What's a Good Object to Do? - PsyBC

14 Neil J. Skolnick
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Then, we work through, once again, as we did in analysis or selfanalysis,
this place of disruption in ourselves, whether it resides in a
neurotic, conflict-ridden arena or a primitive, paranoid/schizoid place.
We reinstate our integrity, our wholeness, and the survival of our
subjectivity without extracting revenge on the patient whose
reparations we lovingly accept and whose life we permit to continue.
In the episode with Marianna, I needed to allow and be disturbed by
my own experiences with precipitous losses, failures of omnipotence,
uncontrollable rage and sadistic pleasures; my own experiences of
paranoid/schizoid organizational states, my own shameful disturbances.
And, equally important, I needed to recall my own recovery from
those places.
Furthermore, these disruptions and recoveries occur in active
participation with the patient (either consciously or unconsciously).
Through this interaction, the processes of our dynamic self enter into
and become structured with theirs. Through the mutual human
phenomenology of our disruption and recovery, patients dynamically
identify with the how of recovery as they gradually internalize and
incorporate our recovery processes into their selves. The patient’s self
is, in turn, strengthened so that it becomes more integrated and
resilient. The patient’s interactions with others likewise become more
the realm of integrative, whole-object experiences. The time needed
for achievement or return to integration shortens.
Let us return to Marianna, whom we left enraged, in attack mode,
and feasting on sadistic pleasure from the experience. Without my yet
understanding the vehemence of the attack, my first task was to
survive. I could have sat back in my chair, stayed attentive, remained
calm, attempted to explore, offered interpretations, contained the rage
with empathic attunement, or just remained silent. All reactions could
be considered forms of survival, which, indeed, they are. Unless,
however, I had allowed the attack to get under my skin, to disturb me
in places I would rather not be disturbed, to touch rage or sadism
within my own experience, my survival would have, in my opinion,
been doomed to be experienced by the patient as formulaic,
inauthentic—or worse, another display of enviable perfection on my
part, to be either idealized or destroyed. I would be saying to the
patient, “I am not ready to go to that place with you. I am overly
anxious or fearful that it will not be safe.”
In order for patients to internalize how we contain, organize, or
negotiate such powerful, overwhelming experiences, they need likewise