What's a Good Object to Do? - PsyBC

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14 Neil J. Skolnick ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ 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
What’s a Good Object to Do 15 ⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯⎯ to experience that we have gone to a place of madness and worked it through ourselves. They need to detect, either consciously or unconsciously, that we have jumped into the muck as they had, and despite our fears we have reorganized and reconstituted a secure self– other vitality. This is the point of connection needed between self and other that patients observe, experience, and internalize. It is not only that we survive, but how we survive, how we venture to insanity and back. When Marianna precipitously attacked, I was unprepared. Unwittingly and uncharacteristically I experienced and displayed a measure of stunned disturbance. She observed my discomfort, which in the moment I neither went to great lengths to express nor to hide. My own not so very pretty sadistic impulses bubbled up, fueling a pleasurably charged string of invectives. My internal voice gleefully, though guiltily, complained, “I can’t just buy a fucking new chair without you giving me grief.” Continuing cursing to myself, I pressed my imaginary eject button and pleasurably watched her fly out the window, sail uncontrollably over Central Park, and land in a strong, icy current in the East River. Then, experiencing an admixture of painful guilt and shame I caught myself and decided it was time to recover. I became aware of how surprised, ungrounded, and frightened I had become, having never experienced such an unpredictable storm from this patient, with whom I had worked for years and for whom I had developed a fondness. I was clueless as to what had actually happened, and I was frightened about what might happen next. I accessed my own comparable childhood experiences. Enter reason, that wonderful harbinger of a more integrated place. I reasoned from a Kleinian vantage point 5 that I was being related to by means of a projective identification. Specifically, I was, in the interpersonal and intersubjective arena, being made to experience one pole of Marianna’s internal object relationship, that of her anxious and precipitously attacking mother, followed by a mother who ruefully experienced both guilt and remorse. During the interaction I was not spared experiencing the opposite pole of her internal self–object ⎯⎯⎯⎯⎯⎯⎯⎯⎯ 5 One’s theoretical convictions can be helpful at times like these, whatever theory one may subscribe to. They can provide meaning when one’s meaningful illusions are attacked.
Page 1 and 2: Psychoanalytic Dialogues, 16(1):1-2
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Page 29 and 30: 30 Jay Frankel ⎯⎯⎯⎯⎯⎯
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What's a Good Object to Do? - PsyBC

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