Portal de Periódicos da CAPES

Case Response I

2024; Wiley; Linguagem: Inglês

10.1111/1468-5922.13065

1468-5922

Deborah Bryon,

Academic and Historical Perspectives in Psychology

My orientation as a Jungian psychoanalyst has been informed by complexity and intersubjective theory stemming from the school of relational psychoanalysis, as well as 25 years of working with the Andean medicine people in Peru. I have come to believe that all healing, including working through trauma, comes through the heart connection we establish with our analysands accompanied by a willingness to enter their world and be with them in the darker regions of the psyche, which Jung (1963) referred to as taking the light into the dark. This is what I try to aspire to—and some days are better than others. In my work with the Andean medicine people, I have also come to believe that the heart connection must be rooted in something greater. The way I will approach the case of Kate is first by describing my own initial response, feeling my way into the transference/countertransference dynamic, followed by thoughts I had toward formulating a theoretical conceptualization of what might be happening within the analytic encounter, and finally how I might try to be in the process as the analyst. Before launching into the material, I would like to acknowledge the courage of the analyst presenting the case in her willingness to share her own experience of vulnerability. As I will continue to reiterate, this is a very challenging case. While reading the case of Kate, I had a strong visceral reaction. The analysand's rage comes into the forefront immediately. The word "annihilation" appears in the first sentence, the word "rupture" in the second. I am immediately weighted down in the heaviness of the fear and dread in the unprocessed feelings that appear to be a psychic meteor shower set loose in the consulting room. I try to separate myself from the affect that has been constellated in the transference/countertransference dynamic. It all feels burdensome, black and white … very arduous, keeping the analysand and analyst stuck. I try to find my bearings. The intensity of the analysand's rage that the analyst is describing feels like an expression of an anti-libidinal complex (Fairbairn, 1944), an aggressive self-state that has a defensive function in the psyche of warding off and preventing the potential for experiencing further pain through rejection. It appears both Kate and the analyst have been taken hostage, with the rage assuming the form of a bully sucking up the life force of anything in its path that might lead to a relational connection … I try to put words around what I am experiencing, perhaps to create some distance. I sit with the idea that Kate's rage is functioning as a defence against the vulnerability that lies underneath … or … could the rage be demanding an opportunity to become multidimensional, to be understood … or both? Initially, I got caught up in avoiding her rage, in trying not to be eradicated. In this avoidant space, I felt a sense of helplessness, unsure of what to say or do, and worry that I, too, am abandoning her. I tried to convince her that I understood, focusing on validation and unconsciously sidestepping the rage. In our work, I have encouraged Kate to slow down and attune to her feelings with curiosity. She was initially reticent and would push back, overwhelmed by affective states that she did not wish to engage. The image that came to mind was a game of hot potato, where we would pass back and forth what was difficult to contain but needed to be held, the heat tolerated. However, like a game of hot potato, the experience is mutual, we both experience and share the heat. After reading the case, my hunch is that Kate will not feel safe until the analyst can walk into the fire with her and be with her in the intense heat of her rage without disappearing or being destroyed. "Unconsciously sidestepping", even while attempting to "validate", may not be enough. I ask myself if both the analyst and Kate are intimidated by her rage. I then ask myself if I am intimidated by her rage? As I sit in the feeling a little longer, I realize that I am not intimidated but rather become aware of feeling a "stuckness" occurring in what appears to be a close-ended loop, the futility of this repetitive dance of rage. As the analyst, I can imagine also feeling lost. This is hard to endure. The other girls were watching me. Marie had to come in. She was breaking the rules. And I was responsible. Our interaction went like this: "Please come in from the fire escape." "I am not on the fire escape." "Please come inside." "I am inside." "You are not inside." "I am too." I wait, then tear up. Wait. Finally, I say, "Your inside is very cold for me … I wonder if you might visit mine." She comes in. Benjamin (2004) has described the third as the intersubjective mental space that emerges from surrendering, the process of letting go of oneself with the ability to assume another's point of view. According to Benjamin, recognition develops in this process. She writes, "Thus, surrender refers us to recognition—being able to sustain connectedness to the other's mind while accepting his separateness and difference. Surrender implies freedom from any intent to control or coerce" (p. 7). … the analyst realizes she must bear her guilt for wanting to be separate and to have her own life, just as the patient must bear his. She has to find a way to distinguish between her deep empathy with the patient's fear of abandonment, on the one hand, and submission to him in his urgent, extracting behaviour, his demand that she give her life, on the other … the interaction is informed by the belief that separating and having one's own independent subjectivity and desire are tantamount to killing, while staying means letting oneself be killed. (p. 16) My reverie shifts back to Kate, trying to find my way into feeling what Kate and the analyst might be experiencing. I ask myself the question: Does Kate need to communicate the murderous rage boiling inside of her so that it—and she—can be understood? No mistaking—her feelings are big and want a voice. Underneath it all, I envision a very young, lonely little girl curled up and hidden in a corner. I imagine feeling torn between wanting to reach out to her and also to respect her need for distance. I don't want to scare her and wonder if the rage that is taking over the room may be an expression of what Fairbairn (1944) and Kalsched (2013) have referred to as a diabolical self-care system. Perhaps that is what happened in the case of my analysand with the abrupt ending …. Kate seems to be encased in a ring of fire … perhaps her version of a fortress … I speculate that Kate's rage is being given too much power, demanding too much airtime. The story of The Wizard of Oz enters my mind and I find myself beginning to metaphorically draw parallels between Kate's analytic process and the characters in the story, perhaps as an attempt to contextualize the raw experience by finding an outside vantage point to gain perspective. Maybe, like the cowardly lion in The Wizard of Oz, Kate's rage needs to be batted on the nose and confronted. Would this possibly create a place for what lies underneath the rage to be heard within the transference? I can feel my own weariness toward the idea of stepping into the psychic space of rage in an attempt to navigate my way through the density of it all. It feels heavy. Suddenly as I am writing this, I feel the urge to go to sleep. I note that I am dissociating from a distance … like Dorothy falling asleep in the poppy fields. This feeling is immediately followed by a rush of empathy as I find my heart going out to the brave analyst presenting … again, this is a challenging case! I recognize that connection is the elixir. Stepping back, attempting to form a conceptualization of what's happening, I ask, who is Kate when she's not enraged? Can she feel her own essence? In her parents' eyes did she even exist? Has Kate ever experienced anyone seeing her, holding her in their mind, or mirroring her? Lying in a playpen, in a state of deprivation, did Kate ever access her own creative sense of agency? Maybe living means death. Is feeling rage the only way she knows how to feel alive—even if it exterminates the capacity for others to be fully present with her. Maybe that's the only way she knows how to protect herself—like the Wizard of Oz hiding behind his curtain. Has Kate ever felt safe enough to experience her own sensuality? The earth around her? The energetic field seems scorched, a place where it would be difficult for new life to emerge and grow. It appears that Kate never learned how to engage with the world in creative play, or, to borrow Winnicott's term, ever experienced "object usage", the safety of knowing that she can hate a parental figure—or an analyst—without the fear of being annihilated. Perhaps Kate's ongoing over-identification with rage is an enactment, longing for the safety to express feelings linked to a fear of obliteration. The idea of the use of an object (or relationship) is related to the capacity to play. … But in examining usage there is no escape; the analyst must take into account the nature of the object, not as a projection, but as a thing in itself. (p. 710) Based upon my experience in the practice of Andean medicine, before stepping into the "ring of rage" I would need to ground myself and connect with something greater so that the energy could move through me and not become lodged in my psyche or physical body. This practice helps me to endure moments of being annihilated by my clients, sometimes over and over, until they can feel safe. From a Jungian perspective, this might be thought of as inviting in the Self. After the event of an act of destruction takes place in the analytic process, creative play can begin to occur in the transitional space between imagination and reality in the co-created third. Play is a safe space for spontaneity; a way to experience before knowing. Through exploring phantasies that arise in the analytic third of the transference with curiosity, the aggression of murderous rage can be worked with, and integrated. This may be a point when an analysand begins to develop the capacity to tolerate being seen and loved by the analyst. In these moments, the reality of the surviving relationship between the analyst and analysand becomes more firmly anchored in the transference, strengthening a felt connection, while continuing to build on a sense of object constancy. Conceivably over time, Kate's analysis may become an act of discovery through playful expression, a place where Kate has the freedom to be as big or little as she needs to be—and still experience a constancy in being loved. Feasibly, Kate's rage could have the potential to become a pussy cat as well as a pariah. Through playful encounters happening in the transference of destruction and emergence, there is potential for the development of a more secure, healthy attachment. Kate may discover that her rage will not kill her or the analyst. According to Winnicott, the analytic process of surviving this kind of destruction creates the potential for building a foundation for love toward a real object, outside of the domain of the analysand's fear of omnipotent control.