child
would have liked to exercise against it. [ibid., p. 129]

Freud does take note of Klein’s discussion as to why the severity of

the child’s superego fails to match the severity of treatment
received by the parents, but, unlike Klein, who explains this with
reference to the child’s unconscious sadistic phantasies projected
into the parents, Freud attributes this discrepancy to constitutional
factors (ibid., p. 130).
In a letter to Einstein concerning the problems of war and
aggression, Freud writes, “The ideal condition . . . would be a
community of men who had subordinated their instinctual life to
the dictatorship of reason” (1933a, p. 213). Freud’s use of a language
of domination and control suggests an understanding of a mind
dominated by a wilful ego, whose tactics are those of a punishing
superego rather than those of reasoned thought applied to an
understanding of instinctual life.
Freud’s (1923a) notion of the superego—a psychical agency
which measures the ego against an ideal—reflects a sense of guilt
for acts or thoughts unknown or imagined, which may never reach
awareness. He discusses unconscious guilt in terms of a sadistic
superego and a masochistic ego, a need for punishment related to
the death instinct, which gives rise to a severe conscience. He also
discusses this need for punishment in terms of the negative thera-
peutic reaction.

We come to see that we are dealing with what may be called a

“moral” factor, a sense of guilt, which is finding its satisfaction in
the illness and refuses to give up the punishment or suffering . . . as
far as the patient is concerned his sense of guilt is dumb: it does not
tell him he is guilty; he does not feel guilty, he feels ill. This sense
of guilt expresses itself only as a resistance to recovery. [Freud
1923a, p. 49]
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What Freud brilliantly defines as the superego is, in my view,

the beginning of the development of a pathological conscience. It is
viewed, however, as the normal development of this natural human
capacity. Because Freud described what is essentially a prevailing
condition, it seems accurate to call it “normal”, but more in the
sense of the “norm” or average than denoting normality or health.
The origin of a healthy conscience is not even addressed.
Klein (1933) considered the ideas about the development of
conscience to be one of the most important contributions of psycho-
analytic research, and her work on the role of pre-Oedipal sadistic
impulses toward the object in superego formation represented a
major contribution to the discourse. Unlike Freud, who placed the
onset of the superego at the time of the resolution of the Oedipal
complex at around age five, Klein saw the superego as born of anxi-
eties related to oral sadistic impulses in early infancy (Riviere,
1936). She felt that

the super-ego begins at the same time as the child makes its earli-
est oral introjection of the objects . . . the first imagos are endowed
with all the attributes of the intense sadism belonging to this stage
of development. [Klein, 1933, p. 251]

However, like Freud, she believed that the superego was first of all
an external agency. In “The early development of conscience in the
child,” she writes:

According to [Freud’s] findings, which psychoanalytic practice has

borne out in every instance, the person’s conscience is a precipitate
or representative of his early relations to his parents. He has in some
sense internalized his parents. There they become a differentiated
part of his ego—his super-ego—and an agency which advances
against the rest of his ego certain requirements, reproaches and
admonitions, and which stands in opposition to his instinctual
impulses. [ibid., p. 248]

Neither Klein nor Freud saw the punishing superego as an accu-

rate representation of the actual parents, but Klein went on to elab-
orate the projective and introjective processes underlying the
transformation of their images in the infant’s mind. She distin-
guished between the adult superego as an approximation of the
parents and the more phantastic character of the child’s superego,
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reflecting primitive pre-Oedipal phantasies of oral, anal, and ureth-

ral aggression. The new parental image, transfigured by projections
of the infant’s own pre-Oedipal envy, jealousy, and rage, is now
introjected by the child as part of his superego. The superego “is
created out of imaginary pictures or imagos of [the parents, so that]
. . . The child’s fear of his objects will always be proportionate to the
degree of his own sadistic impulses” (ibid., pp. 249–251). The projec-
tion and reintrojection of the child’s aggressive phantasies, she
asserts, forms the core of a cruel superego. With the genital phase,
the nature of the superego changes so that there is less anxiety and
more a sense of guilt. At that point, “. . . the super-ego shall have
developed the character and function from which the person’s
sense of guilt. . .—i.e. his conscience—is derived” (ibid., p. 256). Her
ideas about the adult superego, however, still retain Freud’s notion
of conscience as a representation of the internal parents.
Freud places the beginning of conscience at the resolution of the
Oedipal complex at around age five, while Klein places it at the
primitive Oedipal complex at the onset of the depressive position
at around four months. For Klein, this is the origin of the infant’s
capacity for guilt, the initial stage in the development of conscience.
With development, the splitting of the object in the paranoid–
schizoid position gives way to the infant’s ability to integrate his
experience of the frustrating or absent “bad” mother and the
nurturing and containing “good” mother. Feelings of guilt arise in
this awareness of the mother as a whole object, as destructive
impulses toward the “bad” mother are now also seen to be directed
to and damaging to the “good” mother. This is at odds with Meltzer
and Harris’s (1988) assumption of an original state of mental whole-
ness, an idea also at the foundation of my understanding of the
basis for a healthy conscience.
“The wicked man flees when no one is after him; the virtuous
man is bold as a lion” (Proverbs, 28: 1). This passage from Proverbs
expresses something of the idea of paranoid or unconscious guilt.
Since a phantasy is experienced in the unconscious as a real action,
the individual holds himself responsible for his imagined “wicked”
acts. In the legal system, ignorance of the law is not a valid defence,
and it seems that ignorance of the laws of human nature offers no
defence in the internal world, either. As Klein’s theory of projective
identification describes, the talion principle applies in the inner
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world and the payment for one’s “crime” in the internal court of
justice is unconscious or paranoid guilt. Depressive guilt, on the
other hand, can be experienced consciously, and so can lead to
responsibility for one’s destructive phantasies against the object
and to reparation for the damage done in thought. Conscience orig-
inates, then, in the awareness of the destructive mental act against
the valued object.
Since the infant is not yet developmentally capable of tolerating
awareness of separateness and the frustrations attendant to it, one
would expect the earliest experience of guilt, which Klein places at
four months, to be felt by the child as an entity of unknown origin,
a frightening and powerful visceral force which cannot be under-
stood. The infant’s experience of pain is undifferentiated, mind
from body, and the source and meaning of emotional or mental
pain would be a mystery. We see this often in adult patients as well,
where painful feelings of loss, fear, and so on are experienced as
inflicted from without, often by the analyst, an experience which
must be distinguished from an experience of mental pain. Although
this sense of inflicted pain may be the result of a projected feeling,
it may also be derived from this more primitive state of mind when
self and other, and mind and body, are, as yet, undifferentiated.
While Klein saw the infant’s early guilt as only the earliest stage in
the development of conscience, the painful feeling of guilt would
still most probably be undifferentiated from a feeling of internal
punishment from the internalized parent or superego, not a true
sense of guilt. In the latter, differentiation and awareness would
depend on the capacity to recognize separateness.
Paul (1997) talks about a primordial conscience with influences
before birth that he describes as the rudimentary basis for the devel-
opment of an extremely harsh superego whose penitential punish-
ments are meted out in torturous phantasies. He also makes the
point that a psychological birth is required if one is to be released
from the mental prison of this Draconian conscience (ibid., p. 100).
However, any progress or movement in that direction triggers this
primitive superego to stop all development, often resulting in an
impasse in treatment. This hermetic state of mind is akin to a phan-
tasy of being in the womb, an idealized notion of a safe world and
a refusal mentally to emerge into what is felt to be too frighteningly
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Like Freud, Klein addressed the social importance of under-

standing primitive phantasies in relation to conscience. “Repeated
attempts to . . . make [humanity] more peaceable have failed,
because nobody has understood the full depth and vigour of the
instincts of aggression innate in each individual” (Klein, 1933,
p. 257). Her ideas, which provided crucial understanding of the role
of phantasy in early emotional life, have also sparked debates
concerning the vicissitudes of inherent aggression and the role of
the environment in stimulating it. Although she acknowledged to
some extent the effects of early trauma and environmental failure
in contributing to excesses of envy and aggression, this was not her
focus. It is an awareness that was developed further by Fairbairn
and became central to his work.
Meltzer addresses the split between good and bad in his theory
of the aesthetic conflict. It is derived from Bion’s ideas about mental
development and an epistemophilic drive, and describes the
infant’s primary conflict born of intense and profound feelings of
love and attraction for the mother. Meltzer and Harris conclude that
“the depressive position would be primary for development and
the paranoid–schizoid secondary” (Meltzer & Harris, 1988, p. 28).
As Begoin put it, with Meltzer’s theory . . . “Love, and not hate, was
being given the first place in development” (Begoin, 2000, p. 120, orig-
inal emphasis). Meltzer and Harris describe how the profound
appreciation of the mother as an aesthetic object toward whom he
is naturally drawn becomes painful as the infant also has an expe-
rience of her as an enigma whose meaning and internal reality he
is incapable of understanding. “The tragic element in the aesthetic
experience resides . . . in the enigmatic quality of the object”
(Meltzer & Harris, 1988, p. 27), which causes the child to “recoil
wildly from the impact of the aesthetic of the object” (ibid.). It repre-
sents an experience of a painful lack of understanding, which
presumes the presences of a need to understand—an episte-
mophilic instinct.
The simultaneous attraction and repulsion which Meltzer and
Harris describe also seems related to an early awareness of the
mother as a separate entity, which, at that stage of development, the
infant has no mental tools to understand. In cases of early trauma,
the child is forced precociously to become aware of his separateness
and so will try to understand before it is developmentally able to
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do so. The containment of feelings of love and attraction for the

mother would be especially unbearable with a mother who is not,
in Meltzer’s terms, “the ordinary beautiful mother”, or, in Winni-
cott’s terms, a “good enough mother”. In such cases, it becomes
impossible for the infant to reconcile such intense love with the
confusion of having its emotional needs unmet, giving rise to the
kind of massive primitive confusion between good and bad
described by Rosenfeld (1987, p. 273). The immature conscience, or
primitive superego, is a function of that confusion as the child is
withdrawn from emotional contact and reality. The real self, with its
instinctual capacity for attachment, is, meanwhile, sequestered
beyond conscious awareness, giving rise to a confusion between
good and bad which cannot be untangled unless it is made

Environmental factors in mental development

After an exhaustive research of Freud’s writings on the subject,
Symington reaches the conclusion that (with the exception of
Freud’s views in “The question of lay analysis” [1926e])

The notion of a healthy conscience . . . seems to be absent . . . We

must conclude that in all Freud’s works the assumption is that
conscience is . . . a persecutor and is something pathological in the
personality. [Symington, 2004, p. 41]

Symington’s view is that there exists a healthy conscience directed

by an inner guide, free of external threats of punishment. It does not
deny the inherent capacity for aggression, but considers the rela-
tionship between aggressive and libidinal capacities and how the
potential for these capacities is activated or obstructed by the
emotional environment in which the individual finds himself.
Metaphorically, the superego might be seen as the seed of con-
science that mutates as a result of forces acting upon it—receiving
the wrong or insufficient nutrition, perhaps, to grow in a healthy or
robust direction. Perhaps it was underfed or overfed, parched or
flooded, sown in inhospitable conditions subjected to blistering
heat or frigid cold until it could no longer grow into its potential.
Though still an oak, or a rose, it is deprived of its natural beauty. In
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the case of the child, one is still a child, still able to grow, learn,
become an adult, hold a job, and marry and have children of one’s
own. Conscience, though, has become a lacuna, a black hole into
which slips the potential for authentic growth of a healthy self.
In Group Psychology and the Analysis of the Ego, Freud talks about
morality in the individual and in society. He makes the point
repeatedly that people in crowds or groups are selfish, impetuous,
and surrender themselves to their instincts resulting in a low intel-
lectual and moral order (Freud, 1921c, p. 85).

Groups have never thirsted after truth. They demand illusion, and
cannot do without them . . . they are almost as strongly influenced
by what is untrue as by what is true. They have an evident
tendency not to distinguish between the two. [ibid., p. 80]

Freud’s observations about society also hold true within the

smaller nexus of the family, and the clinical material in the next
chapter shows how the child’s natural potential for conscience may
be waylaid by the illusions of that first group. Fairbairn’s ideas
outline in detail how parents, wittingly or not, project their uncon-
scious feelings into the child, as well as the other way around.
Although these ideas are based on Klein’s theories of object rela-
tions, Fairbairn refocuses psychopathological inquiry from the
impulse and the ego to the object toward which the impulse is
directed (Fairbairn, 1952, p. 60).

Any satisfactory theory of the development of the self must be

conceived in terms of relationships with objects, and in particular,
relationships with objects which have been internalized during
early life under the pressure of deprivation and frustration. [ibid.]

The mother’s negative behaviour, distractedness, and so on, he

states, causes the split to occur in the child’s mind, so that some of
what the child projects may be the introjections of what was first
unconsciously projected into him by the parents. The effects of this
are outlined by Rosenfeld in his views about confusional states, in
which “. . . love and hate, good and bad objects become confused,
creating an overwhelming and almost insoluble problem for the
developing infant” (Rosenfeld, 1987, p. 273). Infants, he says, are
acutely aware of the mother as a whole person from early on, of her
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mental states and her capacity to feel related to the infant. If she
lacks this capacity, the child feels traumatized and confused, giving
rise to a “sense of guilt which forces them to destroy their unusu-
ally sensitive capacities” (ibid., p. 33).
Winnicott addresses an idea related to these feelings. In no
uncertain terms, he states, “I suggest that the mother hates the baby
before the baby hates the mother, and before the baby can know his
mother hates him” (Winnicott, 1947, p. 200). He is talking about an
ordinary loving mother, but bases this idea on the inevitable exis-
tence of various remnants of primitive feelings in the mother, which
she is now asked to contain. Despite her love, having to sacrifice her
own infantile feelings of need to those of the baby gives rise to this
natural antipathy to her own helpless newborn. Her inability to be
aware of these difficult and unwelcome feelings increases the like-
lihood that the baby will absorb the unthinkable burden and con-
fusion. In “Recommendations to physicians practising psycho
analysis” (1912e) Freud warned of a similar danger in the analyst.
“Anyone who has scorned to take the precaution of being analysed
himself will . . . easily fall into the temptation of projecting out-
wards some of the peculiarities of his own personality” (ibid.,
p. 117).
It is apparent to any psychoanalyst that the fact of becoming an
adult or a parent (or a psychoanalyst) does not automatically
resolve primitive anxieties, confusions, or destructive impulses.
These will certainly be felt by the child (or patient) and, inadver-
tently or not, projected into him. Clearly, in the case of the analyst,
this is the reason for a training analysis, to avoid such unconscious
projections by maximizing conscious awareness, although the
nature of the unconscious makes it impossible to avoid completely.
We might need a better word for this than “projection”.
Projection is an active word, while this kind of transmission of feel-
ings can sometimes involve a more passive exchange of mental
energy. Perhaps, in less pathological environments, it may represent
what might be called an emotional contagion, implying a toxic
effect, but one with less overtly destructive intent on the part of the
parent. While overt traumas of abuse or neglect, which some chil-
dren endure, are easier to detect, the unconscious transfers of nega-
tive energy also result in mental trauma as the child finds himself
in the emotional bind described by Fairbairn’s “moral defense”, an
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internalization of the bad object in an attempt to protect the parent

(1952, p. 65). According to Fairbairn, the superego is established
with the formation of the moral defence.

It becomes obvious that the child would rather be bad himself than
have bad objects; and accordingly we have some justification for
surmising that one of his motives in becoming bad is to make his
objects “good” . . . He seeks to purge them of their badness and . . .
is rewarded by that sense of security which an environment of good
objects so characteristically confers. [ibid.]

According to this view, the child’s repressed hatred of the parent is

reactive or secondary to the inherent aggression proposed in
Freud’s Oedipus complex and Klein’s early Oedipus complex. Fair-
bairn goes even further, to suggest that “what are primarily
repressed are neither intolerably guilty impulses nor intolerably
unpleasant memories but bad internalized objects” (ibid., p. 62). It
is not the impulses that are bad, as indicated in Freud’s theory of
repression. In Fairbairn’s view, “Impulses become bad if they are
directed toward bad objects” (ibid.). Laing expressed the child’s
dizzying confusion when faced with a situation like the one
Fairbairn describes.

“Mother loves me
because she is good
I am bad, to think she is bad
therefore if I am good

she is good
and loves me
because I am good
to know she is good.”

“To be kind is good. To be cruel is bad.

It is bad to feel mother is cruel to me.

Mother is . . . only being cruel to be kind

because I thought she was cruel
to punish me
for thinking she was cruel . . .
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You are cruel

to make me feel bad to think
I am cruel to make you feel cruel
by me feeling bad that you can be so cruel as to think
I don’t love you, when you know I do”. [Laing, 1970, p. 12]

For the infant bound by these knots of pre-verbal “logic”, what is

most intolerable is the awareness that the parent is “bad”, which
includes the parent’s lack of awareness, understanding, or sensitiv-
ity to the child’s true self. One of the casualties of this emotional
knot is conscience, for any capacity for realistic assessment of good
and bad in oneself or others is obstructed by this fundamental
emotional confusion. Fairbairn describes it as the aetiology of
schizoid tendencies, which reflects the splitting off or numbing of
genuine feeling and the withdrawal into a false self. He refers to the
tragedy of the schizoid individual, who “. . . becomes subject to the
compulsion to hate and be hated while all the time he longs deep
down to love and be loved” (1952, p. 26). What arises in the place
of conscience is the kind of punitive superego based on identifica-
tion with a bad object. The awkward precocious attempts to under-
stand his dilemma gives rise to the erection of a false morality,
described by Bion (1962a) as a moralistic view that has no actual
moral foundation.
Bion’s thoughts about the superego developed from the idea of
an ego-destroying superego (1959) to a god hostile to the acquisi-
tion of knowledge of emotional experience (Bion, 1962a). This
“god” is anti-growth, characterized by a moralistic attitude and a
ubiquitous presence in groups and social institutions. In its most
pathological form, it is stimulated by envy, and becomes “an envi-
ous assertion of moral superiority without any morals” (ibid., p. 97).
Symington (2000) notes that Klein disagreed with Bion’s use of the
term “superego”, believing it should be reserved for internal

Clinical vignette: “Allen”

I would like to give a brief example from a session in the treatment
of a forty-two-year-old business executive, whose case forms the
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bulk of the clinical material presented in Chapter Five. A more

extensive history will be given at that time, but, for now, I will give
enough information to help illustrate the dynamics described by
“Allen” was adopted after spending three months in a foster
home. His adoptive parents, a loving but unstable mother and an
emotionally detached father, divorced when Allen was two years
old. The mother became clinically depressed in Allen’s adolescence,
and the fourteen-year-old boy became responsible for the family in
many ways. He grew into a generous and caring man who has
enjoyed considerable financial success. However, his feelings of
primitive terror, rage, and despair had long since been split from
awareness, and his engaging personality was driven by a compe-
tent, but false, self.
On the day of this session, Allen chattered on while I felt
increasingly anxious, unsure how to approach what I sensed was a
lot of anxiety and confusion underneath. He finally said, “I had a
strange dream where I had to kill an innocent woman. She looked
like a combination of Shirley Temple, Judy Garland as Dorothy in
The Wizard of Oz . . . and my mother.” Allen felt horrified, saying,
“Who could kill Dorothy or Shirley Temple!?” He was relieved,
however, that he had not actually killed the woman in the dream,
whom he felt did not “deserve to be killed”. He mused for a
moment then said, “Everything turned out OK for Dorothy . . .
unlike my mother.” As the session progressed, it occurred to me
that his relief may have been ill-founded, and based on a funda-
mental level of moral confusion. It seemed to me that if he were to
be his real self, Allen would have to “kill” the idealized mother/
Shirley/Judy in his mind, so that not killing her in the dream repre-
sented his resistance to feeling his genuine feelings of terror and
rage. His dilemma is clear, however, for he felt he had to preserve
the image of an “OK” mother, with whom he had become identi-
fied, to preserve the denial of the emotional reality of his very “not-
OK” mother. I thought that my anxiety during the session might
reflect this resistance, for in not denying or “killing” his idealiza-
tion, he was, in a sense, “killing” or denying the truth, his self, his
treatment, and me. His verbosity was one means of trying to project
all of this unconscious hatred and confusion he could not bear to
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The idealized internal parent is a transformation in phantasy of

all the confusion and anger toward the real parent, a phantasy
which must be challenged to facilitate contact with the real self.
However, this feels like a violent act against the self, and, in fact, is
a violent act against the false self, and so feels like a murder. Chal-
lenging or exposing the false self, empowered and protected
through the agency of the pathological superego, is experienced as
a catastrophic blow as that outmoded self is dismantled. Allen,
therefore, experiences the analysis as killing him, an attack against
which he feels compelled to defend himself.
Ultimately this has to do with a fear of separateness. For some-
one like Allen, whose birth was accompanied by abandonment and
loss, birth feels like death. He clings to the idealized maternal
imago as protection from that unthinkable loss, and to be born
again into those forgotten feelings also feels like death. Any idea of
separateness breeds instant terror, and every whisper of mental
progress feels like a threat, bringing swift retribution from a super-
ego which is anti-growth and anti-life. It is associated with the
traumatizing “bad” or abandoning object, now confused with a
wonderful and perfect mother.
Fairbairn’s ideas about the place of bad objects in the aetiology
of repression differs from Freud’s view of repression as the result of
guilt for Oedipal impulses (1927c, p. 19). For Fairbairn, “what are
primarily repressed are neither intolerably guilty impulses or intol-
erably unpleasant memories but intolerably bad internalized
objects” (Fairbairn, 1952, p. 62).
The dilemma seen in Allen’s dream—how to tolerate separate
existence of mental birth—is illustrated in the beginning scene of
the Hindu poem, The Bhaghavadgita. The young warrior, Arjuna,
finds himself facing his own family in battle, and, feeling dizzy and
overwhelmed, he becomes paralysed. He calls on Krishna for help.

“Should we not be wise enough

to turn back from this evil,
o stirrer of men, as we see before us
the wickedness of annihilating the entire
family?” [Bolle, 1979, I: 39]

Krishna replies by educating him to the ways of the spirit—the

“changeless supreme self” (XIII: 31), which “dwells in all and
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everything alike” (XIII: 28). In order to know this more transcen-

dent self, Arjuna must fight and vanquish his parents in his mind.
In psychoanalytic terms, he must become conscious of “bad” inter-
nal objects, which, in Fairbairn’s terms, are always “bad” objects, as
they serve to repress aspects of the true self. The “changeless
supreme self” is a version of that authentic self which is capable of
contact with emanations of O—the infinite and unknowable truth
(Bion, 1970). As we will explore in detail in the next chapter, contact
with O is obstructed by the ego as it reflects these old identifications
with the parents.
A similar message is expressed by Christ, who here represents a
symbol of that divine knowledge or absolute truth. “Anyone who
prefers father or mother to me is not worthy of me” (Matthew, 10:
37). He makes clear the dangers of this battle for one’s own mind,
a mind capable of perceiving higher truth beyond the conventions
of group or family.

Do not suppose that I have come to bring peace to the earth: it is

not peace I have come to bring, but a sword. For I have come to set
a man against his father, a daughter against her mother . . . A man’s
enemies will be those of his own household. [Matthew, 10: 34]

This civil war waged in the internal world is the heart of the moral
dilemma one faces in the battle to embrace one’s essential nature.
As implied in Nietzsche’s ideas about a morality “beyond good and
evil”, this seemingly destructive act against the family group is the
basis of true morality. In “killing” this identification with the
parents, one dismantles through awareness the illusions and ideal-
izations that destroy the mind’s capacity for contact with absolute
truth, as well as the agency of the rigid superego which holds them
in place.

Innate moral sense

Unlike Freud, Jung saw the superego as “a natural and inherited
part of the psyche’s structure” (Jung, 1958, par. 830f). Although
Freud did consider the beliefs of others, like Kant, of the pres-
ence of a “moral law within us” (Freud, 1933a, p. 163), his answer
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to the question of whether or not there is a universal moral law

is that there is not, there is only intellectual and empirically derived
knowledge (Freud, 1933a). In a discussion of the difference between
religious and scientific perspectives on conscience, Edmund Bergler
(1948) points out that the pivotal point around which the debate
centres is whether or not conscience is inborn. In his view, the
religious approach assumes an act of God as the basis of con-
science, while the scientific approach describes observable facts,
such as that the infant shows no manifestations of conscience
without parental education, and that defence mechanisms and the
identifications with the parents bring conscience into existence later
on. The child’s compliance with toilet training resulted in what
Ferenczi referred to as “sphinctermorality”, which was also felt to
be forced upon the child’s mind in the first two years (Bergler, 1948,
p. 1).
What can be observed now, after years of various kinds of
research in infant behaviour, is different from what could be
observed sixty or seventy years ago. Even then, however, Bergler
(1948) raised the question as to what made the child internalize
the educator. It is an important question, the examination of
which casts some doubt on the idea that there are no innate mani-
festations of conscience. Attachment theory, object relations theory,
neurological studies, and infant observation all reveal an instinct
toward attachment to an object, which, I believe, is an antecedent
to conscience and the foundation upon which its development
depends. Unlike Freud’s “hydraulic” model of instinctual drives,
of build-up and discharge of libidinal energy, Fairbairn (1952)
describes libidinal energy as object-seeking from the beginning of
life. Bowlby (1958) discusses this as an innate instinct for at-
tachment. It is this innate physical and mental need for attach-
ment that I believe provides the motivation for the child to heed
the parents’ teaching, a need for attachment which may be viewed
as a precursor to what later develops into love. Klein’s description
of the infant’s impulse to protect the parents from aggressive and
destructive phantasies also gives evidence of an innate sense of
From this point of view, it seems feasible to consider conscience
to be a kind of organic wisdom based on a priori knowledge which
functions to preserve attachment in the face of the forces against it.
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Klein’s theories of early anxieties in the paranoid–schizoid position

imply that, even at this very primal level, attachment, and its even-
tual development in feelings of love, would be known to be life
preserving and therefore good, while rage and hatred (as distinct
from normal aggression), experienced as destructive to object-
relatedness, would, therefore, be bad. The essence of moral behav-
iour could then be described as that which aims toward love,
attachment, and life (in which we would have to include both libido
and normal aggression), and immoral behaviour as that which
aims toward lack of connection, fragmentation, and death. Again,
life and death are defined not only in physical terms, but in terms
of the survival or death of the psyche and the self. Either way,
according to the above definition, it does not seem accurate to view
children as “amoral”, for infants are driven with great power
toward the breast, the source of physical survival, and to the
mother’s psychic function as a nourishing object upon which men-
tal survival depends.
Nietzsche (1887) notes an instinctual source of conscience as
well. “The voice of conscience is never immoral, for it alone deter-
mines what is to be moral” (p. 263). In asking, however, how one
knows that one has judged correctly, he concludes, “Your judgment
‘this is right’ has a pre-history in your instincts, likes, dislikes, expe-
riences, and lack of experiences” (pp. 263–264).
None the less, to say that infants have an inherent moral sense
does not imply that they are moral or know what morality is. The
child’s potential for knowledge, wisdom, and morality needs to be
developed in relation to a containing object. The infant’s mental
development seems analogous to the plight of Adam and Eve,
whose knowledge of good and evil, though contained within their
Garden, has not yet been tasted. Likewise, the infant’s innate poten-
tial for knowledge of good and evil upon which conscience is based
already exists in his or her mind, but as proto-mental thoughts
which cannot yet be thought. In Voltaire’s words, “Il faut cultiver
notre jardin” (1759). The innate potential for knowledge must be
cultivated, for, despite the knowledge that may exist in the still
untended garden of the infant’s proto-mental experience, he does
not yet consciously know what he knows.
As regards the fundamental nature of conscience, Bion’s view is
more in line with Jung’s than with Freud’s.
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The moral impulse is extremely primitive . . . conscience cannot be

appreciated unless its primitive nature is recognized. Unfortunately
we have to use terms like “super-ego” which immediately suggests
something which is above everything else. It is much more likely to
be underneath everything else, basic, fundamental. [Bion, 1978b,
p. 5]

Although we do use terms like superego, it seems necessary to

distinguish this primitive superego from a mature conscience, or
one capable of maturation. This primitive superego remains undif-
ferentiated from the more developed version of this natural
impulse and, in my view, needs to be addressed as potential that
requires development.

Guilt and the negative therapeutic reaction

According to Freud (1933a), patients in whom unconscious guilt is

excessively strong can be recognized by their tendency to regress
when progress has been made. He describes this negative thera-
peutic reaction as a resistance to progress in the treatment, which
results in an exacerbation of their symptoms instead of improve-
ment. Behind this, Freud sees “a ‘moral’ factor, a sense of [uncon-
scious] guilt, which is finding its satisfaction in the illness and
refuses to give up the punishment and suffering” (Freud, 1923,
p. 29). The illness is felt to be just punishment for the patient’s guilt
for unconscious transgressions. From the point of view of object
relations, however, there are other explanations for this behaviour,
as we can see in the following brief clinical vignette.

Clinical vignette
Sarah W is a thirty-two-year-old musician who has had some
success in her field. She sought treatment while suffering severe
anxiety, a kind of mental and physical breakdown in which she felt
physically ill—achy and fatigued—in addition to feeling fright-
ened, vulnerable, lost, and suicidal. Her mother was highly anxious
and depressed, and Sarah seemed to idealize her, despite the fact
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that she often expressed hostility and annoyance toward Sarah and
her older brother for insignificant things.
After two months of treatment, Sarah was no longer suicidal,
but she continued to feel lost and plagued by hypochondriacal
symptoms. She often missed sessions, and seemed somehow absent
even when present. She found it difficult to trust people, including
me, of course, and was frequently silent, unable to talk, remember
dreams, etc. She eventually overcame her distrust of me sufficiently
to use the couch, and she began to make progress. In one session
we saw that, despite her outward discipline and success, she had
never really learnt to work; her true self, in other words, was
disconnected from her external life and achievements and so, essen-
tially, she did not feel she existed. She was extremely troubled by
this realization, feeling she had “slid by” her whole life, and admit-
ted poignantly, “I feel like I don’t know anything.” Feeling utterly
vulnerable, she could not believe that I, or anyone, would be inter-
ested in what she had to say. However, it also seemed that “not
knowing anything” was a good place to start to learn. This painful
reality represented the first tentative indication of the birth of her
real self.
The next day Sarah dragged into her session complaining of
excruciating pain in her jaw and mouth. She felt bereft, and angry,
though at nothing in particular. When I asked if she had any
thoughts about the problem with her mouth, she replied with impa-
tience and annoyance at my stupid question . . . “We speak with our
mouths, we express ourselves with our mouths . . . I don’t know.”
I thought, however, that she had hit on the problem. I pointed out
that she had allowed herself to speak her real feelings yesterday
despite her vulnerability and fear that I could not possibly be inter-
ested, and was now coming down very hard on herself for speak-
ing to me. Terrified of where this might lead, a very oppressive
force had been activated to prohibit her from speaking and stop all
progress. She then related a memory of her mother’s annoyance
with her for “breathing too loudly” at the dinner table. This oppres-
sive force seemed, then, connected to her identification with an
internal mother who cannot tolerate her existence, who will not
allow her even to breathe, much less speak or eat. Essentially, Sarah
was forbidden to be alive, although her awareness of this psychic
oppression had been completely split off. Her annoyance with me
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in the session indicated that she had become identified with that
internal mother who had no patience for her, and now for me, into
whom her painfully naïve, vulnerable child self had been projected.
Citing other examples of her mother’s rage, Sarah reluctantly
and with great pain acknowledged that she hated her mother for
her cruelty. Although she had silenced these feelings as a child, she
had installed this cruel mother as a searing superego who punished
her unconsciously for her anger. It was not only, as Freud sug-
gested, to silence her innate Oedipal aggression toward her mother,
but to silence her awareness of anger at her mother’s aggression
against her.
Through her tears, Sarah said, “I wanted to love my mother.”
The child wants to love, and will love, whether or not the conditions
are present for a real self to be acknowledged, nurtured, and loved
in return. With that real self locked away, the child succumbs to the
pressures of the family group, while unconscious and conflicting
feelings of love and hate give rise to the confusion described by
Fairbairn (1952) and by Rosenfeld (1987). We can see, in Sarah’s
case, that a crippling superego can be a reaction to the emotional
environment rather than internally motivated solely by an inherent
aggression or amorality. It is difficult to distinguish whether one is
dealing with inherent destructive aggression or aggression that is
secondary to trauma, including the trauma of parental projections.
In either case, however, whether it is primary aggression or aggres-
sion as a secondary reaction to trauma, the patient ultimately needs
to be responsible for the aggressive phantasies within his or her
own internal world. In silencing herself in our sessions, Sarah was
attempting to silence her now internalized mother, but was also
silenced by her.
Sarah’s self-loathing reflected her unconscious hatred of her
cruel internal object. She does not know whom to love and whom
to hate, and without the judgement to distinguish between the two,
she lives in the confusion of a cruel and undeveloped conscience.
Her hatred toward her loved object engenders unconscious guilt,
despite the fact that she feels justified, also unconsciously, in
attempting to protect the existence of a real self. She is compelled
to repress her hatred in order to preserve her love for her mother,
and to protect an undeveloped ego from overwhelming feelings of
guilt, self-loathing, depression, and dread. As Klein puts it, “In the
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last analysis the image of the loved parents is preserved in the

unconscious mind as the most precious possession, for it guards
against the pain of utter desolation” (1964, p. 98). This is an exceed-
ingly important idea, for this “most precious possession” not only
guards against the negative outcome of desolation and despair, it is
the first blush of love, the foundation of conscience.
The innate moral interdiction against hatred of one’s parents is
also clearly reflected in the Old Testament. “Whoever curses father
or mother in blackest darkness shall have his lamp snuffed out”
(Proverbs, 20: 20). The price for hating the parents is the extinction
of a sense of connection and of consciousness, the capacity for
awareness of internal and external reality, without which con-
science cannot exist. Sarah’s dilemma is described clearly in Fair-
bairn’s (1952) view of the origin of the superego as a defence against
bad objects, parents who, in one way or another, fail to value the
child in his own right. Fairbairn describes how the psychic confu-
sion between love and hate causes the child to attempt to cleanse
the image of the parent in his mind by making a bad object into a
good object and turning the self bad through identification with the
bad object. The result, he says, is that “Outer security is purchased
at the price of inner security” (Fairbairn, 1952, p. 65). This security
is maintained at further cost to that which he calls the “central ego”
(ibid., p. 85). Fairbairn writes, “It is better to be a sinner in a world
ruled by God than to live in a world ruled by the Devil” (ibid.,
p. 66).
The child makes the Devil’s loveless world good by making
himself evil. Fairbairn’s religious imagery of sinners and devils
connects the question of morality to the emotional and psychologi-
cal reality. The parent’s cruelty or emotional unavailability deprives
the child of the hope of understanding and love at that level of the
central self analogous to the ego or real self. To avoid awareness of
this intolerable reality, the child restores the hope of a loving envi-
ronment by making himself the “sinner”. In the process, reality is
turned upside down and one’s connection with inner and outer
truth is severed. His phantasy, or hallucination, of an ideal object
creates an illusion of love, which enables him to go on loving the
unconsciously hated parent. This transformation into idealization
and illusion prevents the ability to differentiate good from bad, and
obviates development of a healthy conscience.
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Clinical examples

case presentation can never adequately convey the living
reality of a session, the music and rhythm and feeling of
the session, the poetry, even, of what transpires between
two people each trying their best to tell the truth about profound
matters of mental life. But it is poetry that, as Robert Frost said, may
be lost in translation. However, I have tried to provide enough
detailed material for the reader at least to be able to think about the
ideas these sessions aim to demonstrate.
The world of dreams is a mysterious language of symbol and
metaphor reflecting not only repressed unconscious ideas and feel-
ings, but also an innate creativity and wisdom. The analyst is
entrusted with that creative, though often hidden, part of the mind
that he or she can then introduce to the patient. My work with
dreams has been influenced by Bion’s view of dreams as fuelled by
a desire for truth. Unlike Freud, who saw dreams as a way of dis-
torting and disguising repressed unconscious impulses, Bion (1992,
p. 186) began to view dreams as a form of unconscious thinking, a
means of processing and mentally digesting raw emotional experi-
ence to make it amenable to thought. The capacity to dream is, there-
fore, an integral part of alpha function, by which raw emotional

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experience is digested and transformed into the building blocks of

thoughts, or alpha elements (Bion, 1962a). The analyst’s capacity for
this dream-like alpha function forms the basis of his or her inter-
pretation; in essence, dreaming the patient’s dream. It is this, from
Bion’s perspective, which produces the latent content of the dream
by making it conscious for the patient (Bion, 1992, p. 135).
There are analysts who feel that the content of the dream is not as
important as the process of the session and the complex intersubjec-
tive relationship between analyst and analysand. In part, this is a
reaction to the problem posed by a one-dimensional or rigidly intel-
lectual focus on content that excludes attention to the actual experi-
ence of the two people in the room. In my opinion, both reflect each
other at every turn, and the content cannot, in fact, be accurately
interpreted without an understanding of the relationship as it exists
at that moment. The interpretation provides for the patient the
emotional narrative of which he is unaware, and which is necessary
to his ability to digest those unthought feelings and thoughts.
So far, I have given only clinical vignettes to illustrate some of
the concepts along the way. The following more extended presen-
tations from sessions with two patients—both prolific dreamers—
are designed to provide a sense of the process involved in working
with the emergence into an authentic mental life through the
process of psychic birth. I have tried to demonstrate the steps in the
development of conscience, from the recognition of the false self
toward the tentative awareness and experience of a true self. Only
an experience of one’s true self provides the possibility of making
judgements delineating what is good for, or destructive to, that
authentic self. The sessions track the shifting patterns of develop-
ment of a real self, and the obstacles to that development as the stir-
rings of life in the mind begin to disturb the patient’s internal stasis.
Paul’s (1997) work has been instrumental in the awareness of the
specific states of mind involved in this process of psychic birth,
which makes possible the conception and birth of a true conscience.

Clinical example: Allen

“Allen” is a single, successful businessman in his early forties, who
has been in treatment for nine years. He was adopted soon after
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birth, but spent three months in foster care because of the prevail-
ing adoption laws of the time. His adoptive parents divorced when
he was two and his mother had two more marriages after that.
Although troubled and confused, she was in many ways a caring
mother, but, after her second divorce, she suffered a breakdown
when Allen was fourteen, at which point a large part of the respon-
sibility for the household and for his clinically depressed mother
fell to Allen. With this disruptive history, Allen had little real
containment for his own emotional life, which was early on denied
and split off, giving rise to an accommodating false self. This mani-
fested itself in a gregarious and capable personality, an identifica-
tion with an idealized maternal image who exuded strength and
confidence. Allen is an innately sensitive and intelligent man with
a wide circle of valued friends. However, distantly removed from
his feelings, he was promiscuous through his twenties and early
thirties, often choosing women as emotionally distant as he. He has
not yet married, but his increasing access to feelings of vulnerabil-
ity and a growing desire for intimacy is currently reflected in more
serious and long-lived relationships with women.
Allen’s traumatic abandonment at birth came immediately but
indirectly to the fore in his first session with me, and I sensed a
great deal of terror at the prospect of opening up a wound to which
he had never consciously given much thought. He gave me a long
and detailed history of his adoptive family, going back two gener-
ations, which seemed to mask a more essential unconscious sense
of rootlessness. Abandonment continued to be the dominant theme
in his analysis. He had been told by his adoptive mother that he did
not cry as a baby, as if, I thought, he had already given up and cried
himself out while in foster care. As the despair and terror of those
first few months of life emerged, each of my vacations would
provoke terrible “meltdowns” characterized by angry outbursts at
me or promiscuous behaviour during the breaks. These “tantrums”
lessened as he became more able to think about his feelings. His
promiscuity ended after about two or three years of analysis, but
Allen still feels any break acutely and, until recently, continued
intermittently to split off his feelings to greater or lesser degrees,
depending on the current context.
These first two sessions are separated by four years, but I
present them because, not only do both express something of how
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the true self experiences its takeover by the false self, but they both
also use the imagery of physical distance to try to communicate
how far removed one can be from that real self.

Session one
This session took place after two years of treatment. Allen talked at
length about the frustrations at his office. He had previously found
the pressure exciting, gaining a manic sense of power and impor-
tance from it, but, at this point, more sensitive to his real needs, the
pressure usually engendered painful feelings of isolation. Today, he
said, he felt stretched to the limit by the amount of work and the
demands of overseeing so many people. He then told me his dream.

I was camping with Phil (a colleague); it was as if he was my best

friend. I had backpacked fourteen miles to the campsite and had to go
back to get Phil because he was scared to go alone. When I got back he
decided he wanted to go somewhere else to camp. I didn’t know what
to do because I had left all my stuff—the tent and my backpack—at the
Then we were somewhere else with a lot of other people. There was a
chart to tell where people would camp. I was paired with Hank—I
didn’t want to be, I wanted to be with Phil. It was weird but at some
point it was as if I suddenly knew I was dreaming and I thought, I’ll
just change the story of the dream, as if I’d never left all my stuff at the
other campsite. That would solve the problem.

He explained, “Phil isn’t my best friend, I’m just working with

him, but he’s a great guy, he’s honest and open, he never pretends
if he doesn’t know things. I respect him.” Allen continued, “The
campsite was beautiful, like a place I once camped . . . in the dream
I had left everything there, all my stuff—tent, backpack, every-
thing.” He had no thoughts at first about “fourteen miles”, but then
said, “I hated school when I was fourteen years old.” After some
discussion we realized that this was when his mother had her
breakdown, which he described as “the worst year of my life.”
The chart reminded him of work where they have a chart with
everyone’s schedules. “Things are hard there . . . so many people
I’m responsible for, all asking me questions. Sometimes I get tough
and hard just to get through . . . I’ve been feeling so unfocused.” He
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described Hank as “a nice guy, a beginner . . . he’s the receptionist

in the office, but he’s moved up to being my assistant so he works
for me now. Other people still ask him to do things for them though
so it gets confusing.”
He felt it was odd how he changed the story in the dream. “But
it was one way to solve the problem,” he said, “then I wouldn’t
have to walk back to the campsite.”
I told Allen that I thought his demanding responsibilities at
work are reminding him of how overwhelmed he felt at his
mother’s breakdown when he had to take care of everyone. He feels
now as he did then, unfocused and separated from himself, for, in
having to take care of everyone, he had to leave himself—his real
self—behind. According to his associations, Phil is honest, open,
and truthful, characteristics which were lost to Allen at that trau-
matic time when the reality of his life became too frightening to
experience. I thought the campsite—the “beautiful place”—repre-
sented his real self, a place, as he said, where he’d been before. His
comment, “Everything is there,” reflected his unconscious aware-
ness that contact with the wholeness of his real self represents
everything of value that, in order to survive, he had left behind.
The second part of the dream indicates that after he abandoned
his real self, the truthful part of him, he became tough and efficient,
hardened to his feelings and identified with a capable, idealized,
internal mother in order to take care of his actual incapacitated
mother. Lurking behind all of this, of course, was the earlier aban-
donment by his birth mother. The most interesting thing about the
dream is the way he changes the story as if to convince himself that
he had never left his “stuff” behind, for it reflects the lie he created
in his mind. It also indicates his confusion about the difference
between a dream and reality, “unfocused”, not really knowing
whether he is awake or asleep. I interpreted the fact that he was so
frightened of the reality in which he had found himself that he
simply changed the story in his mind, telling himself that he was
not a frightened “Phil” all alone with his terror and loneliness, but
a strong capable mother. With this mental “lie” as protection from
those feelings, he leaves the “beautiful place”, abandoning his real
self along with his capacity to apprehend reality and truth.
If we look at the rest of the dream, we see that once Allen iden-
tifies with the idealized mother, his relationship to Hank—the
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“beginner”, who seems to represent his real baby self—becomes

confused. He is now the assistant who “works for” that internalized
ideal mother, rather than working for his real self, and, like Hank’s
confused role at the office, Allen becomes confused, no longer really
sure who he is.
Although these dynamics of a deep split from his emotional self
reflected the much earlier trauma of his loss of his birth mother, at
this point in the treatment Allen was only beginning to understand
how he deserts himself, his feelings, and his mind. He had begun
to see something of his relationship to truth and reality that, once
severed, left him in the dark woods of his unconscious. Like Phil in
the dream, he is frightened to go back there, this time through the
work with me, to that moment when he changed his story, for that
“beautiful” self is also the one which feels the pain of that terrible
loss. Unconsciously, he senses that finding the beauty of his real self
therefore means finding unbearable pain as well.
This session also illustrates Meltzer’s idea of the “aesthetic
conflict”, for, although Allen’s birth mother left him after only one
day, we saw evidence that he was touched by the beauty of his
initial attraction for her in those early feelings of attachment. We
later learnt that he was breast-fed once by his birth mother before
the hospital nurse realized the baby was to be adopted. This pivotal
incident became a touchstone of Allen’s analysis. Unable to contain
this heartbreaking and mind-shattering loss, as well as the later
versions of an absent adoptive father and clinically depressed
mother, Allen simply created a new reality. Those ancient proto-
mental “thoughts” now appeared in the images of this dream. The
feelings to which Meltzer refers are based on an instinct for attach-
ment and love, but, as he writes, the infant may “recoil wildly from
the impact of the aesthetic of the object” (Meltzer & Harris, 1988,
p. 27). This would certainly be exacerbated in the presence of
trauma like Allen’s abandonment.
Allen has described his time before analysis as “being lost”,
promiscuous, using drugs, and feeling a general sense of unease.
None the less, without any awareness of his anxiety or depres-
sion at the time, the new “reality” he had created seemed to have
worked for him as he parlayed his early defences into profes-
sional success. The dream indicates that what he considered his
reality was actually the rejection of his emotional reality, which
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continued to exist at some incalculable distance from his mind.

Today, his vague sense of dissatisfaction, being “unfocused” or “too
tough”, represented the unconscious traces of knowledge of, and
yearning for, a real relationship with the self left behind, and with
The symbol of spatial distance as a metaphor for emotional
distance re-emerged in another striking example from Allen’s treat-
ment three years later. I present it here because of the similarity of
that imagery, an interesting unconscious effort to conceive of the
distance separating the self in those internal splits within the
personality. A true conscience, moral behaviour toward the self or
the object, depends on the bridging of that gap, for, despite what
appears to be scrupulously moral behaviour, the welfare of the self
cannot be protected without awareness of the unconscious phan-
tasy of its whereabouts.
A feeling of stagnation had taken hold in Allen’s treatment at
one point, as he plied his various defences of emotional detachment
to stave off the terrifying feelings of movement toward the rebirth
of real aspects of his self. At the time of this next session, however,
there had been a kind of breakthrough after Allen finally decided to
add a fourth session. His need for it had come up each time he
dared to touch the live wire of his early feelings and he would flirt
with the idea of increasing his times. Until now, he had always
backed down, as he once again found a way back to his internal
defensive structure. Increasing feelings of need for me and the
treatment over a sustained period of time were accompanied by
increasing terror, uncertainty, and doubt, and the fear that he could
not turn back.

Session two
My month-long summer vacation loomed in Allen’s mind. His
fear gave way to anger at me, although this time the strength of his
positive feelings seemed to have given him an uncharacteristic
sense that he would be able to remember me, that he would not, as
he put it, “disappear me”. At those times, he would become numb
to his feelings and I would cease to exist in his mind. Convinced I
was not coming back, he would be furious with me for weeks
before and after. Some sense of me as a consistent object was slowly
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developing, and this time, upon my return, he reported that he had

“done pretty well” in my absence. He had tolerated his painful
desire to see me, but, as my return drew near, he felt overwhelmed
by feelings of sadness and loss, which then gave way to anger with
me. Two days before the end of the break, he agreed to take a job
out of town, which meant he would be gone upon my return. He
felt immediately that he had made a huge mistake, for he thought
it was motivated by his anger and desire for “revenge”. While it did
seem that he had unconsciously tried to engender those needy,
waiting feelings in me, I was not sure whether it was for revenge or
to communicate how intolerable those feelings were for him, a
desire which was frustrated because of my absence.
Since he was away upon my return, we had agreed to have
phone sessions. Despite his awareness that he had made a mistake,
he sounded emotionally, as well as physically, absent. While the
dream in Session One indicated that he was fourteen miles away
from his real self, the distance was now experienced as much more
extreme. We might even say that the escape from his self had taken
him to the ends of the earth, for the job he had taken was in Pata-
He began by telling me how terribly he regretted having taken
the job. He felt he did not belong there, but did not really know
where he belonged, and the more detached he felt, the more he
attacked himself for having done this to himself. He reported “a
disturbing dream.”

It was like a visitation from my [maternal] grandmother. I realized in

the dream that she was dead so that’s why this felt like a visitation. We
weren’t that close when I was little but we got closer after I was grown
and I said in the dream how much I appreciated our getting close later
in her life. She said, “Are you ready to hold the owl?” I didn’t know
what that meant but I said, “Why would I want to do that, an owl is a
wild bird.” She said, “It won’t be what you think.”

Allen recalled that his mother had collected owl artefacts when
he was young. “I loved them too,” he said, “I loved anything my
mother loved then.” He said he had idealized his grandmother as
the one who would always protect and love him. I interpreted that
it was not only that he loved what his mother loved, but that he
loved his mother, although it meant being subjected to a host of
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confusing and painful feelings. I thought that the idea of holding

the owl represented the question of whether or not he was ready to
hold the wild feelings of his love for his mother mixed with his
sadness, disappointment, and anger at her for leaving. In the trans-
ference, I was also this idealized “grand” mother to whom he had
grown close later in life, and, while he appreciated and loved me,
he was again faced with the terrible feeling that I had abandoned
him. This was indeed a very wild combination of feelings, which he
felt that I, like his birth mother, had unfairly asked him to hold in
my absence.
Allen became aware of feeling great sorrow. “I don’t feel my
mind is big enough to hold all that,” he said. I commented that he
never felt he could, but since he had dreamt it now, there was some
indication that at least he was able to think about “holding the owl”
of these wild conflicting feelings. As he’d said, he had managed for
quite a while this time to think about me in my absence, and so
those feelings formerly lost in a proto-mental realm between mind
and body were in a position to be mentalized, at least for a while.
His underlying feelings of having to take care of his mother, and me
in the transference, consigned him to being a son with no needs of
his own. When this became too much to bear he ended up in “Pata-
gonia”, a mental place very far from himself that cannot be found
on any map. He had spent much of his life exiled from himself and
his feelings in that internal Patagonia which it has taken us years to
Clearly, these distances within the infinite universe of the
mind cannot be numerically computed, and I have no doubt that
“fourteen miles”, which served in part to indicate the time of his
mother’s breakdown, also served to minimize the seriousness of
the split. By the time of this later dream, he was able to tolerate a
more accurate depiction of the seriousness of this loss of self.
With increasing awareness of his false self, Allen was beginning
to suffer more directly the force exerted against his true self.
In Bion’s terms, O, now representing the power of that internal
oppressive force, had evolved to a sufficient point where Allen
could experience it. I thought that part of his detachment in the
session was an effort to detach from the effects of this primitive
superego, which “protects” him from these feelings, but in such a
destructive and ultimately more painful way.
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Session three
In the next phone session the following day, Allen sounded lost. He
found Patagonia interesting, he was meeting interesting people, but
was in despair. “I’m not suicidal or anything,” he said, “but noth-
ing has any meaning or interest to me.” Having turned away from
his needs he had killed his connection to me, so it already was like
an emotional suicide, leaving him numb and detached. I thought
that he felt himself to be that infant in the foster home with lots of
people around and lots to see, but with no sense of his place there
and no mother, there was no sense of meaning.
The theme of separation and emotional distance continued in
his dream.

I told Hannah [a close and admired friend] that I didn’t file a change of
address form with the post office and she said, “Well how are they
supposed to find you then?” I felt, Oh no, will this make me look bad,
like I’m dodging the law?

Allen expressed anxiety about the possibility of buying a new

house. I said I thought that unconsciously his anxiety today seemed
to have more to do with the change of address and having left his
feelings and his connection to me behind. It reminded him of the
multiple changes of address from infancy on: first displaced from
the womb, further displaced in the absence of his birth mother, and
finally his adoptive mother’s breakdown. The terror of those early
losses had provoked him to change his mental address, as we saw
in the dream about the campgrounds in Session One, vacating and
leaving his real self behind with no forwarding address. As these
vulnerable feelings return in the treatment, these old defences are
reactivated, and he tries to hide from me and from himself where
neither of us can find him. But he is then pursued by “the law”, in
part, he thinks, by me, but I think ultimately it is his own
conscience. When he fails to follow the laws of his own nature, he
feels pursued by his conscience, and his unconscious sense of what
is right and wrong makes him “look bad” internally. What looks
like a persecutory superego seems here rather to be the arm of those
natural laws which keep trying to bring him back to life, and so we
see a great confusion here as to which side he’s on. Winnicott
(1960a) talks about degrees of pathology of the False Self, based on
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different functions that allow or obstruct contact with the True Self.
It has to do with varying levels of awareness of the existence of the
Real Self, and, in these sessions, Allen seems unable to differentiate
These dreams, separated by two years, also seemed to represent
the formidable distance separating the contractions heralding his
mental birth.

Session four
The next day, Allen spoke in an animated way about his life, his
work, his girlfriend. Meanwhile, I found myself with an intolerable
feeling of deadness and meaninglessness, so I finally said that he
seemed to be missing from all he was saying. As in yesterday’s
dream of his unreported change of address, I did not know where
to find him. He replied, “I’ve been distracting myself all day with
activities.” He remembered a bit of his dream.

There were lots of people around, all my friends, and one by one they
came and talked to me about the meaning of life. They would say, “Life
is about . . .” but none of what they said really rang true. My favourite
uncle was there . . . so were Hal and Jane and George [all good friends].

He went on to say that all his friends were having troubles of their
own so it was probably true that they really didn’t know the mean-
ing of life either. He said, “I was aware that you weren’t there. That
seems significant since I really do come to you to help me with the
meaning of life, except that you do make sense of things. None of
what they said made sense.” He had an association to “a confused
story I read about parallel universes . . . full of existential ideas.
There was an alternative universe which had a shortage of renew-
able energy and it was stealing energy from the regular universe.
The people there were dying because they had no energy.”
I thought his dream represented a confused state of mind in
which he cannot distinguish his phantasies from his real life. I inter-
preted that these “friends” coming up to him were his internal
friends, who were trying to explain to him the meaning of life.
Despite their efforts, he was turning a deaf ear to them and saying,
“No, that doesn’t make sense,” for he was living in that alternative
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universe he created in his mind, a place without life, without feel-

ings, and without meaning. Although he had made a point of
saying that I was not there in the dream, as if he surely would have
listened to me, I think that, on the contrary, this was an empty
protest, and I was very much one of the “friends” to whom he
refuses to listen. Here, in fact, I was out of the picture entirely.
We can see these “friends” as another version of the “law” he is
dodging in the previous session’s dream, another manifestation of
a true conscience which is out of awareness, reaching out and warn-
ing him to no avail. It was his despair he had been distracting
himself from all day, for, in his alternative universe with “no
forwarding address”, he is isolated and lost in despair. Detached
from the real world, it is his false self which is stealing his energy.
The equivalent of Bion’s concept of K, he has negated life and
Allen said that it feels very unpleasant in that world, like being
nowhere, lost and without meaning. This is very different from the
excitement of a phantasy world, where he had always thrived on
“keeping busy, being on auto pilot”. As his real self emerges, he
feels more acutely the pain of being in a nowhere place where he
cannot distinguish between friends and enemies. In place of a
mature conscience, which can help him with these distinctions,
there is a merciless punitive superego, whose destructive effects
begin to emerge more clearly.

Session five
This next session, briefly reported, took place about ten months
later, during another business trip, this one to China. Work and
travelling had always been welcomed distractions from his feelings,
but he had come to dread these trips as the numbness and isolation
of flight was now as painful as the real feelings. Obviously, he
needed to work, but, in this instance, we could see that his uncon-
scious intention was a defensive need to escape the growing inten-
sity of his feelings, both in his treatment and in the relationship
developing with his new girlfriend. Once away, however, he again
felt displaced, frightened, and lost; he feared he was breaking down
and could not function. Although he said he felt some relief by the
end of this phone session, I still sensed his emotional detachment.
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Session six
In this phone session the following day, his anxiety had abated. He
said he felt more connected to me again, but then began attacking
himself. “I’m a bad person,” he said, “I’m so grateful to you for
your help and yet I had wiped you out of my mind when I went
away . . . I’m ashamed of the person I am because of these traits I
have . . . I feel hopeless because I keep doing the same thing when
I can’t stand the feelings.”
I pointed out that he found his feelings of guilt so painful that
the guilt itself had to be destroyed. Flagellating himself felt better
than feeling his guilt, because then he felt he was in control of the
bad feeling. In inflicting the pain on himself, however, the pain of
his need for me, as well as his remorse for his actions against me,
were both destroyed. I interpreted all of this, as well as my impres-
sion that he was trying to beat himself senseless so he could not
really feel anything. He became silent. He then said it was hard to
explain what he felt, but it was as if his feelings of having devalued
me had taken on a sort of density. I could hear in his voice a simi-
lar sense of density or substance, as if his words and experiences
now had meaning to him. He was listening to himself and his
words and he seemed real, which differed greatly from the words
that earlier were used to attack himself, words spilling thought-
lessly out of him, unconsciously meant to mislead us both.
These dynamics resonate with Bion’s statement about people
“who are so intolerant of pain or frustration that they feel the pain
but will not suffer it and so cannot be said to discover it” (Bion,
1970, p. 9). Allen felt need, and then guilt, but could not discover
them, for whatever awareness he had was quickly obliterated by his
self-inflicted pain, a defence against suffering the inevitable pain
and frustration of being mentally born into the real feelings of a
genuine self.
The following session took place a week later, upon his return
from the job in China.

Session seven
He started by telling me his dream.

I was in an empty office space being set up for a job where I was work-
ing. I had bought a piece of art, an abstract wall hanging, to make my
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office space beautiful. It had a pipe frame that had been taken apart and
I had to put it back together.

“I did buy a wall hanging in China,” he said, “it’s a beautiful

picture of a Buddha with lotus blossoms under him . . . the back is
signed by a monk, it’s blessed by him in a monastery so I guess it
has good energy.” He said that he had tried in reality to put the
frame together at work and had become frustrated. His assistant
had come in and seen him on the verge of tears, which disturbed
him, as she had never seen him like that.
He said that after having seen the effects of over-development
and overpopulation in China, he was feeling overwhelmingly
anxious about the environment. He had fears of apocalyptic world-
wide devastation. He had spoken of this in a previous session, at
which time I had interpreted his fear that if he actually felt the
intensity of his feelings of need and abandonment, he would be
devastated, like the end of the world. He now referred to having
thought about what I had said in that session, but was still in the
grip of terrible anxiety about the catastrophes that would result
from ecological imbalance.
I became anxious as he spoke, experiencing, I thought, an
ancient nameless dread behind these fears. The Buddha and the
lotuses, which grow in water, seemed to refer to his feeling like a
foetus, trying to maintain the illusion of being safely and serenely
contained but without any real way to “frame”—or think about—
the intense terror he was feeling. He was in that watery womb of
unconscious proto-mental experience, in desperate fear of what
would happen if he came out. For Allen, of course, the normal sense
of loss of the caesura of birth was profoundly complicated by the
loss of his mother and the further trauma of months in foster care,
and to lose his anaesthetized womb-like state of mind does feel to
him like the end of the world. He said, poignantly, how terrified he
feels that he will not be able to stand it.
Allen has become aware of his dilemma. He fears it is too late to
go back, and yet he is terrified to go forward. Like his assistant who
had never seen him so emotional, he and I have both had a glimpse
of his real self, but he cannot yet frame in his mind those primal
pre-verbal feelings of losing his mother. Although I was becoming
the frame that could contain these pictures, when I am not there I
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keep getting disassembled in his mind and he retreats back to the

This painstaking process of awareness of the true self and the
pull of the false self in which to remain cloistered is necessary to the
development of conscience. The intense resistance to awareness of
the frustration and confusion of this conflict provides some expla-
nation for the reason why, as Freud said, such precious little
conscience exists in the world.

Session eight (the next day)

I was looking at an aerial view of China and from Beijing all the way
down the coast was submerged in water. My friend, Eleanor, was in the
dream. She was saying something but I don’t remember what.

Allen felt himself to be in a fragile state, but had gained some com-
fort the previous night from a discussion with his friend, Dave,
about The Long Emergency, a book about the potential environmen-
tal disaster. He was grateful for his relationship to Dave, who is
older and more experienced, “like an older brother or an uncle”,
whom he admires and who cares about his well-being. Allen men-
tioned An Inconvenient Truth, Al Gore’s film about the environment,
which showed coastal areas like California and New York sub-
merged under water as a result of global warming and melting ice-
I interpreted that the feelings related to his early abandonment
arouse catastrophic anxiety in him, which feels like a “long emer-
gency”, endless, really, and one of which he has been only dimly
aware. I thought that his associations to Dave expressed his grati-
tude towards me as well, that, despite his fears and his fragile state,
he feels I care about him, and he appreciates that I acknowledge the
danger he feels internally. He sounded vulnerable as he acknowl-
edged his gratitude and affection for me, feelings which are
painfully intimate, and to which he had no access while in China.
Like the image of China in his dream, he had been submerged in
that old cocoon, an en-wombed state of mind cut off from his
perception of these feelings, or any of his feelings. I pointed out
that, although he now feels fragile and scared, he is compensated
by his feelings of love and gratitude and a sense of connection to
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me, although even these feelings can be painful. He agreed, admit-

ting, “I really want to feel, but I still don’t like it.” I suppose the very
existence of feelings is often looked upon as an “inconvenient
truth” of being alive.

Session nine (the next day, Friday)

Allen remained anxious about “the impending planetary crisis”. He
continued, however, feeling more connected to me, causing his feel-
ings of separateness and movement towards mental birth to
become more intrusive, especially as we were heading into the
weekend. He’d had a dream in which he saw

Karen, a girl from high school, at a gathering. They were looking at

each other across a table and he had a good feeling about her, a
“swelling feeling of appreciation”. It was somehow mutual, but not

He described Karen as “really smart, and grounded.” The gath-

ering in the dream reminded him of a panel discussion he had
heard recently by an alliance of women in film discussing why
there were so few women directors. He commented that he had
appreciated these women, who seemed to him to have had a moral
code and a social conscience.
In part because this is his last session before the weekend, I
thought the idea of “so few women directors” referred to his real-
ization that “there are so few mothers”. He fears that without me
around to direct him or help him think, he will emotionally discon-
nect from himself and he will “disappear me” again, as if I no
longer exist. In this context, his terror about the “impending plane-
tary crisis” represents his anxieties about the devastation he fears
his attacks will have on me and on our connection. We do see
another representation of a good mother here, though, for the gaze
between him and Karen in the dream seemed reflective of the
infant’s gaze as a primary factor in the development of a healthy
attachment (Schore, 1994, p. 65). In addition, unlike Allen’s para-
noid fear of his conscience in Sessions Three and Four, his associa-
tion to the “women with a moral code” brings in the idea of me as
a good conscience that is helpful rather than punishing. The danger
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of cutting himself off from me leaves him without a good object,

and without a moral code, also illustrating the link between
conscience and the capacity for loving attachment.
Again, Allen wondered if he will be able to bear having feelings
he cannot control. He then began talking about his plans for the
weekend, at which point I felt he had already left me and his feel-
ings in favour of ruminations about the future. I said, “I think
you’re feeling right now that you can’t bear even to hear what I’ve
said.” He said that he constantly fluctuates in this way internally,
describing it as going from one “chamber” in which he feels terri-
bly vulnerable and can’t stand waiting for me, into an empty cham-
ber where he feels nothing. He said, “I start to feel this pressure so
it’s as if I run across the hall to this other chamber where there’s
nothing . . . I can’t bear it without running away!”
Paul (1981) talks about the stages of mental birth and the sense
of pressure as the individual emerges into himself. As Allen feels
the impending emergence into his own mind or self, he runs back
to phantasy and empties himself of real feelings. He can then create
in phantasy all the mothers/directors/analysts he needs. His view
of a good conscience is short-lived as a result, and his retreat back
to the “empty” chamber is, in part, a way of seeking refuge from his
guilt about his destructive phantasies. We can see here the retreat
from the self as, in effect, a retreat from conscience, once again con-
fused with the punishing superego.

Session ten (The following week)

This session was the day before Allen’s birthday. He spoke of feel-
ing terribly angry, frustrated, exposed, and helpless. That morning
he had dropped the five-gallon bottle of water for his water dis-
penser, spilling water and glass all over the floor. After talking with
a friend about a new project, however, he felt better, and likened
this quick shift to a baby going from one emotion to another in fluid
succession. He reported these dreams.

1. My wallet was torn and all my change spilled out all over the place.
2. I was with May [his new girlfriend] at a workout place. I was ready
to leave but she wasn’t—I was upset that I had to wait. I started work-
ing out with a big exercise ball, lying on it on my back and walking
with my legs on the floor like a crab.
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His feeling of being exposed and helpless seemed clearly related

to a sense of being born (“his water broke”). Everything is different,
he feels uncontained, terrified, as all of this “change” spills out,
despite his feeling of not being ready to be born. In the dream, his
girlfriend, May, like his birth mother, is not ready for him, and he
has to wait and wait, interminably, as it turned out for him as an
infant. He is waiting still. He cannot understand what is happening
to him—did his mother leave him or did he leave her? And during
our break, who has left whom? He is feeling helpless and terrified
in the absence of someone who can contain this very “crabby”
angry baby. In addition, there is a fear that birth will mean the end
of his analysis with me before he is ready, just as he was prema-
turely separated from his mother.
The arousal of so many intense feelings gave rise to a long
period, almost four months—in which Allen was in a kind of limbo.
It was a standoff between his desire to numb himself and his desire
to be alive and to feel. He was good at fooling himself and uncon-
sciously tried to fool me by talking about his pain, but they felt to
me like hollow words. When I interpreted this sense that he seemed
absent, he could recognize that this was so. His capacity to feel the
difference indicated that at least he now knew what it felt like more
genuinely to be himself. This was an important step, even if he
could not always attend to it himself. This capacity to experience
the distance from himself, however, made him feel helpless, for he
knew he could not find himself on his own.

Session eleven
There was a shift in Allen’s state of mind after this. The next day he
announced that he’d had a dream. “It’s my Guess Who’s Coming to
Dinner dream,” he said, but then corrected himself, “or maybe more
like Imitation of Life, that old movie with Claudette Colbert . . . the
dream was like watching a movie.”

There was a light-skinned Black woman who marries a white man

and had a Black baby. His family is very upset and someone yells at
her, “I hate you! You’ve ruined our family!” She was drugged during
birth so she’s out of it and the grandmother takes the baby and is hold-
ing it, but without any sense of connection—she’s shaking her head
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with disappointment. She gives the baby to a Black nurse who holds it
with more compassion.

Allen made the connection to his adoption, and said that his
own maternal grandmother had urged his adoptive mother not to
keep him following the divorce. He mentioned again having been
nursed by his birth mother before the nurse realized he was to be
adopted and removed him for good. He briefly described the plot
of Imitation of Life, in which a mixed-race daughter passes for white
and cruelly rejects her loving Black mother. He also discussed a
novel he was writing about violence.
One essential point about the “cinematic” nature of this dream
is that it reflects a state of phantasy, or hallucinosis, which becomes
confused with reality. Although Allen is not psychotic, we are deal-
ing with the psychotic aspects of primitive modes of thought. Over
and over again in his mind, Allen watches the nightmarish “movie”
of his birth and abandonment from which he cannot awaken. He
lives this “movie”, filled with these raw undigested, unthought
images of that early experience. By the time he got to his adoptive
family, he had found a way, emotionally speaking, to “pass for
white”, to adopt a false self and consign to unconscious darkness
his own dark feelings of terror, despair, and rage. As these feelings
re-emerge he once again feels like that unwanted Black baby, tortur-
ous feelings, to be sure, but ones without which his existence has
really been just an “imitation of life”. Having turned back to the
world of phantasy, he has also once again turned away from me,
and it was interesting to note, although at the time of this session I
did not know it, that the Black mother who was abused by her
daughter in the movie was called “Annie”, my name as well. This
was more evidence of his unconscious anger at and denial of me as
the mother into whom he projected those dark, split-off feelings. At
the moment, however, the split is not so severe that it has erased his
struggle for connection and truth, for Allen’s first association to this
dream was Guess Who’s Coming to Dinner. I thought that this,
together with the feeling in the session, indicated that Allen was
also today that Black baby “coming to dinner” with me. Something
seemed to have opened up in him through our contact yesterday,
and, as with his first feeding, he had come to his session today with
the hope of getting fed.
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Allen’s fear of experiencing his early abandonment was so

severe that his treatment took on a distinct rhythm with repeating
periods of approach and avoidance. At times, these shifts were
more fluid, changing within the space of a week, or even a session,
but this time the threat of awakening to feeling was too close
and Allen disappeared to a very faraway place. During this time he
became busy with work and began missing sessions, and it was
almost a year before these feelings were re-awakened in ways
increasingly difficult for him to ignore. While he then became
devoted to the analysis, any emotional progress exacerbated terri-
ble fears of losing control, and a new, rather more intractable and
deadly equilibrium was re-established. He grew frustrated with me
for pointing out his dilemma without telling him what to do about
it, and, as time wore on, I certainly asked myself what I was miss-
ing and what more I could do to help him. Finally, his awareness of
the dilemma was so inescapable and his experience of psychic
numbness so stultifying that a change seemed inevitable.

Sessions twelve and thirteen: awakening

Allen had two dreams on two consecutive nights, in both of which
an alarm clock was ringing.

In the first dream he didn’t hear the alarm but someone was there
telling him it was ringing.

In that session I interpreted that he could not currently hear, or feel,

his own sense of alarm that was being awakened, and to which he
felt I was trying to alert him. While he could hear what I said, the
barrier against emotional life made it impossible to feel.

In the next night’s dream his alarm was again going off, but this time
he heard it and told someone he just wanted to sleep a little bit more.

I thought this indicated that his unconscious had heard me the

previous day and, feeling desperate, he tried to strengthen his
resolve not to awaken what he fears is unmanageable terror. He is
imploring me, and his own feelings, to leave him alone and let him
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I thought that, once again, I represent here a conscience he does

not want to hear, although it is a “good” conscience, that is, one
aligned with life and truth as opposed to the cruel superego, which
militates against life and feeling. And once again the two are
None the less, Allen began having dreams after this which laid
out the terrain of his encapsulated self in a graphic way. In another
elaborate cinematic dream, this experience was characterized as

a completely different world . . . it was supposed to be outside but it

looked less organic, like a controlled environment, a manufactured
world. It was as if my mind was like a computer hard drive that had
been wiped out by a secret society, and there was a voice trying to warn
me that this secret society was dangerous.

This dream evoked a vivid image of his detachment and isolation

in an eerie mechanized world where he is more machine than
human being, driven by a false self that masquerades as real.
It felt unclear to me which side he was on. Was his computer
hard drive his real mind, now wiped out by the secret society of his
primitive superego? Or was the computer a mechanized false self?
I wondered at first if my confusion reflected his own, but the feel-
ing of this eerie manufactured world led me to think the latter: that
he had made himself into a machine without human feelings. From
this perspective, he sees me as the secret society trying to wipe out
his “hard drive”, his false mechanical self by which he has been
driven so hard all his life. The voice he hears is warning him against
me, for he is aware that I am responsible for his losing the hard
protective armour of that primitive superego which warns him
against feeling and against life. This image of a “manufactured
world” gave us a way to visualize and talk about Allen’s mental
whereabouts in exile from his real self; it illuminated the confusion
he is now beginning to feel about what is real and what is not. It
served as an incremental step towards developing a capacity to
choose his real self over a manufactured self in a manufactured
world. Paul (1997) describes this as a means by which the individ-
ual induces feelings and sensations in place of the uncontrollable
nature of real experience, a phantasy state that creates a barrier to
contact with reality.
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Session fourteen
Over this past year, Allen’s developing relationship with his girl-
friend, Cara, led to new struggles with feelings of trust and commit-
ment. He began for the first time to express feelings of love and
appreciation for her, accompanied by fears of abandonment and
other dire predictions. As his anxieties increased, we began paying
close attention to the patterns of his thinking and saw how his
primitive mental states and replaying phantasies of the past
supplanted his capacity to think about reality. He had slowly
become more able to attend to this and, as a result, was better able,
at times, to manage his anxieties. One day he announced that he felt
proud of himself. He explained that in the midst of a frustrating day
in which everything had gone wrong, both personally and profes-
sionally, he felt himself slipping into a sort of trance in which he
numbs his feelings through a familiar pattern of obsessive negative
thoughts. “I was about to go into my usual spiel,” he said, “telling
myself, ‘This is a sign, I shouldn’t be in this relationship with Cara,
I’m going to be hurt, I shouldn’t have bought the house, I make bad
decisions, I’m incompetent, etc.,’ but I noticed myself doing it and
thought, ‘I’m not going down that road.’ ” Instead, he began to
listen to and think about the ideas he heard in this litany, and real-
ized they were not true. He calmed down enough to deal with the
frustrating business at hand.

Session fifteen
The next day he had this dream:

I was in a bus. There was another bus in front of mine and my “son”
was in it [in reality he has no children]. He was little, maybe five years
old . . . I could see him talking to people, very friendly, and I thought,
“That’s great, he can be sociable, he’s having fun” . . . It seemed good.
But then I got anxious that I wasn’t protecting him and I started think-
ing, “Why is he there, so far away? Something could happen and I
couldn’t get to him.” When the bus finally stopped he got off and I held
him tight. I have to be with him, I thought, I have to be awake! I can’t
just forget about him. How could I have made that decision to put him
on a bus alone? I must have been unconscious . . . drunk or stoned, or
asleep . . . probably asleep.
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Allen’s associations to the bus had to do with a recent trip to see

his family. He noted that the people on the bus in the dream were
“loud young people, maybe gang members”, and he thought
anxiously, “My son should be with me.” Allen almost never made
interpretive comments, but he now had the idea that the boy was a
part of him from which he had turned away. À propos of his obser-
vation, I pointed out the irony: that he had spent his life feeling
abandoned because of the adoption, but he had then adopted
himself out to a manufactured internal family where he could be
the fun-loving, sociable, and happy little boy, asleep to the fact of
being separated from himself. I thought that in wondering at the
wisdom of abandoning his little boy (himself), he had experienced
a pang of conscience, to which he replied, “It was my conscience
. . . that’s what woke me up, I felt so bad for what I’d done.”
Bion’s idea of dreaming as unconscious thinking can be seen
here as Allen’s attempts to digest and think about his awareness of
having abandoned himself. In this attempt, unconsciously, to
process his awareness of the split within him, it was indeed his
conscience that awakened him—his capacity to dream the emo-
tional experience of having betrayed and abandoned his true self.
The confusion about the false self is clearly delineated in this
dream. Allen’s split-off “son” looks as if he is having fun with the
thugs and gang members who make up his narcissistic personality
organization. Designed to protect him, it actually terrorizes and
imprisons him in a non-human machine. I thought it also referred
back to Allen’s description of “the path” he had decided not to take
yesterday, the litany of attacks on himself from a cruelly judge-
mental and moralistic pretender to conscience, which he had for the
first time consciously chosen to avoid through his awareness of its
destructiveness. This choice reflected his relationship with me, for it
indicated that he had heard and learned from our previous ses-
sions. In Rosenfeld’s description of the primitive superego’s envi-
ous attacks on life and creativity, he writes,

These patients seem able to respond to treatment only when the

analyst fully exposes the omnipotent power of the destructive self
. . . [the patient] is in the grip of a primitive superego structure
where positive, often highly erotic and seductive features are mixed
up with omnipotent, sadistically overpowering ones. The demands
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of this superego are very contradictory and therefore confusing . . .

as it creates at first some doubt, but ultimately complete uncertainty
and confusion in the patient. [Rosenfeld, 1978, pp. 216–217]

It should be made clear that this pretender to conscience, which

we call the superego, grows out of primitive ideas about how to
manage feelings that are instinctively intuited to be against life.
The intention, in other words, is a moral one, but implemented by
a mind without the developmental capacity to understand the
nuances of morality. It uses violence against aspects of the self to
fight violent impulses against others. In this case, the destructive
nature of Allen’s defensive structure had been revealed to him.
The following day, Allen had a similar experience, in which he
felt overwhelmed by external frustrations. He felt compelled to fix
them at once, which increased his anxiety and helplessness. He
stopped and thought, “I can take my time, I have to stop adding to
the pressure I feel and just try to do whatever I can in the time I
have to do it. I was surprised how much I got done . . . I felt a space
in my mind. I said to myself, this thinking thing works . . . it’s a
good tool.” Allen was again able to contain his feelings through
conscious awareness. He immediately found himself thinking of
death, however, realizing that if his time today was finite, so was
his life, as were all the relationships he cared about. He felt sad, and
somewhat panicked.
It is not surprising that these thoughts of death arose in Allen’s
mind, for the sense of mental space Allen experienced is a facet
of the experience of mental birth, which is always accompanied by
the awareness of time, and its ultimate end in death. If one is
mentally born, one becomes aware of separate existence. With space
in which to exist mentally, one becomes aware of internal and exter-
nal reality, not only the timelessness of phantasy in the internal
world. Given this awareness of having been born, one will have an
awareness that one will someday die. Paul writes, “The theme of
death is very close in phantasy in these individuals to that of birth,
and to them indistinguishable” (1981, p. 565). The turbulent transi-
tion from the phantasy or mental womb state of the “manufac-
tured world”—a controlled environment with induced feelings—to
a post natal state of real feelings engendered by a real world engen-
ders overwhelming psychic pain which makes discrimination
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impossible. Allen’s experience of time as an enemy is related to his

emergence into a real self living in the real world, when he still
clings to the illusion of a safe womb. His subsequent ability to use
time to think and then to act upon what he thought indicated an
acceptance of its reality.
Although Allen felt thinking to be a useful tool, he also became
painfully aware that this process of mental awakening means
having to continue thinking, making choices every day either to stay
awake or put his feelings to sleep, to choose either the life or death
of his mind. This sense of work and responsibility for one’s mind
represents the foundation of thinking upon which conscience is
based, and, as these clinical examples from Allen’s treatment
demonstrate, this work is fiercely resisted. Bion’s ideas about the
caesura of birth connect this experience of psychic birth to the
vulnerability and helplessness of physical birth. It is an experience
that accompanies all the subsequent mental births of ongoing
mental development.
Of course, the analyst also experiences these ongoing transi-
tions, which correspond to the transitions from the paranoid–
schizoid to the depressive position. Bion distinguishes it from the
primitive or pathological states of the infant, however, by charac-
terizing it as a transition from “patience to security”. He explains,
“I mean the term [‘patience’] to retain its association with suffering
and tolerance of frustration” (Bion, 1970, p. 124). The resistance to
this painful process of mental evolution seems, in large part, to
account for the scarcity of mature conscience among the vast major-
ity, as noted by Freud (Freud 1933a, p. 61).

Session sixteen
Allen was upset, for he had missed his session the day before. He
had been involved with work and had become uncharacteristically
confused about the time. It was also a week before our Spring
break, and, while aware that he was not happy about it, the full
depth of his feelings remained unconscious. He reported a dream
in which

he was in prison, wrongly convicted of a crime. He planned to appeal

his incarceration. His mother was there too, along with a lot of other
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prisoners who all had to spend their time in a kind of cave filled with
water. The prisoners were then allowed out of the water for a meal, and
the food was good. At one point he saw a handsome angel. Other
angels were flying up to the top of a building and going through a
door, a portal to heaven about which the handsome angel had not
known. He tried flying through it but it didn’t open and he fell and fell
and fell. Allen realized, “Oh, that’s Lucifer, but he really isn’t evil, he’s
just confused.”

Allen’s associations to the angel was to a story he had read

about an angel wanting to come down to earth to feel human
emotions like love. I thought that Allen was this fallen angel, the
baby dropped from the womb at birth and who then failed to make
it through the “portal” into the protective womb of his mother’s
mind. He had thus been in a sort of unconscious free fall all his life,
with no containment for his terror, a feeling from which he has been
protected through the unconsciousness of his imprisoning super-
ego. In this dream, however, he seems to be considering that
perhaps the circumstances of his birth didn’t make him evil, just
confused. It is a fair description of the confusion of Fairbairn’s
“moral defense” (1952, p. 65), harshly judging himself as evil for his
perceived transgressions of rage engendered by unmanageable
fear, and imprisoning himself as penance.
I thought that Allen’s dream was in part stimulated by his feel-
ing of unconscious guilt at missing his session without calling, as
well as the guilt of having imprisoned us both in his phantasy of
oneness. However, once out of the “water” of that unconscious
phantasy, he could experience me again as the good food, and so
recognize that he was not evil, but a baby with overwhelming needs,
just out of the womb, who had become frightened and confused at
losing his mother. He had communicated this to me through projec-
tive identification, as I was left waiting and waiting, wondering
where he was and, like he as a baby, dropped. Of course, he also
feels he is about to be dropped by me during the break, but in this
dream, the protective womb of the phantasy, which formerly felt
like protection from his calamitous feelings, was now experienced
as a prison in which he was wrongly incarcerated. In planning to
appeal his incarceration, he is finally challenging his brutal peniten-
tial conscience as he begins to understand that he is not evil but a
frightened, vulnerable baby. Even his capacity to project was a
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healthy sign, indicating, even in my absence, his awareness of a

good me with the good food who might hear him.
Bion (1970) talks about the close relationship between a moral-
istic attitude and taking action as contrasted with thought or medi-
tation (p. 8). Allen, here, has substituted thought for action. The
moralistic attacks on himself stopped as he understands that he is
a confused baby whose terrified rage is a feeling rather than an evil
action taking place in reality. It reflects a capacity to distinguish
phantasy from reality, inner from outer, a necessary step in the
development of a mature conscience capable of thinking about

Session seventeen
A few months later, in this last of Allen’s dreams which I will
present, a healthy split had developed in which well-defined battle
lines enabled him to see more clearly where he stands. He had a
dream that

he was in love with a woman and was listening to her speak. Some of
his colleagues at work criticized her, but he was impressed with her
expertise and how much she knew. Allen asserted his opinion, at which
point the others turned their backs on him with harsh judgement. He
did not stop loving the woman, but they both felt a sadness, and the
negative feelings of his colleagues lingered in his mind.

He associated the colleagues with a company he worked with

who had recently disappointed him on a deal. I was reminded of
our last session, in which there had been an awkward silence
following my interpretation. He then went on talking, but I sensed
his tension and commented that he seemed fearful of my interpre-
tations. In response, he had remarked on his awareness that he had
tightened up his body as if to protect himself from what I had said.
I had then pointed out that he had continued talking to me as if he
were still communicating with me. I thought this was meant to
mislead me and to neutralize my effect, for he was no longer really
engaged with me. All of this was unconscious and so he has also
misled himself, as he becomes identified with a false self. I thought
his dream today revealed his sadness and guilt about what he real-
ized he had done to me, whom, like the woman in the dream, he
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loves and respects. Today, he could defend me by standing up to

those internal “colleagues”, aspects of him that advise him against
contact with me and against contact with his real self. His response
was, “I get so frightened, like I’m being de-constructed . . . And I
don’t like what’s being uncovered is this system where I can’t feel
. . . but I’ve lived by that system and without it I don’t know
anything . . . I feel like a larva, like I have no structure.”
In this dream we see all the related elements of mental birth,
contact with the true self and a developing conscience. His advis-
ers, his “colleagues”, are really his primitive superego allied with
the false self, which uses threats and warnings and judgements to
prevent all development and connection to a real world. Allen’s
conscious experience of his false self moves him towards a mental
birth, where he feels like a larva or foetus emerging into an unfa-
miliar world beyond his control. He feels raw, scared, and inept in
this world, in sharp contrast to his fearless and self-assured
persona. He feels “as if a dream has been shattered,” and yet, he
informs me, that old dream-like state of mind “. . . is like being in a
marshmallow haze, so I feel grateful for the shattering.”
Allen’s case reveals something of the courage necessary to make
the journey through the process of a mental birth, in light of the fact
that it feels like death, and, in fact, is the death of the previously
known self. This journey toward a conscious experience of emotional
reality is a necessary factor in the development of conscience.
Without it, one remains stuck in the grip of a primitive superego
which cannot think, whose aim, in fact, is the obstruction of think-
ing. Although it develops and serves as a provisional conscience for
the infant trying to sort out conflicting feelings of love and aggres-
sion, this superego is actually a derailment of the natural develop-
ment of conscience towards truth. Allen’s oscillations back and forth
between his instinct towards truth and his need for the protec-
tion/imprisonment of the primitive superego are ongoing, but so far
he has continued to use the knowledge he gains to choose life, which
he is more able to distinguish from a state of mental death.

Clinical example B (Grace)

This second case is another example of the emergence of the capa-
city to think in relation to the development of conscience. In this
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patient, we see more of the essential confusion between good and

bad illuminated by Rosenfeld (1987) and Fairbairn (1952), and the
difficulties in teasing them apart. As mentioned briefly in the clini-
cal vignette in Chapter Three (p. 41), “Grace” is an extremely bright,
intuitive, thirty-one-year-old woman who, by now, has graduated
from law school. She has been in analysis for six years, having first
presented for treatment with severe anxiety and depression after
her then fiancé had an affair. This stimulated feelings of abandon-
ment like those she had experienced in relation to her psychotic
mother and emotionally detached father. Grace has had problems
with compulsive eating since her parents’ divorce when she was in
her early teens. She typically binges on sweets, a tenacious and
sometimes violent defence which obliterates her awareness of
unmanageable fears of separateness and her own feelings of need.
The sessions presented here cover a span of three years of treat-
ment. While she is now working as a clerk in a high-powered law
firm, during the time of these first sessions she was still in law
school. In our work, she had been in the painful process of being
born into her true self for almost a year, which had aroused a great
deal of anger and resistance as she became increasingly vulnerable
and sensitive to her primitive needs.
Grace left me a phone message on a Thursday evening saying
that she was anxious about a “terrible” conversation she had had
with Professor X, her instructor at the law school. She had told
Professor X that she would miss work on Friday in order to take her
mother to the doctor, which she had done once before. She added
that she also needed time off to get support for herself—meaning
her treatment with me—around her mother’s illness. She had, in
fact, taken her mother for medical help several weeks earlier, but in
this case it was not true. Feeling overwhelmed by gruelling exams,
Grace just felt desperate for a day off. At the end of her phone
message, she added, “So I need you to write a note saying I had an
appointment with you.” We did have an appointment, so this much
was true.

Session one (Friday)

Grace began the session by saying, “I’m so tired I don’t even want
to talk, I just want you to make everything all better. It’s a very
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infantile feeling.” She talked about the stress and hours of law
school, plus the strain of studying for her forthcoming exam. She
was angry that Professor X, whom she feels is particularly demand-
ing of her, had informed her after class that if she missed two days
she had to make up the time. Grace corrected her, saying that she
understood the rule to say that one was actually allowed two
absences before being required to make it up. These needed to be
excused absences, Professor X explained, to which Grace replied, “I
have an appointment with a therapist, I can get documentation.”
Grace reiterated several times that she would bring in a note, to
which Professor X finally agreed, reminding her that documenta-
tion was necessary. Grace took this as an implication that a problem
could ensue and said to me anxiously, “So I need a note from you.”
I was feeling pressured. “As you said at the beginning of this
session, you want me just to ‘make everything all better’”, I
explained, “and I think that’s what you’re asking me to do—to
intervene in the situation and fix it. But that puts me in an awkward
“Are you saying you won’t write the note?” she asked anxi-
ously, to which I replied, “I’m trying to do what I always do, think
about the meaning of what you’re feeling, but I don’t think you
want to do that—you’d prefer me to fulfil your phantasy of an all-
powerful mother who can fix everything.” In a chilling tone, she
said, “Now I feel like I’m going to lose my mind.”
I pointed out that I thought she felt she was losing the part of
her mind which hopes and believes that she and I are not separate
people. She can then feel sure that I will do whatever she wants
without even having to ask. I reminded her that she had assumed
in her phone message that I would write the note without our
having discussed it. As if she had been struck a fatal blow, she said,
“I can’t believe this. I told her I would bring it and if I don’t . . .”
she trailed off ominously.
As I began to feel a sense of guilt and responsibility for what
happens to her at school, I realized that she was also communi-
cating the guilt she cannot feel for her phantasy of having deprived
me of my autonomy and my mind. I pointed out that she was
asking me not to think but rather to act. This is very much what
happens when she binges—she feels compelled to act as a way of
getting rid of her feelings, thereby also getting rid of her mind and
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her capacity to think. Her teary response today put me in the posi-
tion of seeming cruel if I do not “save” her, but I pointed out that
she was also asking me to collude with her lie about taking her
mother to the doctor. If I wrote the note, I was also in jeopardy. At
this she became contrite and said soberly, “I didn’t think it through
. . . I’m sorry. I didn’t mean to put you in a bad position . . . [quiet]
. . . I feel bad.” [While I thought that Grace was also probably feel-
ing unconsciously that taking her mother to the doctor and taking
herself to the doctor (me) was the same, and so, on that primitive
level, not a lie, I thought that more to the point in this case was how
it was playing out toward me as a transference figure, as well as in
the reality.]
Grace often feels like a victim and is angry at whomever takes
on the role of her internal bully in external life (Professor X in this
case), but we could see something here of why it is so often diffi-
cult for her to accept when something nice is done for her. She
commonly feels tortured, for instance, by needing to ask her father
for financial help, and by what seems to her like his reluctance to
help her. However, she often complains of even greater discomfort
when he provides what she needs. This puts her in touch with
painful feelings that erode her feeling of self-sufficiency. I thought
that her reaction to me in this session was related to her phantasy
that she is not simply asking for help, but forcing me to do it. Her
guilt for this unconscious coercion undermines any feelings of
gratitude and she can never feel that anything is given willingly.
Her guilt is not for being needy, as she believes, but for her denial
of her needs through the unconscious bullying control of the other
person, in this case, me.
Grace could not bear the awareness of us as two people in this
relationship. Instead, I am either felt to be a demanding Professor
X who makes her work too hard and face these painful realities, or
I am perceived as her phantasy womb/mother, protection from the
awareness of separateness, this difficult work of feeling and think-
ing. When I interpreted this, she became quiet. After a while, she let
me know that she was thinking about what I said. I could sense that
she was grappling with the interpretation, and with her conscience.
It did not seem to me that she had run away from these feelings or
from me, but, rather, that she was feeling her dilemma—that
although she still wanted a note from me, she felt bad about having
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tried to bully me into compromising my autonomy and integrity. At

the end of the session, I told her I could not yet give her an answer
about her note, as I felt we needed more time to think it through
and understand more about what it meant to her. She agreed.
We can see several things in this session related to the develop-
ment of conscience. For one thing, it is compromised by the retreat
into phantasies of a womb/mother who offers protection from
separateness and need, and, probably most important, from the
awareness of these feelings. According to Klein (1946), the capacity
for guilt is predicated on the awareness of a whole object separate
from the self, the resolution of the split in the paranoid–schizoid
position as the infant becomes aware that the bad mother attacked
in phantasy is the same good mother whom one loves. With great
pain and difficulty, as if we had been violently wrenched apart,
Grace had an experience of us as two separate people. However,
although her feelings were an incipient from of depressive anxiety
and guilt, the remorse she felt in this session is essentially the
immature guilt of the child who has been caught, the same kind of
guilt she feels when she binges. Her guilt for binging is not con-
sciously related to the emotional reality—the underlying damage of
having done away with her feelings, her mind, and her connection
to me—but to the physical reality that she will gain weight. From
her perspective in the unborn state, she knows nothing about the
underlying hatred and fear of our two-ness, so what she recognizes
as guilt is, in fact, a continuation of an attack on her awareness of
need, which further obstructs her capacity to think. Those feelings
of need and guilt are still felt to be inflicted from without rather
than an experience of internal pain. This sense of being attacked is
generated by a pathological superego designed to destroy feeling
and truth. I think it is for this reason that it is experienced as alien
to the self, for it is alien to the true self capable of authentic feeling,
and there is an inherent sense, an undeveloped proto-awareness,
that this is so.
This attack was in contrast to what I perceived the next day.
Grace was still concerned about not having a note for Professor X,
but she now expressed what felt like genuine remorse at her lack of
awareness of me. I could also hear genuine curiosity and gratitude
as she said, “It feels extraordinary that you could use that awful
experience to point out how I think I make people do things against
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their will. I feel that all the time.” Despite her anger, her ability to
think about the implications of what felt to her so frightening put
her in touch with the feeling that, as she then put it, “There must
be something in me which really wants to learn and grow.” I have
often felt this “something” in her, the courage to look at the truth in
the face of intense mental pain, and so I agreed that “something” in
her does seem to be very much interested in knowing the truth. I
added that, considering how bad she felt yesterday, this “some-
thing” must be extraordinarily strong and essential in her.
I thought that today’s dream provided evidence for this.

I was in high school, in my Mum’s house. I woke up and was trying to

get ready for school but I had layers and layers of clothing on and it
was taking me so long to get undressed. I was afraid I’d be late for
school. Finally I was undressed and ready to get in the shower, but Mrs
J [an older women poet] walked in and started to go into the shower. I
said, “I’ll be late”, and I went in, but she was very put off. “I’m your
elder, you should have let me in front of you!” she said, but I explained
I would be late for school.

She associated Mrs J with me (knowing that I am also a poet),

and mentioned a poetry reading about mothers and daughters
which Mrs J was doing that night. Grace felt suddenly sad about
never having had a nurturing mother, and how she could not feel I
was helping her yesterday because it hurt so much. She had the
thought that sometimes the most nurturing thing a mother can do
is something that is painful. She began to cry, aware of having
mistaken for cruelty what she now feels were my efforts yesterday
to nurture her mind.
I thought her dream indicated how naked she felt yesterday and
her awareness of how long it has taken to divest herself of her
defences—those “layers and layers of clothes”. Once exposed, she
feels ready to “go to school”—to learn something with me—but a
powerful force immediately tries to get in front of her to stop her.
She had experienced me yesterday like Mrs J in the dream, a bad
internal mother who intentionally causes her pain and will not let
her stay in the womb where she does not have to put up with such
vulnerable feelings. This internal bully represents her identification
with a sick mother who also bullies her, pushing aside her desire
to learn. “I’m going first!” it says, although today she was able to
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challenge its authority sufficiently to “shower”, to cleanse herself

through yesterday’s interpretation of its oppressive power, at least
for the moment.

Session two: a month later

Over the next month Grace experienced an increasing sense of trust
in me. In one session she reported a dream in which

she was in the home of an older woman friend and her husband. She
went into their kitchen and ate some “real” ice cream [which she distin-
guished from the frozen yogurt she usually eats during binges]. She felt
anxious, not knowing if she was allowed to have it, but then the people
were there and it seemed all right.

I thought the “real” ice cream represented her sense of a real me (or
mother) as distinct from the frozen phantasy she generates in her
mind. She is anxious because it means giving up that phantasy in
favour of a real connection to a real person. This brings in its wake
the frightening awareness that the “food” she needs does not
belong to her but to the mother, or, as we see in this dream, to the
She feels it is the parents who will prohibit her from eating
“real” food, or truth, for it is the internalized parents of her primi-
tive superego which forbid her contact with real experience. How-
ever, she feels here that it is all right to eat. I saw confirmation in
the next day’s session that her recent experiences of safety with me
had enabled the beginnings of her ability to tolerate the awareness
of separateness.

Session three: Friday, the next day

I was at a block party; there was a nice communal feeling. It was almost
sunset and I thought, When the sun goes down it will be utter dark-
ness. I was really scared, but when the sun set, the moon came up and
I could still see by the light of the moon. I was surprised, and relieved.

I interpreted Grace’s fear that when the sun went down today
(Friday), my absence over the weekend would feel to her like being
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plunged into total darkness, abandoned and alone. However, since

the moon is reflected light, there was a sense that she could still see
a trace of my “light”—my interpretations—in her mind when I was
not there. I felt the dream indicated the beginning of a capacity to
conceive of a good me in my absence, a capacity to contain her feel-
ings of frustration and abandonment sufficiently to allow the
mental space where a thought—mother/analyst—could exist. This
beginning of an experience of a space in her mind for a “reflec-
tion”—a thought, or ability to reflect upon an absent mother—was
a first step in the slow development of her capacity to think (Bion,
1970). This underlies any capacity for discrimination between good
and bad, a necessary prerequisite to conscience. It was followed in
this next session, Monday, by a step backward.

Session four: the following Monday

Grace said, “I tried to hang on to the idea of the sun; that you could
be there even though I couldn’t see you. I felt good, but then I
started feeling lonely and I binged on sweets.” I thought that in
trying to “hang on to the idea of the sun” Grace had concretized my
interpretation and our experience together, trying to make me into
food she could freeze and have at will, an internal frozen yogurt
mother. Her tenuous hold on reality in the face of her primitive feel-
ings had given way to phantasies much more immediate than the
mere idea of me in her mind. She had an association in this session
to violent screaming fights and verbal abuse from her mother just
prior to her psychotic break. “Once, when I was ten, I threw an ice
cream sundae at her . . . it splattered all over the place and we
couldn’t clean it up.”
Bion wrote, “Resistance is resistance to O. Resistance operates
because it is feared that reality is imminent” (1965, p. 127). Grace’s
experience of a mind and the threatening nature of her experience
of psychic reality were followed by an unwillingness to give up the
hallucinatory fulfilment that her binging represents. The bad feel-
ings associated with the absence of a good breast/me was replaced
over the weekend by the presence of a bad breast/me (Bion, 1967),
and, as we see in her association to the ice cream sundae, she tries
to evacuate her bad feelings and this bad absent me over the week-
end, throwing her bad “Sunday” feeling at me until I seem too
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spoilt to clean up. This exacerbates the “mess” in her own mind, as
well as her loneliness, for she now envisions me as a mother who
cannot hold her feelings in mind, but can only scream back at her
as her mother did.
Bion (1970) points out that the experience of the absent object—
which he calls the “no-thing”—can be used either as a thought or
as the foundation of a hallucination. But, regarding the transition
from the unlimited domain of hallucination to mental containment
in the form of a thought, he writes, “A painful state of mind is clung
to, including depression, because the alternative is felt to be worse,
namely that thought and thinking mean that a near perfect breast
has been destroyed” (Bion, 1965, p. 63). The very act of thinking
is evidence of the loss of that hallucinatory phantasy and so acti-
vates feelings of terror, frustration, and grief. Grace’s reaction over
the weekend reflects that loss of an ideal object that accompanies a
thought and the primitive feelings attendant to it. Her battle with
food began to escalate, and continued to do so over the next few
weeks. It was a desperate attempt to reconstitute that ideal object,
for, as her alliance began to shift towards me, a war was waged
against me, against her own emotional need, and against her own
capacity to perceive and think about reality. The tenacity of the
hallucinatory state creates a barrier to any real feeling and thought.

Session five (Monday, almost a year later)

Grace recounted a pleasant weekend in the company of friends.
This was a highly unusual announcement for her, as she frequently
feels detached, isolated, and alone at weekends, either yearning for
me or, just as often, for frozen yogurt. What she wants, however, is
not really me, the analyst who tries to help her understand, but her
phantasy of a mother/me available at all times, a womb-mother
promising protection from the painful awareness of separateness.
Those times when she did enjoy her weekend were invariably
followed by reports of unmanageable feelings of need, of wanting
more, then binging after an evening out in order to obliterate the
feeling of need, and the pleasure. It was therefore surprising to hear
her simply say she had a good time. She had had a nice dinner with
a close friend on Saturday, and on Sunday, still hungry for more
contact with people after studying all day, she called some friends.
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They went to a dance performance, by which she felt nourished and

inspired. “It was so alive and creative,” she beamed, “and I didn’t
feel insecure like I usually do. I could just be myself.”
She said she had thought about an interpretation I had made in
the last session concerning her desire to stay isolated and loyally
bound to her sick internal mother. She mentioned today that she
had somehow hurt her back yesterday. “I couldn’t move one way
or the other,” she said, “I was frozen with pain.”
I thought that even the positive change of being able to have fun
felt frightening to her, a psychic movement which she was then
compelled to stop cold, freezing the live dance of feelings in her
body and in her mind. Should she be born or stay in the womb?
One step away from that safe womb of phantasy felt like a betrayal
of her internal relationship with a mother by now identified with a
moralistic superego against any other kind of relationship. She felt
she was being punished, a harsh moralistic judgement meted out
by an unconscious conscience warning and threatening her against
change. She was then helpless “to move one way or the other”, and,
although this punishing could now be felt only in her body, her
mental dilemma was clear. She feared going forward to experience
the painful feelings of mental birth, but by now she could also feel
the numbing deadness of loyalty to her sick internal mother.

Session six (another year later)

Grace remarked on being happy to see me. She looked exhausted
and complained of feeling overwhelmed with work. Also, her car
had died, leaving her with feelings of shame at having to ask her
father for more financial help. She described a conversation in
which a friend had mentioned the dictum of the Hippocratic
Oath—”First, do no harm”—in reference to a botched medical pro-
cedure and the high incidence of iatrogenic illness. I interpreted her
conflicting feelings of being glad to see me but also angry that I do
not protect her from these calamities of financial trouble and over-
work. Even worse, since our work has allowed her to feel her
painful vulnerability and need, she feels that I, too, have failed to
heed the Hippocratic Oath and have done her harm. Unconsciously,
she feels that anything less than providing a womb where she is
safe from all pain means I have failed or damaged her or made her
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more ill. Overwhelmed, she exclaimed, “I feel like you don’t know
how much I need! No one else feels so much need!”
She cannot reconcile her need for me/mother with her hatred of
those needs, and so she hates me for being the cause of the need. I
am, here, indistinguishable from her mother of infancy who was
unavailable, unable to meet her emotional needs, and so the unsat-
isfied needs themselves are judged as bad by the primitive
conscience. This helps us to remind ourselves that transference is a
hallucinatory state, a denial of reality, although one which exists at
varying levels of pathology, depending on the patient.
In order to be born, the foetus, in a sense, must die, at least to
that foetal form which defined it up until the moment of birth. And
birth, for every neonate, is fraught with feelings of need: the need
for warmth in the sudden awareness of cold on the skin, the need
for food in the sudden awareness of thirst in the mouth and hunger
in the belly, and the physical and mental need for the warmth and
safety of maternal attachment. As the analyst facilitating her
psychic birth, I am perceived as an unscrupulous doctor, indeed, a
murderer of the mental womb that she experiences as life.
Grace reported these dreams. The first one seemed related both
in imagery and in meaning to the dream in Session Three, which
had taken place about two years earlier. Both, I thought, repre-
sented movement toward the capacity to think.

I was at my elementary school, but when I went outside it looked like

my first high school. The sky was split, part was a beautiful sunset with
pretty pinks and blues, and the other side was the darkest night, darker
than I’d ever seen before. I thought, What if the darkness sets in before
I get to my car? How will I see?
Then some people were doing a dance performance at my elementary
school and I jumped up on the stage and joined them. I wondered if I
should be embarrassed dancing like that, but I really wanted to, and I
wanted to learn how.

She recalled the dance performance she had enjoyed so much last
weekend, and remarked that she loves to dance. She then explained
that, as an adolescent, she had transferred to a new high school that
focused on the Arts, for she knew she had a need to express her feel-
ings. She remembered feeling grateful that her father had allowed
her to transfer, despite his preference that she be more academic.
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I saw in these dreams a reflection of Meltzer’s idea of the aesthe-

tic conflict, the memory of an elementary state of wholeness char-
acterized by an intuitive, perhaps a priori sense of one’s needs. But
this was quickly followed by a split in Grace’s mind upon finding
she had no maternal containment for her deep feelings of attach-
ment, wholeness, and truth. In this context, I considered that her
“first high school” was a reference to a kind of manic “high”, the
result of that split which served to defend her against sorrow and
terror of her mother’s illness through precocious mental develop-
ment. In the dream, she experiences this split—the beautiful pink
sky juxtaposed to the terrifying darkness. However, the dream then
changes back again to her elementary school, that elementary state
of wholeness, I thought, with which she had renewed contact as she
allowed herself the experience of freedom and pleasure last week-
end. As in her association to her father, she was feeling grateful to
me for facilitating her psychical move back to a feeling of life and
expressiveness. As with her dream two years ago, with its similar
imagery of encroaching darkness, she had opened up the idea of a
mental space where she could begin to think of me as separate, and
this dream seemed to revisit the apprehension aroused by that
inchoate development.
As we saw at the start of the session, Grace still feels torn
between the confused images of that helpful me and a me whose
role as midwife to a maelstrom of feelings so long sequestered in
the dark makes me appear dangerous indeed. But there was a sense
in this dream of a healthy split, for her increasing awareness of the
“darkness” of her feelings of loss and suspicion allows her, as we
see in the second dream, to jump into the dance of life. Despite the
fear and uncertainty that accompany the experience of change, she
wants to join in. She can then experience both the feelings of love—
symbolized by the beautiful colourful sky—and the terror of those
dark internal forces that aim to protect her from pain by keeping
her dead. This kind of split is preliminary to integration and is the
basis of the healthy and ongoing adult transformations between
paranoid–schizoid and depressive anxieties which Bion character-
ized as Ps↔D (Bion, 1970, p. 124).
I saw this dream as a working through of what felt to her last
week as a daring plunge into life, into the unknown and away from
the womb of repetitive phantasies and prohibitions. As we also saw
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in Allen’s recurring images representing various distances from his

real self, the more he could experience how far he was from contact
with himself, the more frustration he felt. Only by feeling it directly
could he be aware that he was missing from his own life, and only
then was he in a position to change it. We see with Grace, as well,
how the emerging sense of contact with reality, with emotional life,
and with the analyst is so threatening that even venturing out for a
brief moment causes her to recoil as if having touched a hot stove.
There was a shift in Grace after this session, and a nascent abil-
ity to distinguish good from bad. For instance, about a week later,
she was able to tolerate gratitude and affection towards me without
destroying them immediately, as she usually did. The pleasure of
these tender feelings was accompanied by painful vulnerability, the
intensity of a real and profound feeling in relation to another real
person felt almost unbearable to her. They made her aware of how
often she rejected my help, an experience of guilt that was equally
painful and aroused questions in her mind as to how she could
repay me. She felt buffeted about by this dizzying storm of painful
pleasure, which she managed to weather through the next two
sessions. During the next weekend break, however, she could bear
them no longer and, as we see in this next session, set about des-
troying the link between us.

Session seven: the following Monday

Grace had felt an excruciating awareness of being a separate person
in the world. Over the weekend, the oscillations of sweet feelings
of connection and painful feelings of need were too difficult to bear,
and, confused and hopeless, she binged on sweets, trying to mimic
and recapture in phantasy the sweetness of those affectionate feel-
ings. It served, instead, violently to obliterate her awareness of her
need for real contact. I pointed out the paradox, that, while physi-
cally she stuffs herself with sweets, mentally she can bear just a tiny
bit of the intense sweetness of emotional connection. She was struck
by this dichotomy, and became aware that she does not know how
to digest that little bit of real emotional sweetness. She reported this

I was up in the mountains; it was really steep. There was a girl, a more
advanced snowboarder, who went to the top of the mountain. It felt
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too steep for me, but the bottom looked like fun, it was really soft

The mountains made her think of “someplace like Tibet . . . spir-

itual . . . the idea of a peaceful place where I could have some space
to be able to hear what I feel.” She enjoyed snowboarding, she said,
and commented that the girl in the dream was not familiar to her.
I thought her dream reflected the emotional contact she had
made with me last week. Like the “more advanced girl” in her
dream, she had climbed that steep hill with me toward mental
awareness of her feelings of affection and contact. In the face of our
separation, however, she found this awareness to be too steep a task
and had turned it into a feeling of not needing me, inhabiting the
“bottom”, where no effort or striving or work is necessary. I felt she
was experiencing this at a very primitive level, so that, in terms of
primitive phantasy, we might say that she had been able as an
infant to make that journey up to the breast, to contact with grati-
fying mental experiences of love and attachment to her mother, as
well as to the pleasant physical sensations of the taste and nourish-
ment of milk. Without finding a mother there available for real
mental contact, however, she withdrew from these loving feelings
associated with two-ness back into the phantasy of self-sufficiency.
There, she could only feed herself a confusing mix of good and bad,
rejecting attachment to the unavailable mother through the ideal
phantasy of an all-providing internal mother/self .
Tustin (1981) talks about the infant’s experience of hard and soft,
the softness of the breast and the protection of the womb and of the
mother’s mind. Too soon pushed out of that protection, the infant
is faced with unmanageable feelings of the hardness and pain of
separate existence. Here, Grace would like to stay at the bottom
(“the bottom looked good”), which, on that primitive level, may
reflect the displacement from emotional experience to anal sensa-
tions in an attempt to ameliorate the painful awareness of a sepa-
rate existence. These self-induced physical sensations create a
barrier to feeling, instilling soft feelings of protection like a baby in
the womb, or the pleasure of having her bottom powdered. Para-
doxically, these distractions from “hard” feelings of separateness
become hardened and impenetrable defences against real contact
with inner and outer reality.
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Grace’s reactions are typical of the advance and retreat toward

growth, which repeats constantly throughout analytic work. The
movement toward mental birth poses particular threats to those
hardened defenses, provoking violent backlash against change and
the development of a separate mind.

Session eight: next session

Grace expressed fear that I would not want to see her any more
because she keeps numbing her feelings and rejecting my help. I
did not sense in this the more developed feelings of guilt based on
conscious awareness of gratitude, as she had experienced in Session
Six. Her feelings seemed rather to reflect old fears of abandonment
and punishment by me as I represent her mother. In keeping with
this, she reported a dream fragment of which she recalled only that

she escaped from a crazy killer to the home of Jeannette, a childhood


She remembered Jeannette’s family as “sane and loving”, in

contrast to hers. This led me to think, and to interpret to Grace, that
her mental escape into phantasy was originally an effort to create a
sane and loving internal mother, in an attempt to control the inter-
nal chaos and the external chaos of her actual mother and home life.
This small clinical insight helped me to think about the idea that
in the absence of a genuine attachment, the child is more likely to
learn from the parents out of fear of not being loved, as Freud (1930a)
said in his description of the superego, rather than out of love or
genuine attachment. Freud’s idea is based on the assumption of a
good object, but, for the child who has in reality already experi-
enced that loss of love (i.e., the loss of emotional containment and
of understanding), the superego does not represent the internaliza-
tion of a good object but, as Fairbairn (1952) suggests, an internal-
ized “bad” parent who cannot see the real self. In attempting to do
away with the anger at the “bad” parent, this internalized parental
superego prohibits all feeling. It differs from prohibitions of attacks
upon a good parent motivated by a real sense of conscience, for
these are the prohibitions of a moralistic parental imago opposed to
genuine feeling. This primitive superego furthers repression of the
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true self and mires the potential for a true conscience in a confusion
of good and bad.

Session nine: the following week

This last of the sessions from Grace’s treatment took place the
following week. A very dour Grace said, “I’m so angry with you
. . . I feel bad because I know it’s because you tell me things that are
painful.” Grace was able to feel her conflict, for she had managed
to bring reason to bear on her primitive, and usually automatic,
emotional reaction. After a long silence, she expressed the thought
that she hates life; she hates, that is, the experience of being alive to
her feelings. She was uncharacteristically silent again for a long
while. Finally, I said that I thought she did not want to talk to me
today because she feared that if she did I was liable to say some-
thing else she does not like. She laughed openly and with genuine
amusement. I asked what struck her as funny, and she said,
“Because it’s so honest.” I thought this clarified her dilemma.
Humour is often based on paradox, the capacity to experience two
opposing feelings simultaneously. Grace’s love of the truth allowed
her to find paradoxical pleasure in the honesty of my statement,
but, once open to truth, she also feels the pain of being alive. She
then hates the truth, and hates me for bringing it to her attention. I
pointed out that she seems to be the kind of person who happens
to like the truth, but this became complicated by her experiences as
a child who was faced too early with truths too painful for her to
bear. Unable now to distinguish the truth of that painful early expe-
rience (her mother’s illness, absence, etc.) from the truth or reality
of the rest of life, she rids herself of that early pain but in the process
also throws out her love of truth and her awareness of her love of
truth. In essence, she “throws the baby out with the bath water”,
sacrificing her awareness of her mind and her own authentic
nature, along with the unavoidable rejection of those early trau-
matic truths.
In this last dream fragment, Grace says,

Dr. J called and said he was going to work with the Dalai Lama. I was
going too, but it was hard to get there, I didn’t know how.
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Dr J was an old college professor who had once described a

study of the brains of monks, including the Dalai Lama. What they
found was that when thinking or meditating, these monks could
down-regulate the amygdala and calm their brains. The opposite
effect was discovered in the brains of depressed people, whose
amygdalae became overstimulated when they tried to focus or think
about something.
I interpreted her view of me as the Dalai Lama, in the sense here
of being someone whom she sees as capable of regulating emotions,
my own as well as hers. She does not know how to get to that capa-
city in herself—as she says in the dream, “it was hard to get there.”
Her frustration at being unable to “regulate” or think about her
despair engenders helplessness, anger, and envy. As her frustration
becomes more acute, so does her urgency to deny her connection to
me, to truth, and to her own regard for the truth. Relying on these
more primitive methods of dealing with frustration essentially
denies her access to the use of her mind. However, Grace’s associ-
ations to a more developed state of mind, towards which she is
driven in both this dream and the dream in Session Seven, indicate
her awareness of a desire for truth which is fundamental to her
personality, but against which intransigent obstacles had developed
in her childhood.

The core confusion

The difficulty inherent in the development of conscience became
clear in these sessions with Grace. The feelings of pain that her
awareness of separateness and need brought in their wake gave rise
to awareness of her anger at me and dismissal of my help. Unwar-
ranted and unremorseful attacks on others, or on oneself, clearly
indicate a lack of conscience, which cannot be avoided if these
attacks and their motivations remain unconscious. They are auto-
matic reactions, triggers which replay unmentalized past events in
the mind, and preclude the ability to experience or think about
current reality. Illusions and hallucinatory states substitute for the
frustrations of reality and so prevent the development of the capa-
city to think. The capacities for attention and memory, and the capa-
city to make distinctions upon which a reasoned judgement may be
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based, are unavailable, and one is left only with the ancient
pronouncements of a primitive superego informed by nothing but
that old experience.
As Grace indicated, however, she was now aware that her
hatred of me was based on my having shown her painful truths,
and so she is faced with her dilemma of her own knowledge that
she hates truth and my capacity to think. Since she also values the
truth, this awareness was, in itself, another painful truth, and the
basis of the genuine pain of guilt and remorse for having harmed a
good object. As long as the reason for her attack remained uncon-
scious, Grace could react only to the sensation of pain brought
about by her feeling of need, for which I, as a bad object, was felt
to be responsible. This obscured her awareness that what she really
hated was her need for a good or helpful object. The more genuine
feeling of remorse that she experienced in this session represents
Bion’s (1970) distinction between having pain and having the capa-
city to suffer pain. Klein’s (1946) concept of unconscious guilt in
infancy as projections of aggression gives rise to this experience of
pain as inflicted from without, the persecution of split-off and
projected feelings.
Grace was in a fight for her conscience, to separate out and bring
to light this fundamental confusion between good and bad. As her
emotional tides shifted again, she became caught up in seething
anger at me and was unable to trust me for months. Every little
frustration was felt to be my fault, a reaction she sometimes recog-
nized to be irrational, but, since I could not magically remove all
pain, she would then devalue me as useless. Compared to her
phantasy of a womb–mother to which she was accustomed, I was
felt to be leading her in exactly the wrong direction, like the bad
doctor who had violated the Hippocratic Oath (above, p. 109). Life
and death were hopelessly confused in her mind, despite her abil-
ity to remember that our work had so often helped her to function
and to feel alive. I pointed out that, essentially, she was enraged
with me because I was not helping her, mentally, to die
Fairbairn pointed out the importance of bringing the repres-
sed bad objects to light. “. . . [T]he release of bad objects from the
unconscious is one of the chief aims which the psychotherapist
should set himself out to achieve, even at the expense of a severe
‘transference neurosis’ ” (Fairbairn, 1952, p. 69). Observing this
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process in Grace, it seemed even more evident that the birth of con-
science is inseparable from the process of mental birth. Although
painfully aware of her confusion between good and bad, including
her unconscious, and at times conscious, preference to believe lies
over truth, Grace was often helpless to choose truth, connection, or
love, all of which she consciously espoused. “It’s so sad,” she said
poignantly, “I can’t even decide which side of the war to be on . . .
I keep switching from wanting to die and not feel anything, then
coming back to wanting you to help me, to relationship and friends
and life.” Her sadness was born of her realization that she is, in fact,
alive, despite the retreats meant to shield her from pain, and that
these retreats made it impossible to get the satisfaction from her real
life which she so desired.

Update on clinical case B

Although Grace began to feel that the divide between her opposing
impulses toward contact and retreat was getting wider, it was actu-
ally her awareness of it that had grown. She was now quite
consciously aware of not wanting to think, and of wanting to
destroy me and any connection between us. I felt this to be chill-
ingly true in one session after I started interpreting that she “feels
bad” about this destructiveness, but I slipped and said she “feels
good”. I had to admit to us both that I thought she does feel good
about it, for I realized that I was looking at the core of her confu-
sion from which any natural impulse toward love, connection, or
morality could only be seen as bad. From this vertex, she uncon-
sciously enjoyed devaluing me. I did not think it was because of an
innate sense of envy, as might sometimes be supposed, but rather
that beneath whatever feelings of envy she did have, devaluing me
served to give her the illusion of control of overwhelming feelings
of need. Like Allen’s awareness of Lucifer, not as evil, but as the
confused fallen angel baby (above, p. 98), this kind of destructive
impulse is born of profound confusion about what is good and
what is bad. The pleasure in destroying the object is, in this case,
based on the “pleasure” or relief of ridding oneself of the helpless
feeling of need which goes unmet by the object. Secondarily, it may
lead to sadistic impulses, but I find it is worth considering these
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primitive projections and anal–sadistic phantasies described by

Klein as derived from an earlier aetiology in that massive infantile
confusion. This idea reflects Bion’s extension of projective identifi-
cation as a means of communication, in addition to its function as
a means of attack on the object.
Grace’s experience with a psychotic mother contributed to a
reversal of the meaning of good and bad characteristic of this core
confusion. Her unconscious “choice” not to depend on a disturbed
mother was in part life preservative, and therefore experienced as
good; however, since it had the effect of undermining the develop-
ment of her true self, the foundation from which thinking and a true
conscience might develop, it was then also experienced as bad.
There were things learnt in the course of Grace’s analysis which,
in retrospect, helped us both to understand more about her sense of
unmanageable helplessness and need. She had always thought she
was nursed until she was two years old, but had recently learnt that
she had, in fact, been weaned at three months. At that point, her
mother had returned to work, and Grace, left with a care-giver, had
for a time refused the bottle, essentially starving herself until her
mother’s return. The fallout of these events, in addition to the
mistrust already present in response to her mother’s mental illness,
helped further to explain the depth of Grace’s terror about separa-
tion, her problems with food, and the unyielding barrier she had
erected against emotional contact.
It is the primitive superego which erects this barrier against any
painful contact with the external world, or with an authentic inter-
nal world. With no basis in a capacity to think or discriminate, it
leads inevitably to confusion between right and wrong. We saw this
recently when Grace’s work schedule required her to cancel a
session with me, arousing an internal attack which illuminated the
brutal power of her primitive superego. Despite her sometimes
fierce resistance, she almost never missed a session. While this
could easily be viewed as her devotion to her treatment, and may,
in part, reflect that, we now learnt that there was a clear prohibition
in her mind against cancelling. Without this strictly imposed struc-
ture that directed her thoughts and her actions, she feared she
would destroy everything. “If I take a step outside the womb it will
destroy things between us,” she said, “and yet I know I can’t do this
alone without you.” She felt trapped in this dilemma, for the rigid
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structure of her primitive superego, felt to control her capacity for

wholesale destruction, was, paradoxically, the same force that
wrought destruction of her personality and her contact with me.
Although she fears anarchy, it is her own feelings she fears, the anar-
chic experience of human vulnerability, pain, and confusion, kept
in tow by the god-like power which makes and enforces these rules.
As a result of this unthinking and unfeeling internal bully with
its barricade against real feelings, neither of us is felt to be free to
choose to do as we wish. If I help her, she feels it is not out of choice,
but because she has decreed it, forced by that primitive god. Led by
the comforting delusion that this omniscient god will protect and
guide her, she believes she will always do the right thing, as will I,
but the “right” thing is defined as no separateness, no autonomy,
and no choice. This is the source of the essential confusion between good
and bad, for, while Grace does the “right” thing by coming to her sessions,
it is for the wrong reason, and so, from the perspective of her authentic self,
is therefore wrong. It is “wrong”, that is, not in a moralistic sense, but
is internally experienced as wrong by a self in touch with its inher-
ent instinct for truth.
The converse of this also holds true. Once the confusion takes
over, one also does the wrong thing for the right reason, the “right”
reason being one’s incipient moral imperative to preserve the
parents. This brain twister is exactly how it is experienced by the
child in the grip of the moral dilemma (Fairbairn, 1952). The
preceding sessions reveal these kinds of confused unconscious reac-
tions, which masquerade as “thinking”. This confusion has its
source in the internalization of an idealized bad object. As Fair-
bairn’s “moral defense” describes, having made herself evil in a
good world, Grace was compelled to do the wrong thing for the
right reasons.
As Bion (1970) suggested, we must be willing to question even
the idea of cure as good, for that cure, as we see here, may reflect
the kind of unexamined goodness that hides these kinds of con-
fused “bad” intentions. It may be tricky, indeed, even just to recog-
nize these dynamics behind a well-entrenched and often cleverly
disguised false self. One is called upon to tease out this knot at the
core of being where that which is apparently good may long since
have become an outmoded and undeveloped sense of morality
which now represents the hatred of love and of life. It requires, as
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Nietzsche (1888) described it, a more subtle means of making judge-

ments, the kind of “long secret work” (p. 45) he saw as reserved for
the most honest philosophers or, we might add, psychoanalysts. It
requires us to consider, challenge, and resist familiar and accepted
values in a state of mind beyond good and evil, a state of whole-
ness based on the capacity to contain primitive emotional life in
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Summary and conclusions

“Science without conscience is but the ruin of the soul”

(Rabelais, 1532)

have put forward the idea of a mature conscience as a largely
unrealized mental potential. Fundamental to the development
of a mature conscience is the capacity for the containment of
primitive emotional experience within conscious thought, which
requires contact with an authentic self. Early emotional trauma,
including emotional misattunement and parental incapacity for
emotional containment, can obstruct this development and give rise
to primitive confusion between good and bad, delineated in Fair-
bairn’s concept of the “moral defense” (1952). From this pers-
pective, the identification with a “bad” parent is the origin of a
primitive and punishing superego, which represents a pathological
development of a natural potential for conscience. In repressing
the emotional reality of the true self, this primitive superego gives
rise to and empowers the defensive organization of a false self.
It is important to clarify the idea that the use of the word
“bad” is not meant as condemnation of the parent. Rather, it calls

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attention to the child’s experience of trauma, which may derive

from less pathological, even “ordinary”, parental shortcomings
such as the incapacity for emotional containment. This kind of
“badness” is what Khan describes as “breaks in the mother’s role
as a protective shield” (1963, p. 122), her inability to support the
child’s undeveloped ego. Looking at it in this way, “. . . should help
in replacing such incriminating reconstructions as bad, rejecting,
incestuous mothers” (ibid., p. 123). Since we are not talking only
about cases of overt abuse, the confusion and problems of con-
science that result from these kinds of parent–child relationships
reflect problems in thinking and mental development which appear
to be extremely widespread.
This kind of early confusion in relation to the mother impedes
the capacity to distinguish “good” from “bad”, a judgement funda-
mental to the function of conscience. Primitive confusion originat-
ing at a pre-verbal, proto-mental level arises in the conflict between
instinctual knowledge of need for emotional attachment and the
object’s inability to fulfil that need. The child is then faced with an
emotional dilemma. Either he feels his aggression towards the
mother, which is felt to damage or destroy her, or, in an effort to
protect her from it, he denies the reality of his inner life by idealiz-
ing her and identifying with his idealized phantasy. The relation-
ship with the mother, then removed to the inner world of phantasy,
imagination, or hallucinosis, is divorced from a real relationship
with a real parent. This phantasied internal parent may then
become the model for the ego ideal, an aspect of a primitive super-
ego derived from that early defensive split. This conscience, frozen
in time, cannot grow, and places unrealistic demands upon the self.
Like any tyrannical regime, it seeks not to understand, but to purge
those elements of the personality which appear dangerous to the
Destroying one’s awareness of anger to protect the mother is
just such a purge, an act of aggression against one’s own aggres-
sion. This reactionary method, now confused with love and moral-
ity, serves as a provisional conscience, a development of the
natural potential for conscience, but one based on fear and con-
fusion rather than emotional truth. It results in aggression and
hatred toward the self, as well as a split from emotional reality.
Reconnecting with these disavowed aspects of the self through the
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process of a psychological birth prepares the mental ground in

which a healthy conscience can grow.

The good enough mother, revisited

One of Bion’s most important contributions is the idea that the
mind has to develop the capacity to think. According to Meltzer
(1984b), Klein saw the mind as a sort of internal theatre in which
the emotional relationships between the internal “characters”
generate a sense of meaning, but, unlike Bion, she took for granted
the mind’s capacity to think. Bion described the necessary condi-
tions of a capacity for thinking as dependent on certain fundamen-
tal capacities of the mother’s mind: her capacities for reverie and
alpha function (Bion, 1962a). It occurred to me that there is a need
to revisit and reconsider Winnicott’s idea of the good enough
mother in the light of Bion’s ideas about the necessary conditions
for mental development. Our increased awareness of the effects of
early emotional trauma on mental development, including the
absence of maternal emotional containment, also help us better to
understand some of the roots of problems in thinking we so
frequently observe.
Although Klein (1945) made brief references to the effects of
maternal deprivation on mental development, her focus was prim-
arily on the unconscious aggressive phantasies of the child. From
the perspective of the infant’s need for truth as a factor in the devel-
opment of a true self and the capacity to think, that which we
generally consider to be a “good enough mother” may not be
good enough. Such a statement might seem insulting or incendiary,
and clearly a discussion of this sort raises the valid controversy
of whether one is simply “blaming” the mother and ignoring the
role of the infant’s unconscious aggressive phantasies. Framing
the issue in terms of blame, however, is a product of the primitive
superego, that moralistic but essentially amoral perspective which
occludes the capacity to co-ordinate the knowledge we have
gained. It need not be either/or; in other words, it can be both. With
these provisos, we can acknowledge both the critical role which
unconscious phantasies and hostile projections play in the devel-
opment of the child’s view of the mother, while at the same time
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recognizing the presence or absence in the mother of the conditions

necessary for mental growth. While we can observe, that is, that
projections of unconscious phantasies on to the object help to deter-
mine the child’s view of the object, we can also observe that, with-
out the mother’s capacity for alpha function (Bion, 1962a), the child
cannot develop that capacity in himself. The infant may receive
sufficient care and love from the mother to thrive and develop in a
multitude of valuable ways, but, without these capacities in the
mother fundamental to mental development, the development of
higher mental functions will probably suffer. The rudiments of
thinking, housed in the capacity for emotional containment, will be
forestalled, as will the eventual maturation of conscience. The
loving, attentive, and well-meaning mother—the good enough
mother—who cannot, however, contain her own emotional reality
may inadvertently create the situation from which a false self
evolves. The problems that result range from minor—a vague sense
of detachment or unease—to catastrophic schisms in the mind,
depending on the particular attributes of the mother and of the
infant, and the “fit” between their two personalities.
Our awareness of the slow, incremental steps necessary in
psychoanalytic practice to develop the capacity to contain
emotional life within the capacity to think puts us face to face with
the sobering thought that these functions which provide the foun-
dation of thinking, as well as the basis for a mature conscience, may
require years, even generations, to develop.

The question as to whether conscience is innate was discussed. It is
assumed by Freud (1933a), Bergler (1948), and others that the infant
displays no manifestation of conscience without parental educa-
tion. The idea of a more essential foundation for conscience was
posited, rooted in the infant’s inherent instincts for attachment and
truth. It is the basis of a rudimentary but innate sense of morality,
a potential to differentiate good from bad. This foundation for a
healthy conscience can be undermined by environmental factors
that confuse this innate potential and cause it to stagnate. This leads
to the development of a punitive superego, which strangles and
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perverts the roots of that innate moral sense. Identified with “bad”
objects that are idealized and internalized, this pathological struc-
ture erodes the ego’s awareness of the deeper truth of the self and
attacks any attempts to defend that self. This perspective, consistent
with Fairbairn’s, Symington’s, and Bion’s, conflicts with Freud’s
(1930a) view of conscience as fear of loss of parental love, and then
as fear of the superego, the representation of the internalized
This is the basis for the hypothesis presented here, that the
superego as described by Freud is a preliminary step in the devel-
opment of conscience, which, in many cases, becomes truncated by
confusion, either unable to develop or developing into a patholog-
ical version of conscience. The suggestion was made that the clas-
sical theory of the superego often reflects a separate developmental
line motivated by fear of punishment by the parents, the superego
as the “prohibiting parent” (Sharpe, 1978, p. 30). Guilt, in this case,
is based on an identification with a bad object rather than attach-
ment to a good object. From the perspective of that primitive super-
ego, goodness is unconsciously “defined” by the child as the
destruction of his own destructiveness. This does not lead to
emotional attachment, but to a withdrawal from contact and a
pathological development of the natural potential for conscience.
The primitive superego is instituted to cope with the unthink-
able confusion of good and bad impulses that develop towards
the parent. Klein’s theories of the early superego and the projections
of unconscious phantasies that lead the child to split the mother
into a good and bad object are also clear factors in this conflict.
However, her theory does not typically address the confusion
derived from the internalization of a “bad” object. The latter
presents a crisis of the ego with which the child is not equipped
to cope. The provisional conscience, which arises to cope with a
“bad” or disappointing object, is a function of a false self called into
being to deny the actual experience of parental failure and preserve
the feelings of love. In the process, the capacity for truth is also
Though repressed, the rage towards the parent activates a puni-
tive conscience to protect the internalized “bad” object. The internal
split results in a withdrawal from the parent and the development
of false self, while the “real” baby and real self are exiled to the
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schizoid, encapsulated, walled-off state variously described by

Fairbairn (1952), Tustin (1981), Rosenfeld (1987), Paul (1981), and
Steiner (1993). As we saw in the clinical examples, the false self and
the encapsulated real self are based on an idealized phantasy of a
self-sufficient, womb-like state meant as protection from unman-
ageable feelings of need in the presence of an object unable to meet
those needs through the containing function of emotional aware-
ness. While this pathological organization functions as a primitive
conscience, it prevents both the real attachment to a real object and
a real connection to an authentic self. The attachment to a phantasy
of an idealized object that takes its place is the basis of Freud’s
idea of God as the child’s infantile fantasy of the father. It also
underlies his idea of religion as an illusion, reflecting the “false
god” (Symington, 2004) of primitive fundamentalist religion that
precludes rational and scientific thought.
The essential factor underlying the idea of a natural potential for
moral development is an innate epistemophilic instinct. Grotstein
(2004) presents extensive evidence of this kind of “truth drive” in
Bion’s work. Bléandonu refers to this instinct for truth as a “genetic
epistemology” (1994, p. 178). Bion (1967) makes the point that the
mind’s need for truth is analogous to the body’s need for food, that
is, it is necessary to survival. Deprived of truth, the mind and
personality become ill and deteriorate. The child’s knowledge of its
need for attachment represents an instinctual truth, a primal sense
of morality in which food (breast or good maternal function) is
equated with life and is therefore good, while the absence of food
(breast or good maternal function) is equated with death, and is
therefore bad.
The above-mentioned “good maternal functions” depend on the
mother’s contact with the truth of her own real self. However, the
reality of a “good” nourishing mummy able to provide physical
nourishment but unable to provide the nourishing mental food of
emotional truth is a truth too painful and confusing for the infant
to digest and so must be denied. Fairbairn’s (1952) idea of the
“moral defense” describes how the child in such a situation makes
himself bad in order to make the parents good. This constitutes a
mental lie, a betrayal of the instinct towards truth that undermines
the foundation of a healthy and viable self, mind, or conscience. A
superego that might have emerged as a precursor to a real conscience,
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instead becomes engaged by the child to protect him from the “truth” of
his badness, which is formed in part of that lie denying the badness of the
internalized parent. Further confusion in this confused and confusing
maze of proto-thoughts arises because the child also judges himself
“bad” on the grounds of having turned away from truth and from
genuine connection. The infant’s inherent instinct for truth gives
him a natural antipathy to un-truth, which is experienced as poiso-
nous to the mind (Bion, 1992). There is also an inherent under-
standing of rage as destructive toward the object, based on the
incipient potential for morality of a fundamental intuition that
attachment is good. This seems to be at odds with Freud’s (1933a)
notion of the child’s essential amorality.
A deeper understanding of conscience cuts to the core of this
primal confusion, and reveals something of the source of Freud’s
observation about the negligible amount of conscience in human
civilization. However, it also reveals what appears to be the breed-
ing ground of an unconscious and widespread disorder in thinking.
As we saw demonstrated repeatedly in the examples from Grace’s
treatment, unmentalized feelings and thoughts leave one detached
from knowledge of one’s inner world, so that choices in favour of
connection to others, or to one’s true self, are compromised.
The infant’s efforts to use its rudimentary mental equipment to
make coarse assessments of right and wrong are bound to fail, as is
the attempt to sort out the confusional states that arise in relation to
the mother as a result. In order to sort this out, moral boundaries
must be teased out and redrawn, according to what Nietzsche
described as that “long secret work . . . [which is] . . . the living
touchstone of the soul” (1886, p. 45). Traditional morality must
be questioned in order to distinguish those conventions which
may yield apparently “good” behaviours, which lack the capa-
city for internally determined judgements based on thinking and
which are, in fact, disconnected from an authentic self. Most people
easily pass the tests of conscience based on customary standards
of right and wrong, but an internally motivated assessment reflects
a deeper realm of instinctual truth, the apprehension of which
depends upon contact with a more fundamental reality, with O. The
clinical material illustrated the connection between the potential for
this kind of conscience and the process of birth of the true self from
its encapsulated state.
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Bion’s description of rage as a kind of mental lie that serves

as a substitute for another emotion also supports the notion of the
infant’s instinctual feeling of rage as unacceptable. Rage destroys
the mind’s capacity to contain as well as its contents, and, like
Allen’s “manufactured world” in Session Eleven, the negation of
emotional life leaves the child in a negative reality inaccessible to
feeling or thought. The provisional superego, or precocious
conscience, is established before the development of thought to try
to keep this rage in check, not only to protect the parents from the
child’s aggression, as Freud indicated, but also in an attempt to
protect the child from the frightening explosive damage to his own
mental capacities. This truncated superego becomes the basis of a
false conscience, for what looks like attachment to the object is actu-
ally guilt for unconscious rage, kept strictly imprisoned behind a
barrier to emotion. We can see confusion of love and guilt in obses-
sive–compulsive disorders and the over-dependence of insecure
attachments (Schore, 2003, p. 66), where neither a secure attachment
nor a real conscience can grow.
Rosenfeld’s (1987) and Fairbairn’s (1952) ideas about the trau-
matic nature of parental projections into the child provide an
opportunity to understand the profound confusion at this deeper
level of object relations. In Allen’s dream in Session One, we see
how his rejection of reality and emotional truth, along with his
capacity to apprehend them, leads to the creation of an illusory
unreal world by a sort of anti-mind detached from emotional expe-
rience. It demonstrates the idea that the capacity to perceive truth
and reality depends on the mind’s ability to contain its emotional
Also reflected here is Bion’s (1970) concept of “thoughts without
a thinker”. These are universal truths that exist whether or not there
is anyone there to think them, but to which the human mind has
the potential to be attuned. Our capacity to entertain these essential
truths nourishes and sustains the mind and imbues life with a sense
of meaning. Bion adds that only lies require a thinker to think
them—someone to create them, remember them, etc.—and that
these erode the integrity and health of the mind. Allen, having
turned away from his emotional reality by creating the lie in his
mind, existed in a reality drained of meaning and a mind unable to
ascertain truth.
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Theological, philosophical, and

aesthetic models of mental birth

In the myth of the Garden of Eden, a taste of knowledge of good

and evil spells disaster for Adam and Eve, who are banished from
Paradise to a lifetime of pain and work. This seemingly disastrous
ejection from the blissful state in the Garden can be seen as the loss
of the blissful unconscious phantasy of an omnipotent womb/
mother, giving rise to the painful, hated work of mental birth and
psychic development. It is analogous to the infant who, once born,
is faced with the realities of life—separateness, time, mortality—
and the capacity for conscious awareness of these basic truths.
Adam and Eve’s taste of knowledge of good and evil also repre-
sents awareness of duality and the need to distinguish opposing
forces of good–evil, self–other, conscious–unconscious, mind–body.
Bion (1977b) examined God’s harsh opposition to Adam and
Eve’s strivings toward divine knowledge of immortality and good
and evil as representative of a prohibition against the natural drives
toward curiosity and truth. This oppressive God seems aligned
with the force of the primitive superego, whose interdictions
against truth keep one emotionally imprisoned. However, Bion also
calls attention to another kind of God that differs from this mentally
restrictive force. “Religious formulations which divide good and
evil do not possess the significance of the undivided principle resid-
ing in the same deity” (ibid., p. 11). The concept of the undivided
God may be seen to represent the integration of naturally opposing
forces of life (light, consciousness, truth) and death (darkness, igno-
rance, the unconscious). Like Shiva, the Hindu god of creation and
destruction, this God is a paradox: a union of opposites which gives
rise to a third entity, neither bad nor good, but both. The capacity
to bear the experience of ignorance, for instance, creates a mental
atmosphere of curiosity that makes learning possible, so that dark-
ness (ignorance or “evil”) is contained in light (consciousness or
“goodness”). Jung’s (1959) theories focus on the union of opposites
as the annihilation of the two sides as separate entities, giving rise
to a third entity of a unified mind or self (ibid., par. 124).
It is knowledge of malicious intent that makes one good, not
absence of malice, for only with that knowledge is one given choice.
These ideas get to the heart of a psychoanalytic understanding of
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conscience, whereby the “evil” of unknown intention is, first of all,

contained within the light of conscious awareness. It can then be
detoxified by this own awareness, transformed, which gives the
individual the choice of whether to act upon his original impulse or
simply to think it. It is analogous to the function played by the
mother’s awareness in mentally containing and detoxifying the
child’s primitive unconscious thoughts and feelings, making it
possible for the child to experience, digest, and ultimately to think
them. I believe this detoxification through conscious thought is the foun-
dation of the ongoing process of development of a mature conscience. It
may be fair to say then, that conscience is the knowledge, that is,
containment, of unthought and potentially evil feelings, thoughts,
or intentions within the light of one’s conscious mind. Conscience,
therefore, is always a by-product of consciousness, requiring all
the attributes of higher mental functioning necessary in thinking:
attention, memory, alpha function, and the dynamic interplay of
container and contained.
The capacity for integration in the dynamic relationship between
the dual mental functions of container and contained (Bion, 1970)
involves recurring transformations from contained to uncontained
to contained, from knowing to not knowing to knowing. This is
the same transition from faith to patience characterized by Bion
(1970) as Ps↔D, the recurring transformations which characterize
the journey from the healthy and more evolved adult paranoid–
schizoid position to the depressive position.
What Bion referred to as the “undivided principle residing in
the same deity” is also expressed in Meltzer and Harris’s (1988)
idea of the infant’s primary state of wholeness, which predates the
primitive paranoid–schizoid position. It also reflects the state of
mind of oceanic feeling and the essential experience of O. The para-
doxical balance of opposing forces is reflected in Goethe’s Faust as
well. “[Mephistopheles is] / Part of that force which would / Do
evil evermore, and yet creates good” (1808).
Paul (1997) addresses the primitive psychic implications of
the capacity, or lack of capacity, for this kind of unified thinking
relative to a patient’s psychical location either inside or outside
the womb-like state of mind. Being “out” presupposes an ability
for emotional contact and a capacity to tolerate mental pain. This
is characterized by what Paul calls “additive logic”, an ability
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for an inclusive experience of “and”, as opposed to an “either/or

logic” typified by the walled-off state (Paul, 1997, pp. 108–110).
Clinically, this kind of additive logic is not possible for the patient,
who cannot recognize the painful, or “bad”, awareness as also good
or health promoting. We saw an example of inclusive logic in
Allen’s capacity to see that his terror of being “de-constructed”,
cast out of the numbness of his womb-like existence, was also
good. On the other hand, from the infantile perspective, outside the
boundaries of capacity to think, pain equals bad, regardless of
the context. We could see this as Grace stepped away from her
phantasy of a safe encapsulated womb, but then interpreted her
pain either as internal punishment for her badness or punishment
meted out by a bad me. This false interpretation is not based
on thought, but is part of an imposed pseudo-morality that
obstructs the experience of the emerging self, and obstructs think-
ing (Paul, 1997, p. 111). In Grace’s case, she was unable to make use
of or learn from that experience, and whatever potential progress it
For the mind functioning under the “either/or logic”, Adam
and Eve’s painful expulsion from the Garden is assumed to be
punishment meted out by God for their evil transgression. Accord-
ing to an integrative or additive logic, however, their pain may
represent the unavoidable pain of reality, consciousness, and con-
science. The either/or logic is evidence of a primitive and perhaps
pathological superego, which oppresses mental life and is associ-
ated with the false or divided God. Additive logic, on the other
hand, is associated with psychological birth, an experience of
wholeness in the mind’s capacity to contain emotion within
thought. The new morality “beyond good and evil”, variously
attributed by Nietzsche (1888) to the “philosopher of the future”,
the free spirit, or “friends of truth” (pp. 53–56), is an example of this
capacity for integrative or inclusive logic. It is a way of thinking
which presupposes tolerance of mental pain. In all these examples,
opposing functions are transformed by their relationship to each
other bringing about a redefinition of both.
The individual must be able to observe and think about his or
her mental pain to determine whether it is inflicted by an angry
God or parent (or psychoanalyst) into whom the child’s hostility or
envy has been projected (Klein, 1933), or reflects part of the natural
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pain of mental life, the awareness of separateness and of good and

evil impulses in the self. Shakespeare wrote, “There is some soul of
goodness in things evil, would men observingly distil it out” (1600,
IV, i: 4). The capacity to observe and distinguish vice from virtue,
good from bad, is based on uncommon effort of attention and
thought, the ability to “observingly distil out” one from the other
with reference to one’s own emotional compass. If being tossed out
of Eden represents the ouster from unconsciousness and hallucina-
tion, the “disaster” in Genesis is the genesis of the mind itself,
which represents a path to truth, the sometimes torturous process
of observation and evaluation that is the ongoing process of mental

The birth of a mature conscience

The core of problems of conscience is the twisted knot between love

and hate. The birth of a true conscience requires the “death” of the
false self identified with a parent unable to facilitate the child’s
mental development. The child, cut off from its deeper inherent
knowledge of good and bad, is caught in the confusion of having
to hate that which he is instinctually “wired” to love.
The infant’s dilemma is similar to the distinction Dante makes in
The Divine Comedy between “absolute will”—a natural sense of right
and wrong—and “conditioned will”, where one’s will to choose a
moral path becomes tempered by circumstances.

Often my brother, it occurs that men,

against their will, to avoid a greater risk,
have done that which should never have been done . . .
Absolute will does not consent to wrong,
except insofar as it fears
by withdrawing, to incur greater pain. [Dante, 1306–1321,
Canto IV, p. 46]

The infant, whose instinct toward attachment and love is

tempered by environmental circumstances, betrays his instinctual
knowledge. The will toward the development of morality becomes
compromised by the fear of annihilation and the intolerable pain of
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being in a world without a loving object. The choice is made to

abandon the self, and, while it may be a necessary choice, it erodes
the capacity for truth. In addition, since the child also feels respon-
sible for his destructive phantasies against his loved objects, he is
still faced with the developmental task of integrating the good and
bad aspects of self and object outlined by Klein in the paranoid–
schizoid and depressive positions (Klein, 1946).

Conscience and the capacity for choice

Though not often discussed, the idea of choice is an important one
in psychoanalytic work, and in the maturation of a moral sense.
Without knowledge of the true self, one is not in a position to eval-
uate what is in the best interest of that self and make choices based
on that evaluation. As Allen begins to attend to his states of mind
and to the internal propaganda that obstructs that awareness
(Session Fourteen), he is able to think about whether or not his
usual punishing litany of thoughts is true or not. This gives him the
opportunity to choose a more fruitful course of action, which he
does. As he is also more aware of those times when he does not
make those choices in the interest of sanity, growth, or his own or
others’ well being, the idea of conscious choice becomes pivotal in
developing the capacity to experience guilt.
The endurance of symptoms and the persistence of unhealthy
choices over time, despite the patient’s apparent awareness of his
internal dynamics, may be due to various factors, from the patient’s
pathology or intractability to one’s own failure as an analyst. In
Bion’s terms, the patient’s or the analyst’s insight must reflect a
transformation in O, the essential reality, in order for learning to
occur on an emotional, experiential level. To effect transformations
in O, “the analyst has to become infinite through suspension of
memory, desire and understanding (Bion, 1970, p. 46, original ital-
ics). This presents a daunting challenge, as transformations in O—
the experiences of contact or at-one-ment with an infinite realm
beyond the familiar comfort of sensual reality—create feelings of
dread in both analyst and analysand. Change is experienced as a
catastrophic upheaval as both the mind’s container and its contents
are transformed.
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Resistance to this upheaval can be observed in Grace’s Sessions

Nine and Ten. The relationship between her mind as container and
its contents are what Bion described as “parasitic”, where a “formu-
lation is known to be false but is retained as a barrier against truth
which is feared as annihilating to the container or vice versa” (Bion,
1970, p. 118). While Grace’s tolerance for frustration had become
sufficient to allow a thought, and even to feel it momentarily, it was
not sufficient really to contain it, so that she quickly dispenses with
whatever she learns. We can visualize this with reference to the
parable in the New Testament, which equates truth with a seed and
describes the fate of that seed depending on where it is sown.

The one who received [the seed] on patches of rock is the man who
hears the word and welcomes it at once with joy. But he has no root
in him . . . let some trial come, or some persecution on account of
the word, and he falls away at once. The one who received the seed
in thorns is the man who hears the word, but the worries of this
world . . . choke the word and so he produces nothing . . . The one
who received the seed in rich soil . . . hears the word and under-
stands it; he is the one who yields a harvest and produces a
hundredfold. [Matthew, 13: 20]

Although Grace welcomed the truth, her internal persecutors,

her confusion and her fear of contact with her emotional reality, are
like the thorns and rock which, at that moment, render her mind
inhospitable to truth. And so Grace “falls away”, she continues to
binge, feeding herself phantasies of self-sufficiency and hallucina-
tions of an idealized internal mother. This is followed by self-
recriminations and punishing guilt. However, this apparent guilt
represents an attack from the undeveloped conscience of a punitive
superego derived from the primitive belief in mental pain as
inflicted from without; it is not experienced as a mental state. She
cannot be distinguished from her bad object or its internal represen-
tation, and so lacks real awareness of her destructiveness towards
her self or her object. Therefore, she feels guilt for a transgression,
the meaning of which she does not know. Consciously, she feels
guilty for being out of control, for having hunger and needs, all of
which are deemed imperfect according to the standards of a super-
ego opposed to feelings of need. Her anxiety that she will get fat
can be seen as a mental image of herself as a kind of walking
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ideogram of need, an announcement, so to speak, to herself and

the world that she is someone who needs to eat. When cut off
from awareness of these needs, she lives in fear that they will
escape the prison of her primitive ego ideal and be revealed to
others, and to herself. In this symptom, we can see the ambigu-
ity of fixed ideas of good and evil, imposed from without and with-
out access to thought. Grace tries to control her binges, which are
often clear attempts to numb her mind or split off her awareness
of need. However, the binges are also eruptions of need that
escaped the cruel demands of a superego demanding her emotional
starvation. Without an awareness of the specific meaning behind
the intention in that specific instance, she is in the position of doing
the right thing for the wrong reasons, without knowing which is
It seems necessary to distinguish two notions of the ego ideal.
In Freud’s theory of the superego, the ego ideal is an inner repre-
sentation of an idealized parent. If, on the other hand, it represents
an idealization needed as protection against awareness of a failure
in that relationship, it is part of a pathological superego. Like
Fairbairn’s moral defence, it is born of unconscious guilt adopted in
an attempt to pay for the “sins” of the object. This guilt is not
related to a reasoned moral position, but to an unconscious attack
on the self as the inner representation of the hated object. The other
kind of ideal derives from a priori knowledge, the inherent aware-
ness of the need for authentic connection and truth.
This idea of a “pure” or reasoned morality with its origins in
essential knowledge may also seem to be an idealistic notion, but it
differs from the defensive idealization. The latter gives rise to an
ego ideal that is an aspect of a primitive superego based on fear and
denial of emotional life. The former, as I have suggested, derives
from a natural capacity and drive for emotional truth, and repre-
sents a different line of development with the potential to mature
into a true conscience.
The idea of a mature conscience is perhaps better described
more dynamically as a conscience capable of maturation and growth.
This more clearly denotes a process of development rather than the
fixed, concretized, and idealized law of religious dogma or the
primitive superego. It reflects a function of the mind always linked to a
capacity to think, which shapes a constantly evolving moral perspective.
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Unlike the primitive superego, which aims to stop growth, a true

conscience is always in the act of becoming.
In this process of becoming, awareness of a destructive intention
is followed by a feeling of “guilt” based on awareness of its conse-
quences to the self, the object, and to the link between the two. With
that awareness, one is in a position to choose whether or not to act
upon that feeling or intention. The awareness itself also serves as
containment, which, much like maternal containment in infancy,
detoxifies the feeling. Guilt is not experienced as the inflicted pain
of an externally imposed punishment, or internal punishment
imposed by the bad internal object of a primitive superego; rather,
it is felt to be protective of the self. We often see evidence of this
distinction in patients’ dreams, where the symbol of the police or
law enforcement is used to represent conscience. Depending on
which internal “law” is being upheld (for or against growth), the
police may be viewed either as helpful and protective or punishing
and judgemental.
We can chart the development of these differing thought
processes in the following way.

Immature conscience based on a primitive superego

1. Destructive feeling, impulse or intention ➝
2. Unconscious action which fulfils the destructive intention ➝
3. Unconscious guilt for having betrayed the needs of the real
self ➝
4. Self punishment for unconscious transgressions felt to be
inflicted from without, or from an internalized bad object.

Mature conscience as a process of thinking

1. Destructive feeling, impulse or intention ➝
2. Attention to and conscious awareness of the destructive
impulse; awareness of its consequences to the self and others ➝
3. Conscious experience of guilt for the destructive impulse serves
as a deterrent to the destructive impulse, and is experienced not
as a punishment but as protection for the self and other ➝
4. Choice to abstain from action.
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With a mature conscience, awareness of the needs of the self is con-

tained in thought, making it possible to choose in favour of those
needs. Both the destructive intention and the guilt are conscious, so
that guilt can be used as knowledge to prevent an action against the
self, or others. Concerning the unconscious conscience and punish-
ing superego, Freud wrote, “as far as the patient is concerned his
sense of guilt is dumb; it does not tell him he is guilty, he does not
feel guilty, he feels ill” (1923b, p. 49). This resonates with Bion’s idea
that “the patient has pain but does not suffer it” (1970, p. 9). One
must experience consciously that which one suffers in order to have
a conscience which functions as a tool for thinking, rather than a
punishment or action. Conscience can then be experienced not as a
persecutor, but as a positive means of making a choice. Feelings of
guilt are not felt as punishing internal actions, but as a sort of guid-
ing light which illuminates one’s choices. The self and its needs are
experienced as valuable, and conscience provides the opportunity
to make choices consistent with the interests of an authentic self.
The former, associated with a primitive superego, is the kind of
conscience which “. . . doth make cowards of us all” (Shakespeare,
1602, III, i), while the latter is the kind suggested by the adage, “Let
your conscience be your guide”.
Grace’s binges began to be preceded by enough mental space
to allow her to bring her attention to her unbearable feelings of
need, as well as her intention to destroy them, her mind, and her
connection to me as a separate individual whom she needs and
who comes and goes in real time and space. At the point of that
awareness, it became possible to act either for or against herself.
When the frustration became too much to bear, she was unable to
attend to what she knew, but when she could, her capacity to bear
the frustration of waiting allowed her to maintain a real emotional
connection. This brought catastrophic fears of annihilation to the
fore, as those unborn states of mind moved her toward psycholog-
ical birth.
As we saw in Grace’s Sessions Nine and Ten, a distinction has
to be made as to whether the desire to please the parents is fuelled
by the child’s love of a good parent or fear and hatred of the
“bad” parent (“bad” as defined by Khan, p. 124, above). Unable
to recognize the “evil” flaws in the parent because of the need to
preserve the image of the parent as good, the child adjusts his
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perception of reality, resulting in a confusional state. Good and

bad cannot be distinguished, and the child essentially learns to
hate love (attachment) and to love hatred (manifested here as schiz-
oid detachment). It is an assault on reality and mental life that
obstructs the development of the mind, the self, and conscience.
In such a situation, as we see in the clinical examples presented
here, the child’s natural impulse toward socialization in order to
please the parent undermines the foundation of a healthy con-
science and supports a false self whose aim is to destroy aware-
ness of the truth, including the awareness of this basic moral
The superego which, according to Freud (1930a), observes and
seeks to curb the ego’s aggression, cannot untangle this deeper knot
in order to sort out the aetiology of aggression born of the child’s
disappointment in the object.

Socio-political perspective
Any study of conscience presents us with a paradox, for we are
faced with the disturbing contradiction of the most intellectually
sophisticated animals on earth, capable of transcendent empathic
acts of love and unmatched savagery towards each other. The
significance of conscience to social and cultural existence was
clearly stated by Freud, who represented the sense of guilt as
“the most important problem in the development of civilization”
(Freud 1930a, p. 134). The problems he perceived about the uncon-
scious sense of guilt and its connections to morality, education,
crime, and delinquency, are at least as apparent today. Political
emphases on “family values” and fundamentalist religious defini-
tions of morality indicate increasing concern and increasing con-
fusion about the meaning of good and evil and the distinction
between them. Intellectual explorations of morality, whether secu-
lar or religious, often become circular arguments which distract
from the more cogent underlying issues of emotional confusion
outlined above. In domestic politics, this confusion has threatened
constitutional freedoms like the right to privacy and the boundary
between church and state, and enduring wars, violence, and terror-
ist threats speak to the massive costs of widespread failures of
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conscience on a global level. Most individuals profess a belief in

goodness, love, and growth—the qualities which facilitate life.
However, these universal values remain unrealized, not only in
individuals but in groups, countries, and families torn apart by
wars, violence, and “irreconcilable differences”, as projections of
unmentalized primitive thoughts and feelings turn others into
enemies. These projections of unconscious conflicts, hopelessly
confused with reality, become the justification for wars from which,
like those early states of mind, they cannot extricate themselves,
and the internal wars waged in obscurity in analytic offices play out
publicly between husbands and wives, parents and children, and
between countries.
In the simplest terms, conscience is that mental function which,
in some way, impels human beings to be good. However, this raises
the more complicated questions about the meaning of goodness, or
evil, long pondered by philosophers and theologians. We have
looked at the idea of conscience as a facet of an instinctual process
that, in its origin, has similarities to that which guides the behav-
iour of animals. The aim of this inherent potential is to protect
life: that which is life-preserving is experienced as good. In human
beings, however, this quickly becomes complicated, and often
easily confused. Human mental life demands of us another level of
survival, for the preservation of life extends to include the preser-
vation of the mind as well as the body, of emotional as well as phys-
ical life (Bowlby, 1958). From this perspective, goodness represents
actions aimed at the protection both of physical and mental
survival. This raises another critical question as to what determines
the survival and health of the mind. Bion (1967) states clearly that
it is truth, for truth, he points out, is as essential to the mind as food
is to the body. Only this kind of mental nourishment ensures mental
health, the survival and continued growth of the mind. Lies, on the
other hand, poison the mind and erode mental health. And, since
we can observe, or, at times, infer indirectly, the corrosive effects of
mental illness on bodily well being, truth becomes a factor in phys-
ical as well as mental survival. The need and active quest for truth
thus becomes a factor in a moral sense. Morality is dependent upon
what we may call mindfulness, presence of mind, or consciousness;
it is dependent upon having a mind in the process of knowing and contain-
ing the truth.
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Spiritual aspects of mental life

I have stressed the importance of contact with that which might be

called a spiritual aspect of mental life, that is, the non-sensuous
reality of the mind and spirit, but one which is always associated
with emotional knowledge. Like Einstein’s description of “the
cosmic religious experience [as] the strongest and noblest main-
spring of scientific research” (Barnett, 1948, p. 117), Bion’s ideas
about O describe a transcendent realm of absolute truth and ulti-
mate reality often felt to be the domain of religion but which also
underlie scientific thinking and knowledge, including psycho-
analysis. It represents the source of a capacity for contact with a real
self, without which conscience cannot develop. In Buddhist philos-
ophy, the capacity for detachment and the so-called death of the ego
allow for the emergence of a spiritual or transcendent experience of
the present moment, like the oceanic feeling. This kind of ego
detachment can be distinguished from a schizoid state, for it repre-
sents, in psychoanalytic terms, an attempt to describe the detach-
ment from the false ego, allowing contact with the real feelings of an
authentic self. It is detachment from the state of mind filled with
preconceptions, saturated elements, and ideas which prevent access
to O, and so is in the service of expansion into that state of mind
which Bion (1970) sees as the necessary state of mind for doing psy-
choanalytic work. Through the disciplined eschewal of memory,
desire, and sensuous reality, the awareness of the physical body and
the senses can be held in abeyance, thereby facilitating awareness
of, and openness to, that metaphysical realm of an infinite
This perspective may arouse biases against spiritual ideas
judged to be out of place in psychoanalytic thought, especially if
they are confused with the illusions that underlie conventional and
institutionalized religious teachings. However, it is a perspective
that, according to Bion (1970), is an aspect of mental life without
which the capacity for reason cannot develop. Another central
reason for this bias may derive from a tendency to look at this as
an ideal state, when, in fact, it is anything but. Contact with O
stimulates primitive experiences of confusion and anxiety associ-
ated with the paranoid–schizoid position, along with fear of the
unknown, and the exquisitely helpless vulnerability of mental
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birth. Interpreting it as an ideal state is the result of a defensive

need for idealization, a kind of Nirvana that is really a state of
mental death or numbness. What appears to be a transcendent state
actually reflects the rigid pathological defences, which keep unborn
aspects of the self anaesthetized, as we saw in Grace’s attempts
to “freeze” states of mind in order to reinstate her phantasy of a
Huxley (1932) described the true transcendent experience as
fleeting, and perhaps luckily so, given the painful states of mind
associated with it. It comes and goes and comes again in the ongo-
ing process of mental life. One touches briefly this unsettling infi-
nite realm—the source of higher knowledge, primitive emotional
reality, and creativity—then finds one’s bearing in the gravity and
sensuous reality of material existence. This perspective is analogous
to Bion’s description of the oscillation between Ps↔D, which, in its
more evolved version in adulthood, reflects the process of ongoing
transformations from “patience” to “security” (Bion, 1970, p. 124).
The oscillating contact between these two states is the basis of
the mental integration that allows for creative and scientific
thought. The containment of early emotional life within thought is
critical to this mental integration and the apprehension of deeper
truth associated with the realm O. Thinking and emotion are
constantly linked.

The relationship between psychological birth and Ps↔D

Unlike actual physical birth, psychological or mental birth is not a
one-time event but, rather, a long process of emergence from the
pathological defences of that sequestered, drugged, or walled-off
state. The release from the defences which obstruct contact with
reality and with emotional life provides access to an ongoing
process of “mental births” and mental growth. Given the infinite
nature of the unknown, of O, there are always unborn aspects of the
self and unborn ideas of which one is driven to be aware. This is the
healthy process of mental life, continuous forays into the unknown
that reflect the more developed version of the experience of Ps↔D,
this emergence or transition is accompanied by various degrees of
terror and confusion at both levels of development. Later on,
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however, if this terror is sufficiently contained in the mind, it allows

for the birth of the new idea, new thought, or creative moment. One
may still recognize the feeling of terror, but it has been transformed
through experience into something tolerable, something, that is,
which one has the experience of having tolerated and survived. The
awareness that it has resulted in this kind of mental development
strengthens the capacity to put up with the discomfort of the expe-
rience, the capacity to exercise the patience, which leads to that
momentary experience of security, as well as to creativity and
growth. Bion’s idea of Ps↔D can be seen as an ongoing series of mental
births throughout one’s life. He even considered the idea that death
itself is experienced in the mind as yet one more last (presumably)
psychological “birth” into an ultimate unknown O.

The exceptional individual

Bion (1970) makes the point that this direct experience of at-one-
ment with O is not open to everyone, but is reserved for the “excep-
tional individual”, the “genius”, or “mystic”. The fact that these
states, often considered to be supernatural, are viewed as natural to
human mental experience does not mean that the natural explana-
tion is any less fantastic. It still reflects the mind’s capacity for
contact with an unknown and unknowable essence, what Bion calls
“a universal quality of phenomena”.

The Platonic theory of Forms and Christian dogma of the

Incarnation imply absolute essence which I wish to postulate as a
universal quality of phenomena such as “panic”, “anxiety”, “fear”,
“love”. In brief, I use O to represent this central feature of every
situation that the psycho-analyst has to meet. [Bion, 1970, p. 89]

In equating the words “mystic” and “genius”, and using them in

reference to the “exceptional” individual capable of apprehending
these deeper truths, Bion denotes a spiritual meaning to this level
of knowledge. The dictionary defines “genius” as “a guardian deity
or spirit,” linking genius with divine knowledge and guidance.

The “exceptional individual” may be variously described as a

genius, a messiah, a mystic, and his following may be large or small
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. . . For convenience, I shall use the term “mystic” to describe these

exceptional individuals. I include scientists, and Newton is the
outstanding example of such a man: his mystical and religious
preoccupations have been dismissed as an aberration when they
should be considered as the matrix from which his mathematical
formulations evolved.
. . . It would be surprising if any true mystic were not regarded by
the group as a mystical nihilist at some stage of his career and by a
greater or less proportion of the group. It would be equally surpris-
ing if he were not in fact nihilistic to some group if for no other
reason than that the nature of his contribution is certain to be
destructive of the laws, conventions, culture, and therefore coher-
ence, of a group within the group, if not the whole group. [Bion
1970, p. 64]

The group, which does not possess this knowledge or vision,

feels threatened by the existence of a person whose vision may
expose the illusions, repressive ideas, or outmoded knowledge
which characterize the beliefs of the group. Intrapsychically, a new
idea poses the same threat to the individual, for the upheaval of a
psychological birth is equally terrifying to that aspect of the
personality identified with the family group. The re-emergence of
the true self is experienced as a messianic idea designed to destroy
the seemingly protective structure of an existing mental order, as
memories of the original and unbearable helplessness and fear
again become conscious.
It jeopardizes the stability of those early identifications upon
which the old self is based, leaving one, as Allen described in
Session Sixteen, as vulnerable and as exposed as “larva” (p. 100).
However, the child also experiences the emergence of a real self as
potentially destructive to the family group and seeks to protect it
from this kind of destabilizing force, protect it, that is, from its own
authentic self.
Every baby is another “exceptional individual”. The infant’s
oneness with the oceanic experience, described in Chapter Two as
the basis of religious feeling, may pose a threat to those unable to
bear this brush with the infinite. If the mother, or family group, has
no mental space to entertain these modes of experience which are
characteristic of infantile mental life, and which are the precursors
of higher thinking, the child begins to shut down these exceptional
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qualities of his self. Corralled and contained by an oppressive

superego identified with the unconscious wishes or “shrunken ego”
capacities of the parent, the development of the child’s unique self
may be replaced by a false self. Rebellious behaviour familiar in
children and adolescents may develop as the true self struggles to
emerge from domination by the internal “group”, as the repressed
potential of that genius within the child demands to be heard.
Bion defines genius as the capacity to use psychotic mechanisms
in a way that can promote health and growth (1970, p. 63). This
highlights the idea that the integration between the primitive
emotional self and the capacity to think is the basis of mental
growth. When the family cannot make room for the “genius” in the
child to develop, there is the danger that it and the family group
will be destroyed. Addictive behaviours—to drugs, alcohol, food,
sex, violence, etc.—reflect confused efforts to stimulate the neglec-
ted and deadened walled-off self, efforts which instead further
numb the mind and self to the pain of that neglect. They are char-
acterized by the same fundamental confusions between life and
death, and between good and bad aspects of the self and object,
which effectively derails the development of conscience.

Clinical challenge
In the clinical examples of both Allen and Grace, we saw the typi-
cal advances toward, and retreats from, growth that repeat
constantly throughout analytic work. The movement toward
mental birth poses particular threats to hardened defences seeking
to protect against primitive feelings that threaten the organization
of the self. As we saw, psychic movement of this sort provokes a
violent backlash against change which presents the analyst with
particular challenges, both emotional and intellectual. One must
first of all be willing and able to endure the vestiges of primal but
repressed terror of which the patient may not be aware for a long
time, as well as the terror and frustration of not knowing where this
movement will lead. These feelings, experienced both by analyst
and analysand in the process of mental birth, are reminiscent of the
danger and uncertainty experienced by the infant and mother in the
process of physical birth. Desperate for reassurance, patients often
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ask, “Will I make it?” Will they, that is, be able to become them-
selves? Will all this pain be worth it? No one can answer this, so the
analyst, if he or she is honest, has to admit that he or she does not
and cannot know the answer. It depends, as I have sometimes
informed patients, on me and on them, but what will actually tran-
spire in the course of our interactions neither of us can know before-
hand. The awareness of this risk is a painful one, again, both for the
analyst and the analysand.
The patient’s willingness to try, to take what may at times be felt
to be this foolish risk, is based in large part on the particular indi-
vidual’s opinion about truth, as well as his or her capacity to bear
it. However, once having become aware of the ramifications of
having gone through one’s life as a false self, asleep or anaes-
thetized, the dilemma is compelling. The alternative is to suffer the
reality of his self and mind. Still identified with the false self,
however, this may be felt to be the death rather than the birth of his
self. If the patient has felt enough relief in the analysis so far,
through tolerating the experience of his real self, he may be able go
forward. But additional progress is accompanied by more intensely
vulnerable feelings as the numbness of the self begins to wear away.
Once the battle lines between contact and detachment have been
clearly drawn in the patient’s mind, he comes face to face with his
dilemma: it is his choice to make; his life is seen to be in his hands.
Painful progress of this sort may not feel like progress. It often
provokes virulent anger at the analyst, not as a transference figure,
but in his actual role as analyst, for it is the analyst who has brought
the patient to this crossroads, to this difficult choice between truth
and illusion, between mental life and death. The patient feels
betrayed, for he sees the analyst as the source of unbearable pain
and, as the analyst, one has to admit that, yes, it is my fault.
Although one hopes one’s efforts will be helpful and will even
allow the patient a more full experience of life, one cannot stand
behind the delusion that one has done a “good” thing, as it is ulti-
mately for the patient to decide whether or not he can bear to be
alive. “To be or not to be” is indeed the question, and no one can
answer it but the individual himself.
Despite the difficulties and uncertainty, however, there are
psychoanalytic means by which the analyst can maximize the possi-
bility of helping the patient (and himself) through the painful
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process of psychological birth. Being aware of the stages through

which the patient goes helps to orientate both parties and ease the
pain of this journey from inside the illusion of a phantasied womb
state to the experience of being, like Pinocchio, “a real live boy [or
girl]”. Paul (1997) clearly outlines these stages, first the sensations
and feelings of the unborn inner phantasy state, which blocks real
contact, through the transitional phases as consciousness is stirred,
and, finally, to the emergence into a state of mind capable of contact
with internal and external reality. Awareness of these stages helps
one to chart an often dark course and provides help in containing
the patient’s and the analyst’s inevitable anxiety and frustration.
The patient who begins to develop a capacity for truth to feed
his authentic self, suddenly finds himself in an untenable dilemma.
Either he suffers what feel like the deadly “slings and arrows of
outrageous fortune” through awareness of internal and external
reality or, since the health and life of the mind depend upon the
capacity for truth, he becomes witness to his own mental demise.
“Wisdom or oblivion—” Bion wrote, “take your choice” (1991,
p. 576). It is a bracing choice, indeed, and analysis is a bracing
endeavour, for both analyst and analysand. Bion spoke often of
these challenges. “The problem is: How can we become strong
enough to tolerate it?—a much more modest aim than trying to add
something new to psychoanalysis” (Bion, 1974, p. 33).
Through the clinical examples, we have seen something of this
process of the creation of the false self and the gradual awareness
of that false self as we work toward the mental birth of an authen-
tic self. This emergence into a world of reality is the source of terror
and confusion as one recognizes in oneself the fierce struggle
between the desire to live and the desire to remain detached from
life and from the self. However, as I have tried to show, the poten-
tial for a true conscience depends upon this struggle. The mental
“lies” of phantasied or hallucinated oneness with the object obs-
truct the experience of authentic emotional life and erode the foun-
dation of moral development. It is not our job as analysts to decide
for the patient whether this is a “good” thing or a “bad” thing.
However, if the potential for conscience as the highest mental
achievement is to be fulfilled, it will require us first of all to recog-
nize the kind of work necessary to that development, and then,
with our hearts and minds as open as a child’s, to do it.
Reiner_BOOK_Final 28/10/09 12:02 pm Page 149


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adoptive parent(s), 61, 75, 78, 82, 91 Barnett, L., 142, 149
affect, xii–xiii, 4, 13 Beckett, S., 14, 149
aggression, xii, 7, 50–51, 53, 55–56, Begoin, J., 55, 149
59, 64–65, 68, 100, 117, 124–125, behaviour, xii, 4–5, 9, 12, 28, 45, 57,
130, 140 64, 66, 75, 129, 141, 146
Alexander, R., 16, 149 immoral, 65
alpha function, 19, 21, 28, 30, 36, moral, 8, 65, 79
73–74, 125–126, 132 see also: Bergler, E., xviii, 64, 126, 149
elements, alpha Bianchedi, E., 29, 152
anger, xii, 5, 7, 20, 41–42, 44, 62, Bion, F., 11, 149
67–68, 75, 79–81, 89–91, Bion, W., xi, xiv, xviii–xxii, xxiv,
101–103, 105, 109, 114–117, 124, 6–9, 11–13, 16–19, 21, 23–26,
133, 147 28–41, 43–46, 55, 60, 63, 65–66,
anxiety, 8, 13, 39, 42–43, 50, 52–53, 73–74, 81, 84, 85, 95, 97, 99,
58, 61, 65–66, 78, 82, 85–88, 107–108, 111, 117, 119–120,
94–96, 101–102, 104, 106, 111, 125–132, 135–136, 139, 141–146,
136, 142, 144, 148 148, 150
attachment, xxi, xxiii, 14, 42, 56, Bion’s
64–65, 78, 88–89, 110–111, K, 25, 29, 31, 38–39, 41
113–114, 124, 126–130, 134, 140, –K, 12, 84
168 O, xiv, xix, 8–9, 24–27, 29–34,
secure, 17, 130 37–41, 43–45, 63, 81, 107, 129,
theory, 64 132, 135, 142–144

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Birtles, E. F., 46, 154 Dante, A., 134, 150

Bléandonu, G., 128, 150 death, 14–16, 31, 50, 62, 65, 96–97,
Boehlich, W., 24, 33, 150 100, 117, 128, 131, 142–144,
Bolle, K., 62, 150 146–147 see also: life
Bowlby, J., 64, 141, 150 instinct, 51
Brierley, M., 37, 150 mental, xi, xxiii, 14, 16, 42, 97,
Britton, R., xviii, 150 100, 143
of the self, 11, 13–14, 16, 100, 134
case studies/vignettes depression, 14–15, 30, 39, 54, 66, 68,
Allen, 30–31, 40, 60–62, 74–100, 78, 101, 104, 108, 111, 116
112, 118, 135, 145–146 clinical, 61, 75, 78
Grace, 41–43, 100–120, 136–137, position, 39, 53, 55, 97, 132, 135
139, 143, 146 despair, 61, 69, 75, 82, 84, 91, 116
Kristin, 19–21 Deutsch, H., xxiii, 150
Mr A, 4–5
Mrs M, 12–13 ego, xii–xiii, 14, 21, 32, 35–38, 45,
Sarah W, 66–69 50–52, 57, 60, 63, 68–69, 124,
Christianity, 7, 27–28, 32, 63, 144 127, 140, 142 see also: id,
see also: god, religion superego
Adam and Eve, xxi, 65, 131, ideal, xiii, 50, 124, 137
133–134 primitive, 137
Judeo-, 33 shrunken, 37, 41, 146
conscience Einstein, A., 24–26, 32, 46, 51, 142,
healthy, xx, 52–53, 56, 69, 150
125–126, 140, 169–171, 176 elements
immature, 56, 138 alpha, 21, 45, 74 see also: alpha
mature, xiii, xvii–xviii, xx, xxiii, 4, function
10, 17, 21, 46–47, 66, 84, 97, beta, 21, 45
99, 123, 126, 132, 134, 137–139 envy, 53, 55, 60, 116, 118, 133
provisional, 100, 124, 127
real/true, xix–xx, 16, 40, 74, 79, Fairbairn, W., xii, 4, 10, 13–14,
84, 115, 119, 128, 130, 134, 45–46, 55, 57–64, 68–69, 98, 101,
137–138, 148 114, 117, 120, 123, 127–128, 130,
unconscious, xviii, xxi, 3–5, 10, 137, 150
16, 109, 139 Feynman, R., 27, 151
consciousness, xi, xiv, xix, xxi–xxii, Freud, E. L., 44, 49–50, 151
9, 13, 15, 36, 38, 47, 69, 131–133, Freud, S., xii–xiv, xvii–xviii, xx–xxi,
141, 148 see also: xxiii, 4–5, 7, 17, 19–21, 23–25,
unconsciousness 31–39, 41, 43–47, 49–53, 55–59,
containment, xii–xiv, xix, xxii–xxiii, 62–66, 68, 73, 87, 97, 114,
8, 13–14, 16–17, 27–32, 35–36, 126–130, 137, 139–140, 151
38, 41–44, 46, 53, 56, 58, 65, 75,
78, 86, 90, 96, 98, 107–108, 111, god, xvii, xix–xx, 24, 26–27, 31–33,
114, 121, 123–126, 128, 130–133, 49, 60, 64, 69, 120, 128, 131, 133
135–136, 138–139, 141, 143–144, see also: Christianity, religion
146, 148 false, xx, 8, 24, 26–27, 128
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head, xiv, xix, 9, 25, 33 Klein, M., xii–xiii, 35, 44, 46, 51–55,
true, xx, 8, 26 57, 59–60, 64–65, 68, 104, 117,
Goethe, J. W. V., 36, 132, 151 119, 125, 127, 133, 135,
Gould, S., 28, 151 152–153
Green, A., 15, 152
Grinberg, L., 29, 152 Laing, R. D., 59–60, 153
Groddeck, G., 44–45, 152 Leopardi, G., 14–15, 153
Grotstein, J., xviii, 24, 36, 128, 152 life see also: death
guilt, 4–5, 50–51, 53–54, 58–59, 62, emotional, xiv, xxii–xxiii, 12–14,
66, 68, 85, 89, 98–99, 102–104, 17, 21, 35, 46–47, 55, 75, 92,
112, 114, 117, 127, 130, 135–140 112, 121, 126, 130, 137, 141,
unconscious, xviii, 3–5, 51, 53–54, 143, 148
66, 68, 98, 117, 137–138 inner, xxiii, 4, 8, 124
mental, xii, xvii, xix, xxiv, 16–17,
hallucination, xxiii, 5, 38, 41, 43, 69, 21, 46, 73–74, 133–134,
91, 107–108, 110, 116, 124, 134, 140–143, 145, 147
136, 148 uterine, xxii, 17
Harris, W., 15, 21, 34, 53, 55, 78, 132,
153 Meltzer, D., 15, 21, 34–35, 53, 55–56,
hate, xii, 4, 12, 18–19, 55, 57–58, 60, 78, 111, 125, 132, 153
68–69, 76, 110, 115, 117, 131, mental see also: death
134, 137, 140 birth, xviii–xix, xxii, 8, 17, 19,
Hughes, G., 8, 152 29–30, 40, 62, 83, 88–89,
Huxley, A., 36–37, 143, 152 96–97, 100, 109, 114, 118, 131,
143–144, 146, 148
id, 35, 45 see also: ego, superego development, xx, 27, 32, 35,
instinct, xxiv, 36, 46, 50–52, 55–57, 55–56, 65, 97, 111, 124–126,
64–65, 78, 96, 100, 120, 124, 126, 134, 144
128–130, 134, 141 functioning, xviii–xx, xxiii, 35–36,
intention(s) 43, 126, 132, 141
bad, 4–5, 120, 132 growth, 13, 26, 31, 126, 143, 146
destructive, 138–139 pain, 54, 105, 132–133, 136
good, 7 Mitrani, J. L., xix, 47, 153
hidden, 7 morality, xiv, xvii–xviii, xx–xxii, 4,
unconscious, 7, 84 6–7, 9, 12, 23, 39, 47, 49, 57, 60,
unknown, 6–8, 132 63–65, 69, 96, 118, 120, 124,
introjection, xiii, 10, 36, 44, 52–53, 57 126, 128–129, 133–134, 137,
Jones, E., 7, 152 mother see also: adoptive parent(s)
Jones, J., xx, 152 bad, xiii, 53, 104
Jung, C. G., 63, 65, 131, 152 birth, 77–78, 81–82, 90–91
good, 53, 88, 104
Kant, I., xiii, xv, xvii–xviii, 33, 63, -enough, 56, 125–126
152 internal, 15, 67–68, 77, 105, 109,
Keats, J., 38–39, 152 113–114, 136
Khan, M., 124, 139, 152 womb, 103–104, 108, 117, 131, 143
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narcissism, 4, 13, 35, 95 38–39, 46, 49, 128, 142

Nietzsche, F., xiv–xv, 6–9, 17–19, see also: Christianity, god
27–28, 39–40, 63, 65, 121, 129, mature, xx
133, 153 organized, xix, 27, 47
primitive, xx, 24
object repression, 21, 59, 62–63, 68, 73, 114,
bad, 57, 59–60, 62–63, 69, 117, 120, 117, 123, 127, 145–146
127, 136, 138 Riviere, J., 52, 154
good, 59, 69, 89, 114, 117, 127 Rolland, R., 33–34, 43
internal, xii, xiv, 10, 12, 46, 60, 63, Rosenfeld, H., 4, 13–14, 16, 56–58,
68, 138 68, 95–96, 101, 128, 130, 154
relations, 4, 10–11, 46, 57, 64, 66, Rumi, J., 10, 154
whole, 53, 104 sadism, 51–53, 95, 118–119
Oedipus/Oedipal, xii, 62, 68 Scharff, D. E., 46, 154
complex, xii, 52–53, 59 schizoid, 4, 16, 60, 128, 140, 142
pre-, 52–53 see also: paranoid-schizoid
omnipotence, xii, 14, 24, 32, 95, 120, Schore, A., 88, 130, 154
131 self
authentic, xiii–xiv, xviii–xix,
paranoid-schizoid, 8, 30, 39, 55, 97, xxi–xxii, 6, 21, 24, 40, 46, 63,
111 see also: schizoid 74, 120, 123, 128–129, 139,
position, 53, 65, 104, 132, 135, 142, 145, 148
142 emotional, xv, xix, 16, 78, 146
Paul, M., xviii, xxii–xxiii, 13, 17, 20, false, xviii, xxiii, 11–13, 16, 21, 36,
54, 74, 89, 93, 96, 128, 132–133, 40, 60–62, 74–76, 81–82, 84,
148, 153 87, 91, 93, 95, 99–100, 120,
Pessoa, F., 18, 153 123, 126–128, 134, 140,
phantasy, xii, xxiii, 3, 14, 17, 19–20, 146–148
37, 42, 53–55, 62, 69, 84, 89, 91, real, 5, 11, 16, 36, 40, 42, 56, 61–62,
93, 96, 98–99, 102–104, 106, 67–69, 74, 76–78, 80, 82–84,
108–109, 112–114, 117, 124, 128, 86, 93, 97, 100, 112, 114,
133, 143, 148 127–128, 138, 142, 145, 147
unconscious, xii–xiii, 41, 79, 98, supreme, 62–63
131 true, xviii–xix, xxii–xxiii, 7, 11–14,
Piontelli, A., xxii, 153 16–17, 27, 29, 31, 38, 41–43,
projection, xii–xiv, 13, 44, 53, 58, 68, 46, 60, 63, 67, 74, 76, 81, 83,
117, 119, 125–127, 130, 141 87, 95, 100–101, 104, 115, 119,
projective identification, xii–xiii, 36, 123, 125, 129, 135, 145–146
44, 52–53, 98, 119 Shakespeare, W., 31, 134, 139, 154
Sharpe, E., 127, 154
Rabelais, F., 123, 154 Sor, D., 29, 152
rage, 5, 53, 61, 65, 68, 91, 98–99, 117, spirit/spiritual, xix, 24–25, 30,
127, 129–130 33–34, 37, 45–46, 62, 113, 142,
Reich, W., xxiii, 154 144
religion, xix–xx, 23–28, 32–33, aspect, 24, 46, 142
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free, 27, 133 108, 111, 119, 133, 143–144, 146,

higher, 27–28 148
perspective, xiv, xix, 45 transference, 20, 58, 81, 103, 110,
splitting, xii–xiii, xviii, xxiii, 5, 7, 15, 117, 147
17, 30, 35, 50, 53, 55, 57, 60–61, trauma, 13–14, 16–17, 19, 58, 62, 68,
67, 75, 78–79, 81, 91, 95, 99, 104, 75, 77–78, 86, 124, 130
110–111, 117, 124, 127, 137 early, xxii–xxiii, 13–14, 31, 55, 78,
Steiner, J., xxiii, 14, 128, 154 115, 125
superego, xi–xiii, xv, xvii–xviii, emotional, 123, 125
xx–xxi, 5, 7, 12, 16, 49–54, 56, Tustin, F., xxii–xxiii, 13–15, 113, 128,
59–60, 62–63, 66, 68–69, 81–82, 154
84, 89, 93, 96, 98, 100, 109, 114,
123, 126–128, 130, 136–137, unconsciousness, 98, 134 see also:
139–140, 146 see also: ego, id consciousness
pathological, xii–xiv, 50, 62, 104,
133, 137 violence, 91, 96, 140–141, 146
primitive, xiv, 10, 41, 47, 54, 56, Voltaire, 65, 154
66, 93, 95, 100, 106, 114, 117,
119–120, 123–125, 127, 131, Winnicott, D., xxii–xxiii, 11–14, 17,
137–139 35, 56, 58, 82, 125, 154–155
symbol(-ism), xxi, 8, 21, 29, 45, 63, world
73, 79, 111, 138 end of the, 86
Symington, J., 60, 154 external, 46, 119
Symington, N., xviii, xx, 8, 24, inner/internal, xxi, 53–54, 63, 68,
26–28, 56, 127–128, 154 96, 119, 124, 129
manufactured, 93, 96, 130
terror, 14, 16, 20, 44–45, 61–62, 75, real, 17, 84, 96–97, 100, 148
77, 79, 82, 86, 88, 91–92, 95, 98, outside, xxii–xxiii, 36