We discussed firstly an article on Winnicott’s theory of fear of breakdown, the basic premise being that the “real” breakdown has occurred much earlier in a client’s life when some rupture occurs in the mother-infant bond and relationship. This forces the infant “to take on, by himself ,emotional events that he is unable to manage”.
The breakdown, claims the author of this article, “ Fear of breakdown and the unlived life” Thomas H.Ogden (international journal of psychoanalysis,2014 95: 205-223) is survived but not actually registered internally which results in a sense in the adult that “..parts of himself are missing”; the client then feels he “must find them if he is to become whole” as otherwise he will have to continue to live with the feeling that “what remains of his life” becomes “like a life that is mostly an unlived life”, a feeling perhaps of inner deadness and a potential not fulfilled. We grappled with this concept and felt it needed more elucidation with clinical examples, particularly his references to “psychotic defense organizations” which serve to keep unmanageable feelings at bay.
We moved on then to discuss two papers by Neville Symington which we found illuminating and well-written: “Healing the mind-what is the process?” followed by “Healing the mind-what is the healer’s task?” He draws on his own experience and shows humility in his assessment of what the patient is seeking in therapy- namely that hie is asking the therapist to “..help me create a mind that can cope with these disasters that are overwhelming me”. He believes that the therapist must understand the workings of the mind and avoid psychological “muddle” since the therapist has to be able to create a representative image of the client’s pain that fits his experience and he believes that the patient is then able to “embrace” his pain and start to process it. The therapist cannot programme this creation since, states Symington, it is “an inner spontaneous act” but there are outer factors which he claims can facilitate this creation- this is the thrust of the second article where he outlines the four main components of effective therapy as: freedom, the personal, scientific enquiry and compassion.
By the personal, he means : “Don’t ever say anything which is not a personal statement”- he illustrates this idea by describing a friend who “did not generalize, give advice or say how he thought people should act” and who fostered an atmosphere of “freedom” which should be based on a wide-ranging spirit of “scientific inquiry” including a knowledge of the self since he claims that “all personal difficulties flow from our own areas of narcissism”. As therapists we should strive to be “natural” since “the more natural you are, the more a patient will reveal the secrets of the heart”. He tries to define what natural means by saying you have to be “in a role, not acting a role” and the role is combining compassion with a scientific-like probing and curiosity.
We found his two papers interesting and refreshing and less dense than the one on Winnicott.
We then went on to a discussion of whether it is helpful or not for a therapist to cry in the consulting room when affected and moved by a client’s pain. There was some disagreement about whether this demonstration of empathy, whether chosen or out of the therapist’s control, is therapeutic for the client or the opposite. We agreed this would be a useful topic for a future meeting.