THE LIBRARY OF ANALYTICAL PSYCHOLOGY ^

PSYCHOPATHOLOGY
C o n t e m p o r a r y Jungian
Perspectives

EDITOR
ANDREW SAMUELS

k a r na c
PSYCHOPATHOLOGY

Contemporary Jungian Perspectives

THE LIBRARY OF ANALYTICAL PSYCHOLOGY
P U B L I S H E D AND D I S T R I B U T E D B Y K A R N A C B O O K S

Series Editors: Michael Fordham, Rosemary Gordon,

Judith Hubback, Kenneth Lambert

Volume I Analytical Psychology: A Modern Science

Michael Fordham, Rosemary Gordon, Judith Hubback,Kenneth
Lambert, Mary Williams (eds.)

Volume I I Technique in Jungian Analysis

Michael Fordham, Rosemary Gordon, Judith Hubback, Kenneth
Lambert (eds.)

Volume I I I The Self and Autism

by Michael Fordham

Volume I V Dying and Creating: A Search for Meaning

by Rosemary Gordon

Volume V Analysis, Repair and Individuation

by Kenneth Lambert

Volume V I My Self, My Many Selves

by Joseph Redfearn

Volume V I I Explorations into the Self

by Michael Fordham

Volume V I I I Jungian Child Psychotherapy:

Individuation in Childhood
Mara Sidoli & Miranda Davies (eds.)

Volume I X Psychopathology: Contemporary Jungian Perspectives

Andrew Samuels (ed.)

Volume X The Makings of Maleness: Men, Women

and the Flight of Daedalus
by Peter Tatham
THE LIBRARY OF ANALYTICAL PSYCHOLOGY
VOLUME IX

PSYCHOPATHOLOGY
Contemporary Jungian Perspectives
Edited and with an Introduction
by

Andrew Samuels

Published for The Society of Analytical Psychology, London

by

KARNAC

LONDON N E W YORK
First Published in 1989 by
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© 1 9 8 9 Introductions by Andrew S a m u e l s

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A C.I.P. for this book is available from the British Library
British Library Cataloguing in Publication Data
Psychopathology
I. Medicine. Psychopathology
I. Samuels, Andrew II. Series
616.89Ό7

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Printed and bound in Great Britain by Antony R o w e Ltd, Eastbourne

CONTENTS

Acknowledgements vii
Notes on Bibliography and Conventions viii
Contributors ix

Introduction
Andrew Samuels 1

1. Depressed patients and the coniunctio

J udith Hubback 23
2. Success, retreat, panic:
over-stimulation and depressive defence
Peer Hultberg 45
3. A psychological study of anorexia nervosa:
an account of the relationship between
psychic factors and bodily functioning
Eva Seligman 71
4. Object constancy or constant object?
Fred Plaut 89
5. Narcissistic disorder and its treatment
Rushi Ledermann 101

v
VI CONTENTS

6. Reflections on introversion
and/or schizoid personality
Thomas Kirsch 127
7. Reflections on Heinz Kohut's concept of narcissism
Mario Jacoby 139
8. The borderline personality: vision and healing
Nathan Schwartz-Salant 157
9. The treatment of chronic psychoses
C. T. Frey-Wehrlin, R. Bosnak, F. Langegger,
Ch. Robinson 205
10. The energy of warring and combining opposites:
problems for the psychotic patient and the therapist
in achieving the symbolic situation
Joseph Redfearn 213
11. Schreber's delusional transference:
a disorder of the self
Alan Edwards 229
12. Masochism:
the shadow side of the archetypal need
to venerate and worship
Rosemary Gordon 237
13. The psychopathology of fetishism and transvestism
Anthony Storr 255
14. The androgyne:
some inconclusive reflections on sexual perversions
Michael Fordham 275
15. The archetypes in marriage
Mary Williams 291
16. The analyst and the damaged victims
of Nazi persecution
Gustav Dreifuss
(with four commentaries and reply) 309
17. Working against Dorian Gray analysis and the old
Luigi Zoja 327

Index 347
ACKNOWLEDGEMENTS

I
am grateful to the following for their helpful comments on an
early draft of the Introduction or for their support in other
ways; responsibility for the ideas expressed in the Introduc­
tion, the introductory remarks before each paper, and the
selection of papers is, of course, mine: Coline Covington, Miranda
Davies, Hugh Gee, Rosemary Gordon, Rosie Parker, Corinna
Peterson, Fred Plaut, Arthur Sherman, and Barbara Wharton.
Roger Hobdell was the Series Editor for the volume, and I have
appreciated his advice and encouragement.
In addition, the work done on the papers by successive Editors
of The Journal of Analytical Psychology deserves acknowledge­
ment: Michael Fordham, Fred Plaut, Judith Hubback and
Rosemary Gordon.
Finally, I want to express heartfelt thanks to the authors for
reading, revising, and approving the short introductions that
precede their papers. This has made the production of the book a
truly international and collaborative venture.
Acknowledgements and bibliographical details for each paper
are given at the start of that paper.
Acknowledgements are due to Routledge, London, and Prince­
ton University Press, Princeton, NJ, for permission to quote
from the Collected Works of C. G. Jung.

vii
NOTES ON BIBLIOGRAPHY AND CONVENTIONS

Citations of the works of C. G. Jung

E
xcept where indicated, reference to Jung's writings is by
volume and paragraph number of the Collected Works of
C. G . Jung, published by Routledge, London, and Prince­
ton University Press, Princeton, N J (edited by H. Read, M.
Fordham, G. Adler and W. McGuire; translated mainly by R.
Hull).

Note on spelling
The convention has evolved, especially in Britain, of using the
spelling 'phantasy* as opposed to 'fantasy' when it is intended to
refer to whatever activity lies under and behind thought and
feeling. 'Fantasy' is restricted to daydreaming and mental
activity of a similar nature of which the subject is aware. The
contributors to this book, coming, as they do, from diverse
backgrounds, do not display a uniformity of style. Editorial policy
has been to let each writer retain his/her original usage. The
Editor's present personal preference is to use 'fantasy' in all
circumstances, relying on context to make the meaning clear.
viii
CONTRIBUTORS

Gustav Dreifuss, Ph.D. Diploma in Analytical Psychology, C.G.

Jung Institute, Zurich. Training Analyst and former Presi­
dent, Israel Association of Analytical Psychology. Lecturer,
Psychotherapy, Psychiatric Department, Rambam Hospital,
Haifa. Author, Collected Papers 1965-1984 and Bild und Seele
(with Martin Kinz). In practice in Haifa.

Alan Edwards, M.D., M.R.C.P., F.R.C.Psych. Training Analyst,

Society of Analytical Psychology. Former Medical Director, C. G.
Jung Clinic, London. Former Consultant Psychiatrist, Watford
General and Napsbury Hospitals. In practice near London.

Michael Fordham, B.A., M.D., F.R.C.Psych„ Hon.F.B.P.S.

Training Analyst, Society of Analytical Psychology. Co-editor of
the Collected Works ofC. G. Jung. Founding editor, The Journal
of Analytical Psychology. Author of numerous books, including
Children as Individuals, The Self and Autism, Explorations into
the Self In practice near London.

C. T. Frey-Wehrlin, Dr.PhiL Professional Member, Society of

Analytical Psychology. Training Analyst, C. G. Jung Institute,
Zurich. Initiator, co-founder and former Director of Psychother-
P—A« ix
X CONTRIBUTORS

apy, Zurichberg Clinic (Clinic and Research Centre for Jungian

Psychology). In practice in Zurich.

Rosemary Gordon, Ph.D., F.B.P.S., Fell. Anthrop. Soc. Train­

ing Analyst, Society of Analytical Psychology. Editor, The
Journal ofAnalytical Psychology. Author of Dying and Creating:
a Search for Meaning, In practice in London.

Judith Hubback, M.A. Training Analyst, Society of Analytical

Psychology. Former Editor, The Journal of Analytical Psychol­
ogy. Author, Wives Who Went to College and People Who Do
Things to Each Other: Essays in Analytical Psychology. In
practice in London.

Peer Hultberg, Dr.Phil. Diploma in Analytical Psychology,

C. G. Jung Institute, Zurich. Training Analyst, C. G. Jung Insti­
tute, Zurich. In practice in Hamburg.

Mario Jacoby, Ph.D. Diploma in Analytical Psychology, C. G.

Jung Institute, Zurich. Training Analyst, C. G. Jung Institute,
Zurich. Author, The Analytic Encounter: Transference and
Human Relationship, Longing for Paradise: Psychological Per­
spectives on an Archetype, Individuation and Narcissism (forth­
coming). Co-author, Das Bose im Marchen. In practice near
Zurich.

Thomas Kirsch, M.D. Member of the Society of Jungian

Analysts of Northern California. First Vice-President, Interna­
tional Association of Analytical Psychology. Co-editor, Jungian
section, International Encyclopaedia of Psychiatry, Psychoanaly­
sis, Psychology, and Neurology. In practice in Palo Alto,
California.

Rushi Ledermann, Cert. Ment. Health. Training Analyst,

Society of Analytical Psychology and British Association of
Psychotherapists. Formerly psychotherapist, Lady Chichester
Hospital, Hove, Sussex. In practice in Hove, Sussex.
CONTRIBUTORS xi

Fred Plaut, B.Ch., D.P.M., M.B., F.R.C.Psych. Training Analyst,

Society of Analytical Psychology and German Society for
Analytical Psychology. Former editor, The Journal ofAnalytical
Psychology. Co-author, A Critical Dictionary ofJungian Analysis.
Author, Analysis Analysed (forthcoming). In practice in Berlin.

Joseph Redfearn, M.A., M.D.(Cantab.), M.D. (Johns Hopkins),

M.R.C.Psych. Training Analyst, Society of Analytical Psychol­
ogy. Author, My Self My Many Selves. In practice in London.

Andrew Samuels, Dip. Soc. Admin., Dip. Soc. Wrk. Studs.

Training Analyst, Society of Analytical Psychology and British
Association of Psychotherapists. Author, Jung and the Post-
Jungians and The Plural Psyche: Personality, Morality, and the
Father. Co-author, A Critical Dictionary of Jungian Analysis.
Editor, The Father: Contemporary Jungian Perspectives. In
practice in London.

Nathan Schwartz-Salant, Ph.D. Diploma in Analytical

Psychology, C. G. Jung Institute, Zurich. Member and Training
Analyst, New York Association for Analytical Psychology.
Author, Narcissism and Character Transformation: the Psychol­
ogy of Narcissistic Character Disorders and The Borderline
Personality: Vision and Healing. Co-editor of the Chiron Clinical
Series. In practice in New York.

Eva Seligman, Dip. Ment. Health., Cert. Soc. Sci. Training

Analyst, Society of Analytical Psychology. Former senior staff
member, Institute of Marital Studies, Tavistock Centre. Co­
author, Marriage: Studies in Emotional Conflict and Growth. In
practice in London.

Anthony Storr, M.B., B.Chir., M.A., D.P.M.., F.R.C.Psych.,

F.R.C.P. Honorary Consulting Psychiatrist, Oxford Health
Authority. Author of numerous books, including The Integrity of
the Personality, The Dynamics of Creation, Jung, The Art of
Psychotherapy, The School of Genius.
Xii CONTRIBUTORS

Mary Williams, Cert. Ment. Health. Training Analyst, Society

of Analytical Psychology. Former tutor in marital therapy,
Tavistock Clinic.
Luigi Zoja, Ph.D. Diploma in Analytical Psychology, C. G. Jung
Institute, Zurich. Training Analyst of C. G. Jung Institute,
Zurich and Centro Italiano di Psicologia Analitica. Author,
Drugs, Addiction, and Initiation, Co-author, Incontri con la
morte. In practice in Milan.
INTRODUCTION

Andrew Samuels

. . . the loss of manifest psychopathology may or may not

be desirable, for there is a positive aspect of mental
disorder.
[Fordham, 1978, p. 8]
The psyche does not exist without pathologising.
[Hillman, 1975, p. 70]
I am simply a psychiatrist Everything else is
secondary for me— I am merely thinking within the
framework of a special task laid upon me: to be a proper
psychiatrist, a healer of the soul. That is what I have
discovered myself to be and this is how I function as a
member of society.
[C. G. Jung, in Adler, 1974, pp. 70-71]

The Background

S
ince its inception in 1955, The Journal of Analytical
Psychology has stood for the clinical dimension of analy­
tical psychology. Jungian analysts, like their counterparts
in psychoanalysis, have found it necessary to expound their
1
2 ANDREW S A M U E L S

refinement of thinking and technique in a professionally public

arena. The Journal has been edited and staffed by members of the
Society of Analytical Psychology, London, and hence has shown a
marked, though by no means exclusive, orientation towards what
I have called the developmental school of analytical psychology
(Samuels, 1985). I use that term rather than a phrase like 'the
London school' because developmental analytical psychology is
now a world-wide enterprise, and it would be foolish to impose a
geographical limitation where one no longer exists. At one time,
the appellation 'London' made sense, particularly in apposition or
opposition to 'the Zurich school'; 'Zurich', too, is an overly
geographical tag. It is far better to refer to the classical school of
analytical psychology.
In fact, the reader will find some papers in this volume which
emanate from classically oriented analytical psychologists. What
is more, the influence of the archetypal school, with its emphasis
on impersonal, mythopoeic depth, will also be apparent. Two
papers—those on borderline personality disorder and on marital
dysfunction—were not published in the Journal; they have been
included to make the scope of the book as comprehensive as
possible.
It may be asked why it has been thought fruitful to produce a
volume of papers on psychopathology, most of which have already
been published in the same organ. There are two reasons: first, to
meet a very real need for a resource book for analysts and
psychotherapists which deals in turn with the more commonly
encountered psychological conditions, helping the clinician to
sharpen her or his thinking i n respect of the problem the patient
is bringing. Such a need has been put to the editor on numerous
occasions by trainees and by more experienced practitioners. The
second reason for producing the book arose, in true Jungian
fashion, after i t had been decided to go ahead on the basis of the
first reason! I t became apparent that the papers assembled for the
book contained a wealth of clinical knowledge—pragmatic,
flexible, disposable, but, above all, rooted in what actually
happens in analysis. What is more, although these papers speak
to discrete pathologies, it is my contention that the writers have,
as a group, achieved a difficult balancing act between the claims
of the individual, the soul and the imagination—and the claims of
the typical, the professional and the clinical task of healing. I
shall return to this topic in due course.
INTRODUCTION 3

The knowledge to which I have been referring deserves an

airing beyond the Jungian community, which this book is
intended to provide. Psychoanalysis itself is an exemplar of
pluralistic diversity: classical, ego-psychology, self-psychology,
Kleinian etc. But if we were to extend the field and call it depth
psychology (or dynamic psychology), then analytical psychology
takes its place as one strand of the diversity. Not that analytical
psychology and psychoanalysis are the same—rather, they are
complementary, sibling disciplines.

The Jungian heritage

To this end, it may be helpful to outline a few features of the
common Jungian background of these authors, for there are some
areas of theory and practice in which Jung's can now reasonably
be regarded as a pioneering voice. He seems to have anticipated,
sometimes by 25 years or more, what would become accepted as
mainstream in psychoanalysis. Of course, Jung often did not go
on to develop his initial insights and intuitions, but giving a
flavour of some of them will serve as a useful orientation.
For example, the contribution of analytical psychology to the
general area of countertransference reflects Jung's prescience. As
early as 1929, Jung was saying that 'You can exert no influence if
you are not susceptible to influence. ... The patient influences
[the analyst] unconsciously.... One of the best-known symptoms
of this kind is the countertransference evoked by the transfer­
ence' (CW 16, para. 163). And in the same paper Jung refers to
countertransference as a 'highly important organ of information'.
This can be compared with Freud's early negative evaluation of
countertransference as neurotic and suggestive of the analyst's
resistance. In sum, Jung's conception of analysis is of a
'dialectical process'. By this, he means that there are two fully
involved persons present, there is a two-way interaction between
them, and they are to be conceived of as 'equals' (CW 16, para.
289). What Jung means by 'equality' resembles the more modern
word 'mutuality'. It follows that Jung emphasized what is
nowadays called the 'real relationship' or 'treatment alliance'
alongside the transference relationship.
Regarding psychopathology, from his early days as a psychia­
trist, Jung was interested in schizophrenia (then known as
4 ANDREW SAMUELS

dementia praecox). As he developed his concept of the collective

unconscious and the theory of archetypes, he moved to the
position that psychosis could be understood as an overwhelming
of the ego by the contents of the collective unconscious (hence the
fantastical imagery), and as demonstrating the domination of the
personality by a split-off complex or complexes.
The crucial implication of this position was that schizophrenic
utterance and behaviour could be seen as meaningful, if only it
were possible to work out what the meaning might be. This was
where the technique of word association was first used and, later,
amplification as a method of seeing the clinical material in
conjunction with religious and cultural motifs. This led, firmly
and finally, to Jung's break with Freud, which occurred with the
publication of the volume later known as Symbols of Transforma­
tion (CW 5).
But what of the aetiology of schizophrenia and psychosis? The
evolution of Jung's thought reveals some uncertainty. He is clear
that psychosis is a psychosomatic disorder, that changes in body
chemistry and personality distortions are somehow intertwined.
The issue was which of these should be regarded as primary.
Jung's superior, Bleuler, thought that some kind of toxin or
poison was developed by the body, which then led to psychological
disturbance. Jung's contribution was to reverse the elements:
psychological activity may lead to somatic changes (CW 3, para.
318). Jung did attempt to combine his ideas with those of Bleuler,
by means of an ingenious formula. While the mysterious toxin
might well exist in all of us, it would only have its devastating
effect i f psychological circumstances were favourable to this.
Alternatively, a person might be genetically predisposed to
develop the toxin, and this would lead to psychosis if the
psychological circumstances were so inclined.
That psychosis was anything other an an innate, neurological
abnormality was, in its time, revolutionary. That its causation
was psychogenic within a psychosomatic framework (Jung's final
position—CW 3, paras. 553ff.) enabled him to propose that
psychological treatment might be appropriate. The decoding of
schizophrenic communication and its treatment within a ther­
apeutic milieu are central stands in the existential-analytic
approaches developed by Binswanger (1945) and Laing (1967)
and are, to an extent, recognizable in contemporary psychiatric
endeavours.
INTRODUCTION 5

When psychotic material is florid, it can resemble the

phenomena of creative inspiration and religious conversion.
However, the psychotic lacks a container of sufficient strength
(such as mother, or work of art, or religious ritual) for stability
and a sense of purpose to be maintained until individual balance
is restored and meaning becomes apparent.
Concluding this brief survey of some pertinent aspects of
Jung's thought, there is a sense in which his is an object relations
psychology. Jung was among the first to spell out the primary
importance of the relationship of mother and infant in terms
recognizable today. This has to be compared with Freud's
insistence that it was the oedipal triangle that imposed its
vicissitudes on later relationships (CW 8, para. 723, written in
1927). In the same paper, Jung stressed the centrality of the need
to separate from the mother. In his view, clinicians have to accept
that, throughout maturation, there will be regression, that
separation from the mother involves a struggle, and that
nutritional functions are of central psychologial importance.
Jung gave descriptions of psychological processes, some of
which he applied to infantile states, all of which anticipate object
relations theory. One such process is splitting, which is usually
seen in Kleinian theory as an early defence involving control of
the object by dividing it into a good and a bad part-object.
Similarly, the ego is also divided into good and bad. Jung refers to
splitting in relation to the mother—or, to be more precise, the
image of the mother. He wrote of the 'dual mother' (in 1912), and
this phrase can be understood on several levels: as the duality
between the personal mother and pre-personal psychological
patterning of the mother archetype, or as the duality between
good and bad images of the mother (CW 5, paras. I l l and 352).
A second process is delineated by Jung as 'primary identity'.
By this he means an experiential likeness based on an original
non-differentiation of subject and object. Such identity, as
experienced by a baby in relation to the mother, for instance, is
unconscious and 'characteristic of the mental state of early
infancy' (CW 6, paras. 741-742). Already in 1921 Jung had
depicted a stage of development similar to Balint's 'area of
creation' or Mahler's 'normal autistic stage'.
Then there is Jung's use of a special kind of identity for which
he employs the term participation mystique. This is a phrase
borrowed from L6vy-Bruhl, the anthropologist. In anthropology
6 ANDREW SAMUELS

this refers to a form of relationship with a thing; in this

relationship, the person involved cannot distinguish him- or
herself from the thing in question—be it cult object, holy artifact
or spirit. Jung used the term from 1912 onward to refer to a state
of affairs between people in which the subject, or a part of the
subject, attains influence over the other, or vice versa, so that the
two become indistinguishable to the subject's ego. Translated into
psychoanalytic language, Jung is really describing projective
identification in which a part of the personality is projected into
the object, and the object is experienced as if it were the projected
content.
Jung was wont to claim that his approach to analysis
subsumed and transcended those of Freud and Adler (CW 16,
paras. 114r-174). To some extent, this claim does little more than
illuminate Jung's leadership complex and power urges. But, in
quieter vein, it is possible to see in many of these papers how the
Jungian 'bit' sits firmly on or in a psychoanalytic grounding,
whilst retaining its distinctiveness. The integration of analytical
psychology with many aspects of contemporary psychoanalysis
has been an absolute necessity as and when Jungians faced up to
the deficiencies in Jung's clinical teaching. In my view, many of
the criticisms of analytical psychology that were valid in, say,
1945 have been addressed by this integration. So the debt to
psychoanalysis is acknowledged to be immense. However, it is
fair to say that the contribution made by analytical psychology
has not always been duly recognized (see Samuels, 1985, pp.
9-11, 270-271). In the short introductory passages that precede
each paper I try to pick out the Jungian heritage and highlight it,
thus facilitating the use of the book by psychoanalytic and
eclectic practitioners.

Attitudes to psychopathology
Psychopathology is a quest for the meaning of the soul's suffering.
At its worst, as Hillman says, it can involve the soul's suffering of
meaning (1975, p. 71). There is a general ambivalence towards
psychopathology within depth psychology, though hardly ever a
total turning away from the fascinating task of trying to say
something definite, even for a moment, about the shifting
INTRODUCTION 7

grounds of mental pain. Even those who loathe conventional

psychopathology will sometimes find themselves using it. But
what about this ambivalence? What is the problem with
psychopathology?
There seem to be at least seven main objections to the project of
psychopathology:
1. By the patient being labelled, her or his individuality is lost.
When aping a medical doctor, the soul doctor deprives himself
of his best medicine—an intuitive, attentive connection to the
internal world of the individual before him.
2. There is an epistemological objection. The categories of
psychopathology do not describe anything in the patient, for
they are mere constructs. Rather, diagnostic categories
imported unnecessarily from descriptive psychiatry primarily
reveal the clinician's state of mind.
3. Psychopathology is sometimes regarded as *unpsychological'—
an insult and affront to the psyche itself.
4. Psychopathology fails to see through itself, fails to notice how
relative its findings are—normality for women is different
from normality for men; last century's madness is not this
century's; Italian and British stereotypes of behaviour are
different; no two psychiatrists can agree on a diagnosis.
5. The use of psychopathology plays into the modern tendency to
overvalue expertise and professionalism. The problem here is
that the expert pathologist may be a poor therapist. Moreover,
part of the appeal of psychotherapy in a dark, technocratic age
is that there are no obvious tools of the trade other than the
self or selves involved. Psychopathologizing throws this
treasure away.
6. Notwithstanding struggles to avoid moralizing, psychopathol­
ogy cannot avoid contamination from ethical hierarchy,
whether this is on a collective basis or contained in the
analyst's own prejudices and problems (see Samuels, 1989, pp.
11-13).
7. There is a political angle to psychopathology in that segments
of the population are marginalized.
Clearly, there is some substance to each of these objections.
However, rather than defend psychopathology, it occurred to me
that it might be possible to scan the list for a possible
8 ANDREW S A M U E L S

enantiodromia. This term, which Jung borrowed from Hera­

kleitos, means that sooner or later everything turns into, or is
seen to be identical with, its opposite (CW 6, para. 708). Psycho­
pathology is apparently inimical to any therapy based on depth
psychology. It is apparently hostile to the development of the
individual. It is apparently moralistic. How could this undeniably
flawed enterprise possibly contain something of the highest value
for psychotherapists?
At the outset, we need an anatomy of psychopathology; the
blanket term is really of use only in dinner-party debates.
Following Rosenbaum (in Rosenbaum & Beebe, 1975, pp.
273-275), it is possible to see many different uses of the term. For
example, we distinguish a label for a symptom or syndrome (such
as Obsessional neurosis') from one that refers to a whole
character or personality (such as 'anal character*). Then there are
labels that refer to specific disorders (such as 'narcissistic
personality disorder'). A fourth category is that of'organ system'
labels, designed to cover psychosomatics (such as when a peptic
ulcer develops at a time of personal difficulty and we refer to a
'psychophysiological gastrointestinal disorder'). This is different
from a label that is used to depict a current situation (such as
'adjusting to adult life') or a life-stage label ('adolescence').
Behavioural traits may also acquire labels (such as 'perversion' or
'addiction').
Rosenbaum mentions one particular kind of label that is of
importance for analysts and therapists. Aetiological labels imply
some kind of causation or at least foundation for the psycho­
pathology in question. These can be of two kinds: 'statements of
early life experiences suggesting predisposition toward the
current symptomatology' (such as 'early oral deprivation'), or
'assessment of current threats to harmony' (such as leaving
home). The themes of aetiology and causation are discussed in
greater detail towards the end of the introduction.
The careful sub-division of the notion of psychopathology may
help the clinician to be more aware of the implications of the
language he is using, whether to the patient, to himself, or to
colleagues. A word like 'depression' may be played through all or
any of the variants of psychopathology that have been listed.
Another advantage of breaking up the ideogram 'psycho­
pathology' is that light may be shed on what we mean by formal'.
INTRODUCTION 9

As Joseph (1982) pointed out, the use of the word 'normal' by

psychoanalysts is not synonymous with 'regular', 'standard',
'natural' or 'typical', as the dictionary seems to suggest. Rather,
what is normal is determined by subjective evaluation. Freud
(1937) had talked of normality as an 'ideal fiction', and so, Joseph
concluded, Freud equated normality with analysability and with
the outcome of a successful analysis. Jones (1931) proposed that
normality could be assessed in terms of 'happiness', 'efficiency',
and 'adaptation to reality'. Klein (1960), in a similar vein, wrote
of normality as involving the harmonious interaction of several
aspects of mental life such as emotional maturity, strength of
character, capacity to deal with conflicting emotions, a reciprocal
balance between internal and external worlds, and, finally, a
welding of the parts of the personality leading to an integrated
self-concept.
The term in analytical psychology that corresponds most
happily to this specifically psychoanalytic idea of normality is
individuation. I f we consider Klein's suggestions, we can see
striking similarities with Jung's idea of individuation: a person's
becoming her- or himself, whole, indivisible, and distinct from
other people or collective psychology (though in relation to these).
Each kind of psychopathology represents a verbalization of a
different kind of threat to what psychoanalysts seem to call
'normality' and analytical psychologists call 'individuation'.
The kind of psychopathology to which I have been referring
occupies one end of a spectrum. The spectrum stretches from what
might be called a professional approach to psychopathology to a
poetic approach. Making diagnoses such as 'narcissistic personal­
ity disorder' or 'anal character', or discussing normality and
abnormality, represent the professional dimension. However,
there is also the poetic style of pathologizing to consider. Before
doing that, I would like to make a few comments about the
spectrum, itself a creative falsehood, offered for its heuristic
value. Of course, the spectrum does not really exist, for there is no
reason for the poles to stay in permanent opposition (though they
certainly are, on one level at least, opposed to one another). What
is more, no one analyst will occupy one pole exclusively; indeed,
many analysts will claim that they make explicit use of the whole
spectrum in their work. There may even be a level on which the
two poles turn out to be identical: the poesy of consummate
10 ANDREW S A M U E L S

professionalism and the professional cutting edge of an acute

poetic imagination. My view is that a linking of analysis-as­
science and analysis-as-art may be regarded as an ideal at which
to aim. But in the everyday sense, there is a professional-poetic
split in the attitudes to psychopathology held by analysts.
What of the poetic end of the spectrum?
Hillman (1975, p. 58) places pathology at the core of the
psyche. Provided we do not get seduced by cheap professionalism,
and provided we do not attempt an artificial division between
normal and abnormal, then, according to Hillman, the study of
psychopathology is an absolute necessity. Of course, Hillman
means something different from what Rosenbaum means by
psychopathology, but the central point remains: the individual
case, or symptom, contains the person, or culture, or God. The
part contains the whole. So, working towards the whole implies a
working on the parts. And, what is more, Hillman suggests that
we do not abandon the familiar medical jargon, but merely use it
so imaginatively that it starts to function once again as psyche's
language, psyche's words, psyche-ology. The problem with Hill­
man's approach is in its denial of its own professionalism, its own
importation of jargon and its own dogmatic distinction between
an acceptable and unacceptable use of psychopathology (abnor­
mal psychopathology?).
The idea I want to advance is that there is one way in which
the creative and careful use of psychopathology by workaday
analysts may, through enantiodromia, subvert the contemporary
tendency to see everything as susceptible to psychological
therapy, a tendency that casts the therapist in a falsely powerful
and censorious position. The way in which the study of psycho­
pathology serves this subversive end has to do with what has
been called analysability. Stripped down, this means: whom do I
turn away when they ask for analysis?—those I cannot help
rather than those I can.

Analysability and the wounded healer

Returning to the professional end of the professional-poetic
spectrum, in 1983 Edwards, a psychiatrist and analytical psy­
INTRODUCTION 11

chologist, proposed a list of criteria on which suitability for

treatment might be based. These were:
1. the strength, flexibility, and integration of the ego, and the
quality of ego consciousness;
2. the capacity of the ego to maintain boundaries between
inner and outer, and between phantasy and reality;
3. the degree of differentiation and disidentification of the ego
from the self and the archetypal level, and the extent to
which the representations in the ego were possessed or per­
meated by archetypal images, whether of a positive or a
negative nature;
4. the degree of splitting of personal self- and object­
representations in the ego, and the resultant effects on
identity and the perception of the external world;
5. the nature of the defences that predominated and whether
these were of a primitive type;
6. the kinds of anxiety and their intensity: panic, fears of
annihilation and disintegration, or hypochondriacal,
persecutory, phobic, or depressive anxieties;
7. the extent of controlling behaviour, linked, as it often is,
with omnipotence, compulsive needs for narcissistic self­
objects, or the control of bad persecutory objects;
8. narcissistic vulnerability, with feelings of being easily
wounded or humiliated in response to criticism or dis­
approval, or with shame reactions and loss of self-esteem;
9. The presence of depression and whether it is empty,
hopeless or despairing; or combined with guilt, remorse or
self-accusation;
10. the presence of psychosomatic illness with liabilities to
exacerbation triggered by emotional stress; early develop­
mental levels are usually involved with splitting defences
firmly established and resisting therapy;
11. poor or threatened control of instinctive impulses and
primitive affects, with the chance of breakthroughs of
unpredictable aggression, self-destructive acts, impulsive
or perverse sexuality;
12. motivation for, and type of resistance to, therapy;
13. capacities for humour, imagination, insight, and the use of
symbols, [p. 310]
Edwards's final comment on the subject of analysability
concerns the matching of the patient with the 'right' analyst.
12 ANDREW SAMUELS

Here, intuition plays its part. We could extend this last point to
coin a term like dialectical psychopathology; for is it not the case
that each of Edwards's criteria or desiderata may be applied to
the analyst as well as to the patient? It would follow that the
analyst's knowledge of her or his own psychopathology, or
assessment of that of a colleague in supervision, would also lie at
the heart of analysability. Turning a patient away is reframed as
a creative and altruistic act. What is more, now that the analyst's
use of self has come to occupy a central place in reflection upon
the patient's dynamics, psychopathology and the use of counter­
transference go together (see Samuels, 1989, pp. 143-174).
Psychopathology, the archprofessional activity of analysts,
undermines that very professionalism, leading to a reining-in of
clinical omnipotence and to psychology assuming a modest place
in cultural consciousness (and, hence, becoming more credible).
Edwards ends with Jung's words: 'Not everything can and must
be cured' (CW 16, para. 463).
Just as psychopathology illumines the weaknesses of the
analyst, so it can point up the strengths of the patient. Here, I am
thinking not only of the value of symptoms as indicators of the
patient's psychological destiny, but also of the intimate connec­
tions between wounds and health. This is exemplified by the
image of the wounded healer, which, as Guggenbuhl- 6raig (1971)
V

has pointed out, is an image that our culture tends to split. As far
as the individual is concerned, the wounded and the healthy/
healing parts of the personality are split off from each other.
When that happens, health is seen as being confined to the
analyst, and the patient is seen as the only wounded one. I f the
patient is to develop her or his healthy potentials, the analyst
must contribute her or his wounds to the process—wounds that
may have led to the choice of profession in the first place. In
psychoanalysis, a similar argument has been advanced by
Searles (1975) in a paper called The patient as therapist to his
analyst'. Briefly summarized, Searles's view is that it is an
inalienable part of being human to be a 'therapist'—that is, to
want to help others and to be able to do so. In a neurotic or a
psychotic, the potential to be a therapist is also damaged. It
follows that the healing of mentally ill persons requires that the
patients work on and improve their capacity to be therapists.
Searles suggested that the patient must develop the capacity to
INTRODUCTION 13

be a therapist by practicing on the one person available for

this—namely, the analyst (see Samuels, 1985, pp. 187-191, for a
fuller discussion).
The tendency of psychopathology to provide an absolutist
account of the patient is another feature which, when the angle of
vision alters, may turn out to have quite different implications.
For, in the formulation of a diagnosis concerning the patient, a
pluralistic process is hopefully in train. One needs to hold the
tension between 'this is what I think' (a unified view) and 'maybe
there are other possibilities' (a diverse view). The introduction of
other possibilities suggests a tension within the analyst, and this,
too, is a characteristically pluralistic endeavour. Is i t too fanciful
to suggest that any psychopathological label results from intense
bargaining within the analyst between the various interest
groups represented by the various diagnostic labels?
I am working towards a suggestion that there is a sense in
which psychopathology may have an individualizing, in addition
to a generalizing, effect upon analysis. To the degree that analytic
understanding alters analytic technique, and to the degree that
analytic understanding employs some aspect of psychopathology,
then it is psychopathology that makes a central contribution to
the analyst's attempts to meet the patient as an individual. As
Greenson says: 'Clinical experience has taught us that certain
diagnostic entities make use of special types of defence and
therefore that particular resistances will predominate during the
course of the analysis' (1967, p. 93). I n other words, the kind of
pathology involved will directly affect the course of the analysis.
In particular, the patient's response to interpretations will be
markedly different, and the analyst will be reminded that not all
patients are the same. Judicious employment of what is known to
be generally true may protect what is sensed to be unique.

Jung and psychopathology

So far, I have been reflecting on the ambivalence towards
psychopathology and making some suggestions about a refrain­
ing of our understanding of the subject. At this point, it may be
interesting to look in greater detail at how Jung came to terms
14 ANDREW SAMUELS

with the same ambivalence, this split between professionalism

and poesy. In Memories, Dreams, Reflections (1963), Jung wrote
that though 'clinical diagnoses are important, since they give the
doctor a certain orientation ... they do not help the patient. The
crucial thing is the story' (p. 145). We may well wonder how it is
possible to help the doctor without helping the patient! Later on,
Jung says that he does not have a particular method and that
"psychotherapy and analysis are as varied as are human indi­
viduals' (p. 152). Yet, an analyst 'must be familiar with the
so-called "methods"' (p. 153). There is a discrepancy, or at least an
ambiguity, here. McCurdy (1982) also notes this and understands
it in terms of Jung's tendency to 'find answers in the tensions
between opposites'. If this is so, then the opposites that McCurdy
discerns as being relevant to Jung's ambivalence concerning
psychopathology and diagnosis may repay study because they
could speak for the general ambivalence we have been nego­
tiating.
McCurdy (1982) understands these opposites as being
the clinical responsibility of the analyst to be well trained in
the fundamentals of depth psychology and psychopathology; to
understand and be able to apply insights from the basic schools
of psychological thought; and, above all, to have had experience
in these ways of diagnosing .and working with people, (p. 48]
The other opposite concerns
the ability and responsibility to 'forget' all of this information
and to orient him- or herself to the person in analysis as an
individual. It is much like the artist, who, after great efforts
and much time spent in mastering the fundamentals of a
medium, can produce art without 'thinking' of fundamentals,
[p. 49]
McCurdy concludes that it is a matter of 'letting go' and 'holding
on' at the same time.
But there is a problem with this formulation, surely an ideal
one for the average analyst, when we come to apply it to Jung.
For Jung's 'letting go' tends to receive more attention than his
Tiolding on'. Indeed, Jung is often accused of letting things go so
far that his work is not really analytic at all (cf. Goodheart, 1984)!
But, throughout this introduction, I have been illustrating how
Jung also held on to his role as a psychiatrist and analyst, writing
INTRODUCTION 15

like a professional on the stock-in-trade of his profession:

neurosis, psychosis and depression.

Modes of psychopathology
Reading and re-reading the papers in this book, it occurred to me
that psychopathology signals its presence in differing modes. It
may, for instance, be manifest in an affective mode. The patient
may be conscious of problematic emotions, unwanted feelings and
fantasies, and so forth. Or the analyst may, by scanning the
countertransference, be alerted to a disturbance or incongruence
of affect.
A second psychopathological mode reflects a preoccupation
with psychic structure. Hence, disturbance is verbalized in terms
of imbalances and unresolvable conflicts between parts of the
personality, or invasive behaviour by one part towards the other.
Thus, confused sexual identity may be understood as stemming
from an inflation of animus or anima to the point where the
personality as a whole is flooded.
The third mode I can identify operates on a model of deficit I
would include the notion of excess here because to have too much
of something is implicitly a form of deprivation (stuffing mothers
are as problematic as withholding ones). When analytic writers
mention deficits, they refer either to something deficient in
parental handling or to some constitutional (inborn) lack/excess
(such as instinctual aggression), or to a combination of these.
Cutting across these modes of psychopathology, all of which
are represented in the book, there is an axis of understanding
ranging from the phenomenological to the aetiological. What I am
getting at can be depicted diagrammatically (Figure 1).
As I mentioned previously, an aetiological approach has a
crucial place in a great deal of thinking about psychopathology.
Does this have to be the case? In analytical psychology, there is a
long tradition of questioning seriously whether experiences in
early life do have the determining effect on adult personality that
has been claimed. And there has been a more recent counter­
movement stressing the importance of early experiences which to
some eyes, including this writer's, can be excessively determinis­
16 ANDREW SAMUELS

P
H
E AFFECT A
N E
O T
M I
E O
Q STRUCTURE ^
L G
0 I
G C
1 A
C DEFICIT L
A
L
FIGURE 1

tic and literal-minded. Storr (1979, pp. 148-149) confronts this

issue. He states that his approach to psychopathology is 'pri­
marily descriptive', rather than being concerned with causes
(though he is careful not to rule out the effects of early
experiences on adult personality altogether). He goes on:
partial explanations of adult character in terms of possible
childhood influences ... are not essential in understanding. ...
When Freud began the practice of analysis, he was ...
concerned to trace the origin of particular symptoms; to
discover their cause in some traumatic event occurring at an
identifiable time. However appropriate this way of proceeding
may be in the case of traumatic neurosis or certain kinds of
hysterical symptom, it is not, in my view, important in
understanding most of the difficulties which patients seeking
psychotherapy present us today.
This still leaves those deficits due to adverse inborn imbal­
ances of instinctual energy or activity, and it is to the credit of
analytical psychology that it attempts therapy in the full
consciousness that what is being addressed is nothing less than
the fateful disposition of character that is the individual's
inheritance. It is much easier to work knowing or claiming to
know why your patient is as he/she is, but it may not be as honest
or profound an approach.
INTRODUCTION 17

Jung's synthetic method

The objection may be made that sophisticated analysts do not
deal in anything so crude as 'causes'—rather, the concern is for
pattern and repetition. While the desire to escape the charge of
being mechanistic is understandable, the current tendency to
speak of 'patterns' of adult psychological performance which
originate in childhood is still deterministic, i f not outright
causalistic. So, even when reference is made to spiral models of
development in which the earlier elements appear later in
transmogrified form, the venture still sits firmly within the
deterministic-causalistic camp.
Actually, there is nothing wrong with being causalistic. Jung's
approach was happily causal, though, for him, it was Aristotle's
causae finales (final causes) that were of central importance. This
teleological viewpoint (from telos, meaning goal), or prospective
approach, is characteristic of classical analytical psychology. It
involves considering a psychological phenomenon from the
standpoint of what it is for, where it is leading, for the 'sake' of
what it is happening. All these were more interesting to Jung
than the effects on the situation of causes located in the
chronological past (Aristotle's causae efficientes). The search for
causes in the past, which characterized psychoanalysis as Jung
knew it, was regarded by Jung as 'reductive'; his own method was
termed 'synthetic', with the implication that it was what emerged
from the starting point that was of primary significance.
Jung's emphasis on teleology led him to propose that
symptoms, and, indeed, mental illness itself, may often signify
something of great psychological value for the individual. For
example, Jung saw depression as a damming up of energy, which,
when released, may take on a more positive direction. Energy is
trapped because of a neurotic or psychotic problem but, if freed,
actually helps in the overcoming of the problem. A state of
depression is one that should be entered into as fully as possible,
according to Jung, so that the feelings involved may be clarified.
Such clarification represents a conversion of a vague feeling into
a more precise idea or image to which the depressed person can
refer. Depression is connected to regression in its regenerative
and enriching aspects. In particular, it may take the form of 'the
empty stillness which precedes creative work' (CW 16, para. 373).
18 ANDREW SAMUELS

In such circumstances, what has happened is that the new

development, already active unconsciously, has siphoned off
energy from consciousness, leading to depression.
Jung pointed out that the synthetic method is taken for
granted in everyday life, where we tend to disregard the strictly
causal factor. For example, if a person has an opinion and
expresses it, we want to know what she or he means, what is
being got at, rather than the origins of the remark. Use of the
synthetic method in analysis means considering psychological
phenomena such as symptoms as if they had intention and
purpose—i.e. in terms of goal-orientedness or teleology. Jung
grants to the unconscious a kind of knowledge or even fore­
knowledge (CW 8, para. 175).
It must be emphasized that Jung never eschewed the analysis
of infancy and childhood as such. Rather, he regarded this as
essential in some cases though unavoidably limiting (CW 16,
paras. 140-148). My own feeling is that there is much to be
gained even from a highly mechanistic, deterministic and
causalistic approach—provided that this is balanced by the
simultaneous use of a non-linear, metaphorical and teleological
approach to the development of personality. Paradoxically, the
existence and use in parallel of two competing perspectives
guarantees that neither will dominate the mind of the practi­
tioner. Then, as I have tried to show elsewhere (Samuels, 1989,
pp. 48-65), diachronic models of personality development, with
images of an unfolding of personality over time in a causally
connected way, battle creatively with synchronic models, which
attempt to embrace the all-at-oneness of the personality with an
accent on what is eternal therein. Moreover, the pluralistic
sparks that fly from such competitiveness prevent decay into
either therapy-by-numbers or therapy-as-fortune-telling—the
respective ultimate dangers of the reductive and synthetic
methods.

Psychopathology and culture

Jungian analysts often hear during their training that 'when you
treat the patient, you treat the culture*. The slogan can be
understood in two ways. The patient is an individual expression
INTRODUCTION 19

of the Zeitgeist, positive and negative; an analysis of any depth

must include an analysis of the patient's portion of collective
consciousness. Then there is another, more subtle sense in which
treating the patient means treating the culture. Treatment of an
individual's malaise is a contribution to a psychological therapy
of a cultural malaise. The analysed individual may become a
'change agent', or the influencing may be less direct and more
mysterious.
These remarks are intended to explain the presence in a book
on psychopathology of papers on the Holocaust and on old age.
These cultural phenomena, both of them collective though rather
different in kind, display psychological characteristics that are
met in the consulting room, In Britain, in recent years, an
interest in the psychological aspects of mass disasters has arisen.
The focus has been on the consequences for both survivors and
mourners. There was a fire at a football stadium, a ferryboat
capsized, a madman with a gun killed many people in a small
town, an oil platform went up in flames with heavy loss of life, an
airliner crashed on a small town. When Dreifuss wrote his paper,
this current interest would have been unfamiliar, yet the paper
has a striking relevance. Similarly, demographic revelations
about aging populations in Western countries add a piquancy to
Zoja's thinking on the subject.

Concluding remarks
In this introduction, I have tried to give the background to the
book and to say for whom it is intended. The general ambivalence
in depth psychology concerning psychopathology is to be found
par excellence in the Jungian world. However, if we are careful
not to use 'psychopathology' in an all-inclusive manner, and if we
nurture the tension between the professional and poetic nuances
of the theme, psychopathology may lead creatively to the
patient's being seen as an individual to whom health, potency and
a sense of enablement can be returned. The play of opposites
between a professional and a poetic standpoint makes in itself a
fruitful contribution to analysis as well as to personal psycholo­
gical reflection.
2 0 ANDREW S A M U E L S

Jung's ambivalence concerning psychopathology is illumi­

nated when one considers the specific contributions he makes
concerning clinical practice and psychopathology—whilst, at the
same time, his professionalism is itself undermined by the poetic
assumption of clinical humility.
Psychopathology need not be wedded to reductive or to
synthetic analysis. Rather, its straddling of the professional­
poetic spectrum facilitates movement between these orientations.
Similarly, psychopathology provides one bridge between an
analysis of the individual and an analysis of culture.

REFERENCES
Adler, G. (ed.) (1974). C . G. Jung, Letters. V o l . 2. London: Routledge and
K e g a n Paul.
Binswanger, L . (1945). I n s a n i t y as life historical phenomenon and as
mental disease: the case of Use. I n R. May, E . Angel & H . Ellenberger
(eds.), Existence. N e w Y o r k : Basic Books (1958),
Edwards, A . (1983). Research studies i n the problems of assessment.
Journal of Analytical Psychology 28:4.
Jungian Psychotherapy: a Study in Analytica
Fordham, M. (1978).
Psychology. Chichester: Wiley. [Reprinted 1986, London: Maresfield
Library.]
F r e u d , S. (1937). A n a l y s i s terminable and interminable. Standard
Edition 23. London: Hogarth.
Goodheart, W. (1984). C . G . Jung's first *patient': on the seminal
emergence of J u n g ' s thought. Journal of Analytical Psychology 29:1.
Greenson, R. (1967). The Technique and Practice of Psychoanalysis.
London: Hogarth.
Guggenbiihl-Craig, A . (1971). Power in the Helping Professions. New
York: Spring Publications.
H i l l m a n , J . (1975). Revisioning Psychology. New York: Harper & Row.
Jones, E . (1931). T h e concept of the normal mind. International Journal
of Psycho-Analysis 23.
Joseph, E . (1982). N o r m a l i n psychoanalysis. International Journal of
Psycho-Analysis 63:1.
J u n g , C. G. References are to the Collected Works (CW) and by volume
and paragraph number, except as below. Edited by H . Read, M.
Fordham, G . A d l e r & W . McGuire, T r a n s , i n the main by R. Hull.
INTRODUCTION 21

London: Routledge and K e g a n P a u l ; Princeton: Princeton University

Press.
(1963). Memories, Dreams, Reflections. London: Collins and
Routledge and K e g a n Paul; F o n t a n a (1972).
Klein, M. (1960), On mental health. British Journal of Medical
Psychology 33.
L a i n g , R. (1967). The Politics of Experience. Harmondsworth, Middlesex:
Penguin.
McCurdy, A. (1982). Establishing and maintaining the analytical
structure. I n M. Stein (ed.), Jungian Analysis. L a Salle: Open Court.
P e r r y , J . (1962). Reconstitutive processes in the psychopathology of the
self. Annals of the New York Academy of Sciences, Vol. 96, article 3.
Rosenbaum, C , & Beebe, J . (1975). Psychiatric Treatment: Crisis/Clinic/
Consultation. New York and London: M c G r a w - H i l l ,
S a m u e l s , A. (1985). Jung and the Post-Jungians. London and Boston:
Routledge and K e g a n Paul.
(1989). The Plural Psyche: Personality, Morality, and the
Father. London and New Y o r k : Routledge.
Searles, H . (1975). The patient as* therapist to his analyst. In
Countertransference and Related Subjects: Selected Papers. New York:
International Universities Press (1979).
Storr, A. (1979). The Art of Psychotherapy. London: Seeker and
Warburg/Heinemann.
CHAPTER ONE

Depressed patients
and the coniunctio
Judith Hubback

Hubback's paper is of interest because of her express intention of

using both 'archetypal structuralist concepts'and 'the findings of
developmental research ; the former is represented in the paper
9

by a tracking of the dynamics of the coniunctio oppositorum,

the patterns within a person of integration and unintegration,
harmony and dissonance, and the latter by a study of the part
played in her patients' depression by their having had a
depressed mother. Where experience of parental imagos of a
depressed kind has led to splitting defences, this has injured the
innate capacity of the person for coniunctio. What is more, when
the parental marriage is experienced as divisive, weak or
non-existent, a further injury is done to the prospect of internal
marriage within the patient
This is the background for Hubback's noting a special clinical
phenomenon in relation to her group of depressed patients: the

F i r s t published i n The Journal of Analytical Psychology 28:4, i n 1983.

Reprinted i n People Who Do Things to Each Other: Essays in Analytical
Psychology, by J u d i t h Hubback (Wilmette, I L : Chiron Publications,
1988). Published here by kind permission of the author and the Society
of A n a l y t i c a l Psychology.

23
24 JUDITH HUBBACK

necessity of analysing the patient's 'phantasies about his

mother's inner life'. The interactive focus naturally falls on the
inner life of the analyst in general and on her countertransfer­
ence in particular. Thus the analyst's participation in the
patient's process is explicitly noticed—and compared by Hubback
to the vital presence of the soror, the alchemist's assistant, in the
alchemical process—a Jungian metaphor for analysis itself.

A.S.

Introduction and theme

here are six particular people—patients—whose lives and

therapies are at the empirical core of this paper. What they
J L have in common is that their mothers were each of them
seriously depressed during their son's or daughter's infancy and
childhood. The other thing they have in common is that they had
their analytical therapy with the particular analyst that I am,
and that over the years I have had a growing interest in trying to
find out more about what it is that enables someone effectively to
emerge from long-term depressions. I would like to isolate one
particular factor from those, often explored and discussed,
concerning the nature, the manifestations and the treatment of
depression. I am thinking of a factor whose absence could be a
great disadvantage, but whose presence can enable a patient to
become, in the course of therapy and time, less depressed, less
frequently so, and less paralysingly; such a factor might also help
the person to be less aggressive towards others and facilitate the
development of a truly viable sense of self.
Depression as a form of feeling ill, and as a clinical syndrome
or illness, has been known for thousands of years and described
from the earliest days onwards both by sufferers and by their
doctors. A precise or short definition cannot be offered here,
particularly as I am not a psychiatrist and because all authorities
agree that there is a wide spectrum of symptoms and indications.
At one end of that spectrum, depression is a natural reaction to
painful emotional experiences, to bereavement and loneliness, to
DEPRESSED PATIENTS AND THE CONXUNCTIO 25

physical ill-health or the approach of death—all features of the

human condition. At the extreme melancholic or pathological end
of the spectrum the mood change is extreme and persistent. If
more of us had time to read (rather than occasionally dip into)
Robert Burton's The Anatomy of Melancholy, first published in
1621, as well as to study modern psychiatric textbooks, we would
appreciate even more widely than we do from introspection and
as Jungian psychotherapists the many aspects of the whole
depressive picture. Its main attributes are: (1) alteration in mood
to sadness, apathy and loneliness; (2) a negative or otherwise
self-attacking self-concept, with self-reproaches and self-blame;
(3) regressive wishes, the desire to escape, to deny, to hide, to die;
(4) crying, irritability, insomnia, loss of sexual appetite; (5) a low
level of general activity, loss of decisiveness and of other ego
capacities, sometimes a heightened level of inappropriate anxi­
ety, fear or agitation. In this paper there is no possibility of
describing or accurately naming in psychiatric terms just which
kind of depression afflicted the mothers of the patients about
whom I am writing, e.g. whether these were basically endogenous
depressions reactivated during their son's or daughter's infancy;
the more important common feature was that the mothers had
suffered a serious personal loss, a bereavement from which it
appeared they had not recovered. None of them was hospitalized;
the patients each had a far clearer impression of the depressed
moods than of any intervening manic ones that there may have
been; and the suicide of one of the mothers undoubtedly affected
her daughter's life most deeply. The manifestations of depression
in the patients themselves will emerge, I think, in the course of
the paper.
The following thoughts have become the theme of this paper:
too many and too strong negative archetypal images are absorbed
by an infant or young child from a depressed mother, most
particularly i f she is a bereaved woman who is still caught up in
her anger and sadness, so that she cannot direct herself towards
the baby and genuinely smile into its eyes. Not enough validation
of its lovableness is offered to such an infant at the stage in
life when that experience is essential for a healthy self-belief
to develop, which will be based on enough internal feeling that
26 JUDITH HUBBACK

there is more growth than destructiveness both in himself and in

his environment. To alter the attitudes stemming from those
early inner and outer pathological experiences, an analytical
therapist makes herself available for a relationship to grow
within which a number of coniunctiones can occur: if, at the level
of the objective psyche as manifested in the analyst, there is a
well-established coniunctio of internal images, and if the patient
is able to identify with that inner healer—whose outer scars may
still be evident—then what is happening is that both archetypal
structuralist concepts and the findings of developmental research
are confirmed.
I am not speaking simply about the patient's need to (I quote
Jung) 'kill the symbolic representative of the unconscious, i.e., his
own participation mystique with animal nature . . . the Terrible
Mother who devours and destroys, and thus symbolises death
itself (CW 5, paras. 504-506). The patient with a depressed
mother does need to emerge from an unconscious identification
with his mother because of the killing quality of her depression
and needs to cease participating in her anger and sadness. After
the passage quoted above, Jung added in brackets:
I remember the case of a mother who kept her children tied to
her with unnatural love and devotion. At the time of the
climacteric she fell into a depressive psychosis and had
delirious states in which she saw herself as an animal,
especially as a wolf or pig. ... In her psychosis she had herself
become the symbol of an all-devouring mother.
And, following that clinical vignette, he went on:
Interpretation in terms of the parents is, however, simply a
fagon de parler. In reality the whole drama takes place in the
individual's own psyche, where the 'parents' are not the parents
at all but only their imagos: they are representations which
have arisen from the conjunction of parental peculiarities with
the individual disposition of the child, [ibid., para. 505]
If for the term participation mystique we substitute the words and
concepts unconscious identification, then I can go along with the
way Jung used L6vy Bruhl's term. Many writers since Jung have
used the concept of participation mystique in a more simplistic
manner than he in fact did, at least in the passage quoted. And it
DEPRESSED PATIENTS AND THE CONIUNCTIO 27

is regrettable that the anthropologist L6vy-Bruhl should have

had his phrase over-used and distorted, when the perhaps rival
psychological concepts of projection, introjection, identification
and the transcendent function really serve us better. Identifying
with those structures in the analyst which have developed as a
result of her working on instinctual 'animal nature' in herself can
and does happen within the therapeutic relationship; projections
and introjections can be discerned and described. I think they are
marvellous, but not mystical.
The patient with a depressed mother is suffering from a serious
narcissistic wound. I develop in this paper the theme that such
patients benefit greatly—perhaps essentially—from the analyst
using to the full a combination of developmental observations and
her own internal search for harmony, for coniunctio.
From the following brief descriptions of the patients (with
fictitious names) it can be seen that the character and quality of
their mothers' depressive reactions to the loss of either their
husbands or an earlier child ran the whole spectrum of
possibilities: paranoid, manic, animus-ridden, schizoid, closed,
sulky, aggressive, obsessional and suicidal. Some of these
patients made images, or allowed the images to make themselves,
easily and early on in their analyses, others with difficulty and
only much later. They also varied in their ability to fantasize in
the transference, and to dream. Each of them suffered from
internal impoverishment.

Anthony
A's father abandoned A's mother when he was very young; the
precise age is unknown. This unsupported woman suffered all the
rest of her life from a depressive and persecutory reaction to that
loss. I n addition to having to try to learn to live with such a
mother, A (who became my patient in middle age) had certainly
inherited some of his father's capacity to opt out of emotional
commitments. He was evacuated at the age of six from a large
city, with his school, for the duration of World War I I , and billeted
with several different families, who treated and ill-treated him in
various ways. His parental imagos were of course very confused.
28 JUDITH HUBBACK

He related to other people in as distant a way as possible.

Virtually the whole gamut of possibilities reappeared in the
transference, from delusional idealization, via distancing cold­
ness, to destructive hatred. Trust and self-confidence grew only
slowly, through many discouraging phases.

Belinda
B's father disappeared even earlier in his child's life than did
Anthony's; she thinks he was not told she had been born, and he
may even not have known she had been conceived. All through
her childhood her mother suffered from that, to her, crucial
object-loss; it came after other similar losses. As a mother she
seems to have been unable to emerge enough from her own
narcissistic wounds to offer her daughter (my patient) a reliable
self-feeling as a reflector of the child's potential belief in herself.
The mother's long-drawn-out self-attacks, sulky depressions and
obsessional cleanliness were partly introjected by her daughter
and partly defended against; the defensive manoeuvre was fairly
successful, perhaps as a result of the daughter having inherited
from the father what may have been a self-protective ability to
push 'the woman' to one side. But analysis, as it progressed,
revealed how very powerful the damaged and damaging mother
still was.

Christine
C was the younger of two children and was in her fourth year
when her parents' marriage broke down in violence, and her
mother never forgave her father for the loss not only of economic
support but, more dangerously, of personal happiness. While the
mother saw herself as the injured and wronged one, the father
also had in fact been deeply hurt and deprived of his children. My
patient C grew up with an aggressively depressed mother and an
absent, rarely mentionable, unmourned father, for whom all the
same she hankered. C's depression had, for a time, a paranoid
quality to it. In her, the defences of the self (Fordham, 1974) were
DEPRESSED PATIENTS AND THE CONIUNCTIO 29

obstinately structured, and early in her analysis she was blocked

against using her imaginative or symbolizing capacities.

Dominic
D's mother had lost her first son when he was aged about eight
months, before D was born, and although there was no factual
evidence that he was a mere 'replacement baby', his insistent
conviction of hardly having his own real identity was tenaciously
held on to for many years. His mother's depression was so
thoroughly introjected that it acquired a most powerful melan­
cholic grip on him. He knew a great deal about the losses of other
significant males in his mother's and his maternal grandmother's
lives, each of those males having either died suddenly or been
killed in various wars. In analysis the transference projections
were intense, violent, cold, envious and haunting; the counter­
transference affect was inescapable. But, as in the cases of A and
B, he had internal warmth, which, however strenuously he used
his splitting defences to ward it off, always came back sooner or
later.

Erica
E's mother had had to leave her country of birth and childhood
when, as a teenager, her parents became refugees. This woman
apparently never fully accepted the loss of her mother country:
she gave all her children, E and her brothers and sisters, names
that were clearly foreign in the country of their birth, which was
in the Antipodes. E could not identify with a mother who was still
mourning, everlastingly yearning for the impossible. She came to
England. She developed moderate anorexia nervosa; in spite of
the somatization of her mother complex she made a fair
beginning i n analytical therapy. But the shadow of her mother's
depression came between her and all attempted relationships
with men or women. And my offer of intensifying her analysis,
which would have taken it a stage forward, into a deeper
commitment, and would have involved the underlying arche-

P—B'
30 JUDITH HUBBACK

typal structures, led to her abrupt flight to the place where her
parents still lived, as far away from me as possible: the other side
of the world.

Freddie
F was the first of three children of his mother's second marriage:
before that she had twin sons in a marriage which had broken
down in a way or from a cause which F never heard mentioned.
Her intensely erotic relationship with F when he was a baby and
a child, her grousing attitude to life, her constant denigration
both of the twins and of F's father and a number of physical ills
probably indicate a long-term depression. There was a mysterious
or glamorous other man between the two marriages. She does not
seem to have mourned the failure of her first relationship, nor the
disappointment over the mystery man, but moaned about her
marriage. F was very closely bound to her and decided one day
early in puberty that he was a homosexual. He would not move
from that decision: it meant to him that he was not an ordinary or
banal man like his father, he was going to be extraordinary, his
mother's lover. He himself was not a depressed man, but his
psychic development was held up by the bond to a mother who
had—as far as I could tell—not been able to mourn losses which
occurred before F's birth.

In the interests of analytic theory it would be satisfying i f i t

were possible to point to some factor in these people which seems
to have made them especially liable to identify with their
mothers, and to receive the projection of the mother's damaged
self. For example, the stage of the patient's life at which the
mothers were bereaved might be significant: but it was not the
same for all, e.g. the first year of life, or one of the later
developmental stages, such as the oedipal one, when the incest
archetype dominates. Then, another possible factor would be
personality type; they were all certainly more introverted than
extraverted, but in terms of the classical Jungian typology of the
four functions I can discern no categorical significance.
Another possibility, to which I incline, but it is a speculative
one, is that the characterological feature of both the mother and
the father by which each of them was both victim and victimizer
DEPRESSED PATIENTS AND THE CONIUNCTIO 31

had been inherited by the son or daughter, and the component of

aggression-passivity led the child to identify with the available
parent, namely the mother, in whom the victim/victimizer
syndrome had led to depression. That factor would be a somewhat
subtle version of the well-known defence of identifying with the
aggressor. The theme of identification needs more examination
than is possible here, and contributions from several angles, with
clinical examples.

Self-feeling, narcissistic deprivation and depression

Many analytical psychologists have studied both the self in the
sense that Jung used the term, and the patient's sense of himself,
self-feeling, or self-experience. Moreover, the originally
psychoanalytic (Freudian) term, narcissism, is currently used
more frequently in studies relating to the Jungian self and the
primal self by analytical psychologists than in Jung's own
writings. (See, for example, Ledermann, 1982; Gordon, 1980;
Humbert, 1980; Schwartz-Salant, 1982; Kalsched, 1980; and
Jacoby, 1981). The study of narcissistic personality disorder is
proceeding apace, within a current Jungian frame of reference.
Jungians are also making use of Kohut's and Kernberg's
post-Freudian observations. My impression, derived from
depressed patients in analysis, is that the relation between
narcissistic unsatisfaction in infancy and depression in adulthood
is extremely close. Further analytical studies of different groups
of depressed adults may, i f they are undertaken, lead to deeper
understanding of exactly how the two kinds of suffering are
related.
The depressed patient, whose mother was not subject to
depression, brings to his analyst pathological material which is
principally his own. The one whose mother is known to have been
seriously depressed when he was very young will be listened to by
an analyst with her ear ready to try to extricate the mother's bad
internal self-view from the patient's phantasies about it. There
are cross-currents of identifications which can be navigated
successfully, if slowly, through the patient's transference man­
ifestations and the analyst's counter-transference self-analysis.
We are concerned with more than the familiar process of enabling
32 JUDITH HUBBACK

the patient to separate out from his mother and to develop firm
(but not rigid) boundaries between himself and every later
representative of the first object, that first partner. Rather, our
focus is on the task of analysing his phantasies about his mother's
inner life. They cannot be assumed to be totally fantastic, or
'merely* subjective. The analyst's familiarity with her own inner
life and willingness to use it indirectly in her work will be a major
factor in analysing the patient effectively. She has to be bold, and
enough in her own residual depression, or depressive phases, and
at the same time to have good enough boundaries, to distance
herself enough from her depressive tendencies so that the patient
can use them in the transference—symbolically.
The symbolic attitude and approach (Hubback, 1969) to the
patient whose mother was depressed brings together the under­
standing of environmental influence, of developmental studies
and of archetypal disposition. Jung has written that the
'appearance of the mother-image at any given time cannot be
deduced from the mother archetype alone but depends on
innumerable other factors' (CW 9i, para. 155). Jung also insisted
that *the archetype in itself is empty and purely formal . . . a
possibility of representation . . . the representations themselves
are not inherited, only the forms, and in that respect they
correspond in every way to the instincts, which are also
determined in form only.' The ethologists' theory of internal
release mechanisms is in line with that formulation. In another
passage Jung wrote: \ . . the contents of the child's abnormal
fantasies can be referred to the personal mother only in part,
since they often contain clear and unmistakable allusions which
could not possibly have reference to human beings' (CW 9i, para.
159, emphasis added).
We can also observe normal infants when they are in the grip,
early on, of desperate hungry anxiety, infants who gradually
grow less anxious and angry when there have been repeated
experiences of someone responding to their hungry, demanding
and envious attacks. Working for many months or even years
may be necessary with patients who despair of ever becoming free
from hatefulness. They feel over-full of hate against the
apparently ungiving mother analyst, and over-full of terror that
she will hate them for hating her.
The phantasies that such patients have are very extremist. On
two separate occasions, with two different patients, I took
DEPRESSED PATIENTS AND THE CONIUNCTIO 33

marginally longer than usual to answer the door-bell when they

arrived. One, a woman, said she had, in those instants, imagined
me lying on the floor of my room, dead from a heart attack. The
other, a man, phantasied that my husband had been killed in a
motor accident and I had been called away. On another occasion,
a man patient phantasied dying then and there while lying on the
couch, of heart failure, which would give me, he hoped, the most
difficult situation I had ever had to deal with. That was the day
after he had voiced both a grossly idealized description of me, and
his miserable envy, saying, 'You have a really good, balanced,
internal self-feeling, you believe in yourself. I don't.' I told him I
saw the imagined 'heart attack' in the present session as a
suicidal phantasy of self-punishment following the envious
attack on me of the day before, but that he was also telling me
that he was very much alive, to be able to go at me like that, with
such attacking hunger. His response was, 'Yes! I'll attack, and
attack, and attack again! I'm very hungry!' The following week,
the atmosphere between us changed. The feeling arose in him
that there was a 'we', and he remembered some of the earlier
positive phases of the analysis. He smiled on arrival, ruefully, he
grew gentler. And he even managed a joke.
In therapies with such patients i t was never any use to skimp
on the long process of working through the experiences of
unsatisfied narcissism or the images associated with them. Time
and again the transference and counter-transference projections,
when elucidated, showed how the lack of outgoing and positive
response of the personal mother had contributed in a major way
to the patient having not only a consciously poor self view and an
unconsciously grandiose and arrogant one, but an actively
negative one. It was when that self-attacking view was in the
ascendant that the structures in-forming the analysis were put to
the greatest strain. The patients I am talking about were all
either extremely sensitive to even the minutest alteration in
externals, such as my appearance or the contents of the room, or
they defended themselves against their sensitivity being appar­
ent. Each of them i n his or her own particular way would make
use of whatever came to hand to try to demonstrate how
inadequately they considered I was treating them and how
impossible was any change. Things were as bad as they could be,
always had been and always would be. There was no time any
more, only timeless hell. Their very present despair could only be
34 JUDITH HUBBACK

reached with the help of accumulated experiences in the analysis,

from which they gradually discovered that change, time and
development do exist. They began to recognize the alternation of
hell and heaven. Then, in time, those extremes were modified.
Both patient and analyst have their own personal and actual
selves which stem from primal body-experiences of psychosomatic
unity. The self is a concept which is the best possible way of
referring to the sense of selfhood that each person needs if he is to
use, rather than be misled by, what he gets from other
people—identifications. He needs to have boundaries, and a sense
of those boundaries, before he can identify healthily. If the actual
mother fails to grant the infant boundaries, otherness, indi­
viduality and aloneness, as she has not detached herself from the
image of another person to whom she was ambivalently
over-attached, then she ties the infant in a false closeness based
on her unconsciously identifying with her own abandoned self
that she has projected into the infant. That infant is then grossly
over-burdened. His mother's angry depression is experienced by
him in infancy and childhood as though it were his own capacity
to attack, to defeat and to be defeated. Each of us in our original
undifferentiated libido has the potential to direct it positively or
negatively (experiencing the world as giving us nourishing food
or destructive poison, love or hate, life or death, and so on), but
the infant whose mother is depressed over-develops his negative
potential. The infant's need to discover the difference between
despairing loneliness and positive separateness is not met by a
mother who has not achieved it herself. Such a mother offers the
infant a model of much more bad than good, as compared with a
model (or image) of a person who discovers that the self contains
both, and that the loving, constructive, forces can defeat the
destructive ones.

Questions connected with technique

and countertransference
The problem of where the most powerful force of pathology lies for
any particular patient may or may not affect the course of the
analysis. How much does it matter whether the analyst gives
great weight (in the reflections she does not communicate directly
DEPRESSED PATIENTS AND THE CONIUNCTIO 35

to the patient) to the presumed influence of the mother's

unworked-through mourning, or adopts the other course of
paying major attention to the patient's autonomous imagery?
How much difference does it make to the healing process, to the
development of reconciling and integrating forces, to the patient's
potential for continued self-analysis and further improvement of
personal relationships after he has separated from the analyst, if
there has been concentration on one approach to the problem and
neglect of the other? Or, is the wisest course to work with no
framework of theory at all, no model associated with any group or
school?
Only tentative answers can be offered here. Several of the
patients produced images of quite exceptional force. But the
transference projections were very powerful, whether there was
much or little imagery. The mother's unworked-through mourn­
ing seemed to me to be still exerting a pathological influence, so
that I consider attending to the images on their own is not
enough. I observed that the introjected image of a depressed
mother became more amenable to analysis at times when I myself
either was, or was believed by the patient to be, depressed. The
analysis became more stressful. It was important then that I
should try to understand what losses or personal failings I had
not yet faced, mourned and accepted. It would be defensive
idealization to see myself as fully individuated, or so free from
ever being disturbed by personal emotions that no affect leaked
from me to a patient.
Integration of all kinds of shadow material proceeded when I
was able to use a combination of intuition, memory and well-tried
theoretical concepts to come to something I hoped could be
dignified with the name understanding. That is where acquaint­
ance with, and reflection on, other schools of analysis and other
arts and sciences can be of great help.
Granting full acknowledgement to powerlessness is very
necessary if the analyst is to avoid getting enmeshed in the
patient's projective identification. The illusion of omnipotence
must be dissolved. Being myself a parent, I find that unhappy or
anxious affects in relation to one or other of my children can on
occasion intrude and cause me to associate (privately) to a
patient's perhaps similar experiences. Usefully, however, I find
that they tend to see my professional persona as giving them a
36 JUDITH HUBBACK

convenient experience of me being a sort of father to them. None

of those I am speaking about had an effective father—he was
either physically or psychologically not available to them. With
most of these patients, the father transference has been frequent,
necessarily negative at first, gradually or intermittently becom­
ing positive, and useful in both ways. The evidence of dreams and
phantasies has, however, accumulated and attacks on the
father-whom-the-mother-had-come-to-hate could be convincingly
detected via attacks on me or self-attacks. A male patient's
self-attacking actions make me feel angry with myself, as I
believe a father does, when he worries about whether he is being
a good-enough father to his son.
As a mother in the transference, Ifindthat the countertrans­
ference affect, perhaps more frequently experienced than anger,
is that of a nearly despairing kind, with predominance of a
defensive splitting of affect. One patient in particular had
received a great deal of despair projected from her mother, who
seems to have been oblivious of her own pathological attitudes. In
the mother and the daughter the negative animus was very
powerful. In the countertransference, I had phases of losing
self-confidence, and at times felt that I was not the right analyst
for her.
An adequately functioning partnership within the analyst of
libido both from the self and from the ego structures is necessary
for treating a patient who is defending against ego-development
by blanking, which can represent total destruction. I remember
the dream of one of my patients: she looked in a mirror and saw
no one, nothing. Some time later, she was feeling upset and was
talking about my approaching holiday: she described how I
'vanish into thin air' when she knows I am away from home. If
she cannot make an image of me being in a particular and
familiar place, she is imageless. She cannot reconcile terror and
hope. The parental imagos are, in her, not so much negative (e.g.
hated or feared or despised) but more dangerously they disappear
completely at difficult junctures. I do not know whether they have
an existence of their own, so that their disappearance happens to
her, or whether she has an as-yet fully known anger against them
so that unconsciously it is she who makes them disappear.
From the point of view of the day-to-day work with that
patient, my experience is that if I interpret that she is actively
DEPRESSED PATIENTS AND THE CONIUNCTIO 37

blanking and destroying, that feeds her capacity to develop on the

ego side and to begin emerging from the dangers attendant upon
such imagos. The central criterion I use is to try to speak within
the transference in such a way as to foster her potential for
experiencing herself as an individual, subject to certain forces but
not entirely at their mercy.
When a patient begins to feel sure of being an individual, he
will credit the other person with individuality. When the healing
process is at work and the old imago of mater dolorosa is less in
power and the introjection of her is less strangling, then a
reconciling symbol appears in a dream or a phantasy. For
example:
The dreamer was mixing a drink at a party, for his sister, his
wife and his daughters; the drink was made up of milk and of
semen. Also at the party, in a communicating room, were his pro­
fessional colleagues.
Some months later I came across the following in Transforma­
tion symbolism in the Mass', in which Jung is explaining a
passage in an alchemical text of Simon Magus, who was quoting
Hippolytus' Elenchos:
It [the divine pneuma] is the very ground of existence, the
procreative urge, which is of fiery origin. Fire is related to
blood, which is 'fashioned warm and ruddy like fire'. Blood
turns into semen in men, and in woman into milk. ... The
operative principle in semen and milk turns into mother and
father. [CW 11, para. 359]
The dreamer had not read the book.
His dream shows, first, a patient's use of body imagery; second,
his desire to reconcile himself and get back into harmony with
certain closely related females who usually received various
anima projections from him; and third, the desire that there
should be a better internal communication than previously in his
feelings about himself as the son of his parents, as a family man
and as a worker. There were transference and countertransfer­
ence features at the time which contributed significantly to the
dream «_nd the combination of those with the symbols in it
heralded a new phase of development.
The purposive nature of instincts releases healing and creative
symbols since, in the analytical treatment, the patient has been
38 JUDITH HUBBACK

put in touch with his capacity to connect the conscious mind with
growth processes from the unconscious. I t is his own capacity: the
analyst is the assistant, similar to the alchemical soror.

Attacks of envy and envious attacks

The flow of reconciling symbols is often held up by renewed
envious attacks on the analyst. The stage of hungry envy
(Hubback, 1972) is followed by the second stage of denigratory
envy. Sarcasm, scorn and cynicism are the consulting-room
versions of the emotions belonging to the stage at which 'the
infant in the patient* is trying to emerge from its deep-seated
fears of another abandonment.
So i t happens that there is a new envious attack in a phantasy
or a dream just when it seemed possible that real progress had
been achieved. For example, the absence of my car from its usual
place i n the street outside was said to 'mean' that I had gone off to
enjoy myself with someone I found more attractive than the
patient. Another patient dreamed that he met me on the doorstep
of my house as I departed, most elegantly dressed, with a
high-and-mighty Afghan hound which bared its teeth fiercely
while I took no notice of him.
The patient who has been enviously attacking the analyst as
the present representative of the once-powerful mother gradually
comes to recognize the character of the images in such dreams
and phantasies and discovers how to reconcile the warring
emotions. Where work with such a patient is concerned, there is
an optimistic passage in Jung's paper entitled, 'Concerning the
archetypes with special reference to the anima concept': 'The
projection ceases the moment i t becomes conscious, that is to say
when i t is seen as belonging to the subject'—but a footnote to that
runs as follows:
There are, of course, cases where, in spite of the patient's
seemingly sufficient insight, the reactive effect of the projection
does not cease, and the expected liberation does not take place. I
have often observed that in such cases meaningful but
unconscious contents are still bound up with the projection
carrier. It is these contents that keep up the effect of the
DEPRESSED PATIENTS AND THE CONIUNCTIO 39

projection, although it has apparently been seen through. [CW

9i, paras. 121 and 121n]

Conclusion:
Mysterium Coniunctionis
The dissociation between spirit and matter, of which Jung wrote
a great deal in the last chapter of Mysterium Coniunctionis, is
comparable—in the inner world of some of the patients described
here—to the dissociation between the imagos of each of the two
parents. Other patients could not make contact with any image of
loving parents, and less despondent images about life emerged
only gradually during their analyses. Early in the paper I used
the concept of coniunctio to refer to the kind of healed split which
I think the therapist of depressed patients should—if possible—be
able to offer. My thesis is that, via the transference/countertrans­
ference, there can be a carry-over of the psychological possibility
of coniunctio from the analyst to the patient. The theme can be
worded in the fully Jungian form of granting coniunctio
archetypal status, so that the constellation of that archetype can
be postulated to activate in the patient the capacity to move from
dissociation to internal harmony, or integration—the integration
of the father and mother imagos. The analogy of Jung's concern
with spirit and matter in Mysterium Coniunctionis seems to me to
be one which can validly be used, and other writings of his, e.g.,
Transformation symbolism in the Mass' and The transcendent
function', also give the background and basis for this theme.
Much work has to be done before the depth and extent of the
dissociation is well enough appreciated, which lends weight to
Jung's statement that 'a conscious situation of distress is needed
in order to activate the archetype of unity' (CW 14, para. 772).
Then, in the 'Epilogue', he enquires whether the psychologist can
throw out the antagonistic forces, or whether he had not better
'admit their existence ... bring them into harmony and, out of the
multitude of contradictions, produce a unity, which naturally will
not come of itself, though i t may—Deo concedente—with human
effort' (ibid., para. 791).
I have often been struck by just that—the great and total
'human effort' that the patient puts into the therapeutic work at
40 JUDITH HUBBACK

this difficult stage. He or she is often in a renewed state of

depression, angry and sore, or again in an ambivalent mood
towards me. The affect in dreams and phantasies is either
painful, or split off. One patient, for example, who was recovering
from a serious schizoid depression, dreamed of the parental pair
in a car, under which there was a smouldering fire, perhaps a
bomb, and the dreamer/son saved them just before the petrol tank
blew up. Presence of mind—ego capacity—was required of him, as
well as a warmth of feeling towards his parents. The dreams of a
woman patient over many months grew around images of the
limitless sea and then other kinds of water, with a gradual
diminution of boundlessness, of isolation, of nameless terrors, and
a steady growth of pictures in which some focus of safety was
perceptible, places or situations where there were square
enclosures or encircled areas, a potential coming-together, a
possible coniunctio. Many months later, the images were again of
a vast sea, greyness going on for ever. A renewed and strenuous
effort had to be undertaken. Although the sea had no boundaries,
there was fish pate in a bowl on her kitchen table, ready to be
made into sandwiches: bread from the earth, fish from the sea, a
modern coniunctio.
The coniunctio and harmonization of internal imagos is
unlikely to take place if the analyst does not find the right
combination within herself of responsiveness and self­
boundaries. If she can keep her sense of self, she will be able to
become the internal representative of the union of the opposing
pair. Unless she can respond from out of her own sense of healed
self, the imagos do not come together well enough for the patient's
healing to be soundly enough based.
The last chapter of Mysterium Coniunctionis is a mine of
wealth. For example, The adept produces a system of fantasies
that has a special meaning for him/ (ibid., para. 694). "The
alchemists called their nigredo melancholia, "a black blacker
than black" night, an affliction of the soul, confusion, etc.' (ibid.,
para. 791). I t was ... of the utmost importance to him [the adept]
to have a favourable familiar as a helper in his work.' That
'familiar' analyst knows in herself that nigredo, mortificatio,
separatio and diuisio precede coniunctio. The illustrations from
the Rosarium Philosophorum and the use Jung made of them in
The Psychology of the Transference (CW 16) are not always easy
DEPRESSED PATIENTS AND THE CONIUNCTIO 41

to connect in a living way with clinical material. Their initial

impact can be one of major fascination, which is of little use in
day-to-day work. When they, and Jung's other studies of the
psychology of alchemy, are returned to—perhaps again and again
with personal development having taken place in the mean­
time—then the possibility grows of applying them in understand­
ing clinical interactions with patients whose experience of
parental imagos has contributed substantially to splitting
defences.
Mysterium Coniunctionis uses much material from alchemists
living, broadly, at the same period as those men studied by the
historian Frances Yates, whose works are now essential compan­
ions for students of Jung's work on alchemy. Most of those men
were written about by both authors: they include Ramon Lull,
Marsilio Ficino, Pico della Mirandola, Cornelius Agrippa, Para­
celsus, Giordano Bruno, John Dee, Christian Rosencreutz and
Robert Fludd. The search for harmony was the driving force
behind many of the deep thinkers of the fifteenth, sixteenth and
seventeenth centuries, men in turbulent public life as well as
philosophers. The parallel between the archetypal yearnings for
harmony and the researches of the alchemists gives added
significance to the internal search for coniunctio of depressed
patients. It happens to give me personally much interest and
encouragement when I find the main lines of observations,
thoughts and intuitions being followed in several arts and
sciences. At the same time the differences between them must be
taken into account, analogies must not be overworked, and there
is also the danger of falling into the simplistic view that 'history
repeats itself.
The reconciling symbols have to be the alive ones for each of
us. A particular patient may have no inclination whatsoever to
make a living connection with the mythologies, or the periods of
history or the particular arts which appeal to his analyst.
Detailed descriptions of the clinical use of amplification would
perhaps help those analysts who are chary of introducing their
own cultural associations, who fear they might prevent the
development of the patient's own imagery, or interfere with its
potential flow. I do not think I have helped patients forward
significantly when I have tried amplifying openly. It is rather, I
find, that the implicit offering of a concentrated extract (so to
42 JUDITH HUBBACK

speak) of my attempted inner harmonization, and of the work

done so far on splitting and other defences, will be what the
depressed patient who was once the child of a depressed mother
will feed off and make his own. I t is the psychology of conjunction
which has to be understood and appreciated.

Summary
The hypothesis is offered that patients whose mothers were
depressed during their infancy and childhood may be enabled to
emerge from their own long-term depressions (or other conse­
quences of early emotional difficulties) if in the therapy they are
able to make use of their analyst's having achieved a reasonably
viable sense of self, based on the internal coniunctio of parental
imagos. Transference and countertransference manifestations of
the workings of malign imagos and of the gradual emergence of
benign and uniting symbols in phantasies and dreams are given
in relation to the therapies of six patients.
It is suggested, implicitly, that current observations and
studies of narcissistic deprivation, splitting defences, shadow
material and hungry and envious attacks can be usefully
furthered if they are related to Jung's exploration of the theme of
coniunctio as having been the main psychological importance of
alchemy.

REFERENCES
Fordham, M . (1974). Defences of the self. Journal of Analytical
Psychology 19:2.
Gordon, R. (1980). N a r c i s s i s m and the self: who am I that I love? Journal
of Analytical Psychology 25:3.
Hubback, J . (1969). T h e symbolic attitude i n psychotherapy. Journal of
Analytical Psychology 14:1.
(1972). E n v y and the shadow. Journal of Analytical Psychology
17:2.
Humbert, E . (1980). T h e self and narcissism. Journal of Analytical
Psychology 25:3,
D E P R E S S E D P A T I E N T S A N D T H E CONIUNCTIO 43

Jacoby, M . (1981). Reflections on Heinz Kohut's concept of narcissism.

Journal of Analytical Psychology 26:1.
Kalsched, D. (1980). Narcissism and the search for interiority. Quadrant,
13:2.
L e d e r m a n n , R. (1982). Narcissistic disorder and its treatment. Journal of
Analytical Psychology 27:4.
Narcissism and Character Transformation.
Schwartz-Salant, N . (1982).
Toronto: I n n e r C i t y Books.
CHAPTER TWO

Success, retreat, panic:

over-stimulation
and depressive defence
PeerHultberg

Hultberg's use of the concept of over-stimulation enables him to

throw new light on depression, grandiosity and mania. The secret
presence of grandiose phantasies attached to what would
otherwise be realistic achievements in the concrete world makes
these achievements feel like threats to psychic integration itself.
From a personal-historical angle, the patient may have had
pressurizing parents, or have been used as a cure for a parent's
narcissistic wound. Then the tension aroused by achievement is
unbearable because this is felt by the individual—in a sense
accurately—to be against his or her own best interests.
Analysts and therapists will readily recognize Hultberg's
depiction of underachieving patients with their fear of success.
His usage of Jung's idea of degressive restoration of the persona',
in which the individual denies ambition and aspiration, takes on

F i r s t published i n The Journal ofAnalytical Psychology 30:1, in 1985.

Published here by k i n d permission of the author a n d the Society of
A n a l y t i c a l Psychology.

45
46 PEER HULTBERG

an added dimension when added to the list of neurotic counter­

transference possibilities of which we are aware. In particular,
the 'greyness'of meticulously conducted analyses certainly has to
be reframed as a result of Hultberg's speculations.
Two sub-themes of the paper deserve mention: (1) the role of
alcohol as a retreat from over-stimulation, and (2) the link
Hultberg makes between Klein's work on gratitude and the
coniunctio.
A.S.

he concept of over-stimulation or hyperexcitement has

until recently been used predominantly in connection with
J L children. It has been discussed as an intense reaction of
over-involvement resulting from too-strong stimuli from the
outside, especially from over-close and over-taxing parents.
However, in the past decade there has been a tendency to consider
the concept also as an inner psychic phenomenon frequently
observed in adults. This change of emphasis is mainly the result
of work of American writers on so-called self-psychology, notably
Heinz Kohut and his followers. Over-stimulation in this latter
sense is, in the language of Kohut, defined as a 'mobilization of
archaic exhibitionistic libido* (Kohut, 1971, p. 5) which threatens
to flood the ego. This process may be triggered offby something in
the outside world, or an inner stimulus or phantasy may be
externalized. It is, however, in contrast to the classical concept of
over-stimulation, essentially an endopsychic process. In the
language of Jung one might say that over-stimulation in this
sense is a process whereby conscious or unconscious psychic
contents of an inflationary or grandiose nature are aroused and
threaten to overwhelm the ego. The ego, however, is strong
enough and has sufficient reality sense, as it were, to defend itself
against both identification with the grandiose content and
general non-psychotic states of inflation, and against irreversible
submersion psychosis. The process, however, does call forth an
excitement which is felt as highly uncomfortable and which gives
rise to strong anxiety. The manner in which the ego defends itself
against this anxiety is mainly by retreating. An ego which is
SUCCESS, RETREAT, PANIC 47

especially prone to become hyperstimulated seems above all to

protect itself by secluding itself from the wave or source of
excitement. This is then generally experienced either as a state of
resentful depressive hopelessness or as apathetic isolation and
utter passivity, or both.
The process may be illustrated by the following story.
A young painter from a provincial town in Denmark held his
first exhibition in Copenhagen. It was received well. Encouraged
by this, he was soon afterwards able to arrange a second
exhibition with a reception equally favourable, if not better. The
young artist then went home to visit his parents in their idyllic
little Danish town. As he was sitting in the train he suddenly felt
as if he were about to burst, to fly into a thousand pieces. He was
overwhelmed and entirely unable to control his phantasy that
when the little local train eventually pulled up at the station a
red carpet would have been laid out and a delegation headed by
the mayor would be awaiting him with music andflowers.He got
into a panic and started to pace frantically up and down the
corridor of the train, imagining with dread the deafening sound of
the brass band welcoming him. Overwhelmed by an inexplicable
anxiety, he found his way to the small bar in the train. And when
his parents met him at the station—needless to say without any
municipal delegation or brass band—their son literally fell out of
the train, totally drunk. Curiously enough, however, apart from
the alcoholic poisoning his state of mind was tranquil and
composed. He had mastered his excitement and the subsequent
anxiety, and he no longer felt torn to pieces. Although his mood
was somewhat sad and even resigned, at the same time he felt
calm. However, for a very long time afterwards his creative
powers seemed to fail him, and he was unable to paint properly
for several years. He lived in something akin to a mild apathy
and dejection and chose to finish a very conventional course of
university studies rather than go on trying to make a career as an
artist.
This small scene seems to speak for itself as an illustration of
the problem of over-stimulation and retreat. Here was a man in
his late twenties who all of a sudden sees the fulfilment of his
most daring hopes. To become a painter and to be recognized as
such was to him the supreme goal in his life. It had been so ever
since he was a small, sensitive boy who, from the age of six, had to
48 PEER HULTBERG

assert himself at school by means of his intellectual, and

especially his artistic, talents. His parents never understood his
situation. They did not see his plight and never considered his
painting as anything of value. He quickly saw through his
mother's superficial and sentimental praise of his efforts as a
child and carefully kept everything he painted away from her lest
she should use it for her own self-enhancement. The father was
just not interested. And when he exhibited his pictures they were,
in fact, both shocked and extremely embarrassed that their little
boy could paint such big and such blatantly erotic canvases. On
the other hand, they mildly flattered themselves on their son's
success. The painter had thus never obtained any real recognition
till the unexpected success with his first two exhibitions. But
rather than finding strength and encouragement for further
steady work he became overjoyed and subsequently hyper­
stimulated. And this tendency to be almost torn to pieces at the
fulfilment of his most burning wish had to be defended against in
such a way that over-stimulation gave way to apathy and
dejection for a long time to come. He fell into a state of emptiness;
his initiative was blocked, and he felt paralysed. In short, he
experienced a condition close to depression.
It is, however, important to underline that at no point was
there any question of his falling into a manifest depressive
psychosis. His ego seemed to function with a certain degree of
reliability as it had always done, and he kept up his fairly good
work record. In other words, he seemed quite early in life to have
acquired a minimum of psychic cohesion, or ego strength, which
prevented any complete submersion in the world of his phanta­
sies. All the same, his ego did appear frail and seemed protected
only behind rigid walls which then came under fierce attack
through the realization of his burning ambition. It was, however,
strong enough ultimately to withstand and to defend itself
against the onrush of over-stimulation. The psychic tension could
be regulated and the falling-apart prevented, albeit by rather
immature or even archaic defensive manoeuvres.
The manner in which the walls are generally rebuilt after a
flooding of over-stimulation—especially in the non-analytical
setting—is also illustrated by this case. However, the following
brief extra-analytical account may show even more clearly the
essential features of this restorative process.
SUCCESS, RETREAT, PANIC 49

A woman violinist, on the strength of a very successful first

performance, was awarded a scholarship to go abroad to study
with one of the most famous of violinists. She returned home to
give her second concert, which was a startling success. The
audience recognized her as the national equivalent of the
eminent violinist, and the enthusiasm was almost uncontrollable;
people would hardly let her leave the platform. She reacted by
getting into a panic after the concert. She hid in her dressing
room, allowed no one to get near to her, cancelled immediately all
further arrangements for concerts, and the following day decided
to give up her career as a violinist entirely. It was impossible for
anyone to persuade her to do otherwise. She broke away from her
musical milieu and in due course obtained a post at a school as an
ordinary music teacher, and she remained there for the rest of her
working life.
For the young painter and for the violinist, the fulfilment of
the greatest and most intense wishes of their lives led to a
dangerous situation where the ego of each of them was about to be
entirely flooded by grandiose phantasies. In both cases the ego
defended itself by retreat and apparent emptiness. But when it
came to a restoration it was, especially in the case of the violinist,
unable to restore itself to its former dimensions. The young
painter had to live for several years in a state much below the
level of his artistic talents and possibilities and was, in fact, only
helped out of this condition through analysis. The violinist lived
like that for the rest of her life, contenting herself with a job that
she found rather mundane; although her decision was naturally
supported later by other defence mechanisms such as intellec­
tualization, rationalization, and ideological and ethical argu­
ments.
From a Jungian point of view, one notices here the resem­
blance, especially i n the latter case, of this sequence of events to
Jung's concept of'the regressive restoration of the persona'. Jung
coined this term i n his 1916 lecture 'Uber das Unbewusste und
seine Inhalte' and elaborated it in the enlarged version of the
lecture, The relations between the ego and the unconscious'. He
uses it to describe one of the possible reactions to the break­
through into consciousness of unconscious contents and illus­
trates it with examples taken from everyday life, since:
It would [...] be a mistake to think that cases of this kind make
50 PEER HULTBERG

their appearance only in analytical treatment. The process can

be observed just as well, and often better, in other situations of
life, namely in all those careers where there has been some
violent and destructive intervention of fate. [CW 7, para. 254]
The restoration of the persona in a regressive way means that
the individual in question 'will have demeaned himself, pretend­
ing that he is as he was before the crucial experience, though
utterly unable even to think of repeating such a risk. Formerly
perhaps he wanted more than he could accomplish; now he does
not even dare to attempt what he has it in him to do' (CW 7, para.
254). In other words, the person leads a life on a lower level than
before.
The difference between Jung's description and the problem of
over-stimulation as described here is that Jung uses the reaction
to a catastrophe as an illustration of his concept: he takes as an
example the case of a business man going bankrupt. In the
context of over-stimulation, however, one is dealing with the
reaction to an unexpected success, the fulfilment of a deeply
nourished hope which threatens to upset the psychic equilibrium
and create unmanageable inner tensions. The individual with­
draws into isolation, either concretely as in the case of the music
teacher or into an alcoholic aloofness as in the case of the young
painter. But when they eventually emerge from their protective
and calming isolation it is not with an ego which is better able to
defend itself; it is with a patched-up psychic equilibrium. They
emerge with an ego which is able to defend itself against the
onrush of over-stimulation only because it has given up the
ambitions and wishes the fulfilment of which caused the almost
uncontrollable flooding. The healthy part of the psyche has not
been strengthened; on the contrary, the psychic scope has been
reduced and apathy adopted as a major defence mechanism. It
might perhaps be said that here is a defensive mechanism which
is the reverse of the regression in the service of the ego, and akin
to Anna Freud's concept of ego-restriction.
Like the regressive restoration of the persona, the retreat after
over-stimulation seems rarely to bring individuals into analysis.
The retreat in itself is defence enough to keep them going. The
avoidance of risks and of situations which may give rise to
hyperexcitement generally assures a relatively smooth day-to­
day functioning. And, as Jung indicated, the phenomenon is
SUCCESS, RETREAT, PANIC 51

encountered perhaps less in analysis than among one's friends

and acquaintances.

Overstimulation in analysis
However, there is a group of patients for whom over-stimulation
appears to lie at the core of their problems. These are people who
in their youth and also as children have frequently given the
impression of being very talented, at times even exceptionally so.
However, they never really seem able to live up to the promise
they initially inspired. Instead of developing and realizing their
gifts they appear, often fairly early in life, to slip into a somewhat
mild depressive state; and they tend to remain in it for ever,
except perhaps for the odd short outburst of creativity in which
they suddenly seem to rekindle the expectations they originally
awoke. Generally, however, they live a reduced life, not in the
sense that one feels that their intellectual powers or their
creative talents have dried up, but merely that these never
appear to have been led into channels where they may be fully
and purposefully employed. The most typical feature, however, is
that there is a specific task which they cannot accomplish,
although they seem generously equipped to do so and also very
well prepared for it. They may even come into therapy explicitly
to be helped to perform this task, or it transpires very early in
therapy that they are worried (or at times through rationaliza­
tions resigned to the fact) that they cannot finish their doctoral
dissertation, that they have broken off their course of study a
short time before the final exams (which naturally they had every
reason to believe they would pass well), that they are simply
unable to make the last preparations for their crucial recital,
although the programme has been rehearsed for years. The
rather absurd modern notion of concert abstinence seems to be a
rationalization for such an inner state. Here a performing artist
may rather retire than expose himself to the enthusiasm of an
audience, as in the case of the violinist mentioned above. The
following account may serve as an illustration of over­
stimulation as a basic psychic problem.
Mrs Lake is an American. She is close to forty and has come
into analysis with a 'man's disease'. She has a bad heart. She is
52 PEER HULTBERG

working overtime at her school without extra pay, is engaged in

trade union activities, and in addition gives courses in art history
almost every evening. The weekends are spent organizing
political work, and she has not had a holiday for more than two
years. However, she feels amply rewarded by the prestige she has
achieved as an ardent environmentalist and by the small political
organization devoted to these problems which, she feels, she
herself has created from scratch. Were it not for the heart,
everything would be well. In the initial interview she mentions a
curious fact: she, the prizewinner at school and at university, she
who won some highly coveted scholarships and whom everyone
expected to climb to the top of the university ladder, just cannot
finish 'her book'. After a sabbatical year to do research in Europe
she even had herself posted back to Germany to carry on the work
which was supposed to assure her a top position in her former
university department. 'Mark you', she adds in the initial
interview, 'when I have written my book and proved my point,
everyone working on Durer will have to take it into account; and
all the encyclopaedias in Germany and subsequently in the whole
world will have to be revised.'
In the following session I try to test her claim, and as far as I
can see it is not just inflatory madness. She explains her ideas to
me painstakingly and accurately, showing me supporting reports
from museum directors and professors. It appears that she really
has a point which will throw an entirely new light on her topic
and she seems able to prove it.
The sore point, however, is that her book cannot be written.
She is now in her late thirties and it should have been finished
years ago. Everyone around her is encouraging, everyone
supports her; but the book stays where i t has always been, in a
box of neatly filled-in index cards. It has long ago ceased to be
embarrassing to her. She has swallowed the hurt of disappointed
expectation, she just plods on. But still she cannot write, although
she has all the material she wants, and from an intellectual point
of view nothing prevents her.
This problem and not her heart quickly became the focus of the
sessions.
There was no difficulty i n linking the problem up with Mrs
Lake's negatively experienced mother, but then everything
seemed to stop. Mrs Lake had been brought up by her divorced
SUCCESS, RETREAT, PANIC 53

mother who kept her, the only child, away from the father until
his death. And it was not till she started analysis that Mrs Lake
really began to see how brutally she had been exploited by her
mother from childhood up till the present day. So we both tended
to search for the root of her problem i n her relationship to her
mother.
Was the reason that she could not finish her book defiance
against the mother? Was it revenge and an expression of rage in
connection with the early trauma that she had never been
accepted as she was but had always been exploited narcissis­
tically in order to enhance the mother's self-esteem? Was she
begrudging the mother the triumph of having a daughter who
had published a book of her own? Or was i t guilt over her success,
because as the author of an important book she would finally
have superseded the mother? Could i t be just defence against
competitiveness with the mother? Or had she through projective
identification incorporated the inferiority and incompetence
against which the mother defended herself so vehemently? Was
she merely treating her book with the same demands of
hyperperfection with which the mother had treated her as a
child? Was the thesis her child, which she, unmarried and
childless, would not permit to develop according to its own laws
and of which she could not let go? Or was the block a deep
prophylaxis against the shattering diappointment that the
mother would after all not recognize her and accept her but
remain as indifferent to her achievements as she had always been
even after she had accomplished this, to her, tremendous feat?
Did her block thus express deep doubts about her own worth and
her own intelligence which could not be counter-proved by
realistic self-esteem? Or was it just the puella aeterna's fear of
entering the world of the grown-up? Or a fear that growing up
might mean irrevocably leaving the mother, and thus finally
having to give up the neurotic entanglement with her, which had
been almost the only form of human relationship she had known,
or at any rate the most important? Or could it be a question of
identity, a fear of abandoning the identity of the daughter as
such, of the doctoranda, the eternal daughter of the Alma Mater?
Or had the book been the only means whereby she could confirm
herself to herself and maintain an inner continuity? Was she then
clinging to it as a child clings to a transitional object? Or was she

P—c
54 PEER HULTBERG

clinging to it because she had not been able to transform it into a

transitional object, but kept experiencing it as a gift to the
mother? Was the book one of the few stabilizing factors in her life;
and would it then be possible for her tofinishit if the analysis and
I, in the transference, took over this stabilizing function? And,
conversely, was the inability to get on with the work in the
present context of the analysis, and in spite of my various
interpretations, a transference phenomenon: she feared that just
like her mother I might take the credit for her work if she were to
finish it because of therapy with me; a fear that I, too, would
exploit her for my narcissistic needs and treat her and her work
as a feather in my analyst's cap. Or, worse still, a fear that I, like
the mother, might choose just to ignore it and treat it as a matter
of analytical course?
We looked into all these possibilities, and all seemed quite
convincing. There was something about them all, but none of
them seemed to hit the mark. Only one thing seemed certain: Mrs
Lake was depressed in a restless, tooth-grinding way, not because
she could not write her book, but in order not to write it.
It was not till the concept of over-stimulation was introduced
that the reaction was more in the affirmative. It was even
possible to speak about the classical 'aha-experience'. Things now
seemed clearer. The book was the goal of her life. More she did not
want from life; she had in advance decided against any further
research. It was enough to her to think that when she had
officially proved her point all the major encyclopaedias in the
world would have to be rewritten and that her name from now on
would appear in the indexes of all works on Durer. She would
expect nothing more from life. Perhaps this limitation of herself
was a kind of anticipatory and prophylactic restoration of her
persona in a regressive way. However, it did not succeed in
curbing her over-stimulation and the subsequent anxieties at the
thought of what might happen when she hadfinishedher book.
On the contrary, the confinement of her life's work to this single
book seemed to have the adverse effect: it appeared to accentuate
the absolute character of the fulfilment of that most burning wish
and to exacerbate her fears of the consequences to her psyche
when she had fulfilled her task. She was not afraid of being
drained, or of the emptiness which might come over a person who
SUCCESS, RETREAT, PANIC 55

has reached the goal he has set himself, nor of the feeling of
sudden bewilderment which one might suppose comes over the
donkey when it has suddenly devoured the carrot which for years
has been dangling before its nose. What she was really afraid of
was simply of bursting with joy, of being overcome with
excitement to such an extent that she could not control it. And
her feeling of emptiness as well as her severe work inhibition was
her way of coping with this anxiety and defending herself against
it. In these overstimulating phantasies the mother naturally also
cropped up. One of the most hyperexciting phantasies was of an
ultimate reconciliation with her mother. Through her success she
would at last have replaced and even superseded and surpassed
the father whom the mother had castrated so effectively. She
would finally be able to compensate the mother for the severe
troubles which the father in her eyes had caused her in the
marriage, and thus in the end she would win the mother's love.
It now transpired that over-excitement and hyperstimulation
were very important features in the life of Mrs Lake. She was, for
example, totally unable to calm down if she had experienced some
form of success in her professional life. She described how she
would then talk incessantly to herself in her car or when walking
in the street, where people would even turn round and look at her.
At home she would argue with herself for hours, either sitting on
the edge of her bed or pacing up and down in her study until five
or six in the morning, when from sheer exhaustion and by means
of a couple of glasses of Dubonnet she would at last collapse into
bed for an hour or two. She was now herself able to connect this
with her mother, who had never given her any admiration or
recognition for her often exceptionally good achievements nor
any sympathy in her worries. Mrs Lake then grew unable to feel
any real joy in herself and in her accomplishments. Furthermore,
she was provided with no measure by which to appraise
realistically the value of her achievements. She thus had no inner
joy in herself and in her activities and no inner criteria for
judgement of herself. Indeed, many of her dreams pointed to this
general depressive state of her soul; deep down, behind her often
sparkling vitality and her 'green* environmentalist activities,
there was a bleak psychic desert and a dream-ego deprived of any
illusions. It was therefore understandable that she should react
56 PEER HULTBERG

with terror to the thought of having to cope with the extreme

happiness when she had reached her long-cherished goal; and
that she should prefer her subdued, somewhat depressive and
blocked state rather than risk exploding from a joy which she had
no means of controlling. In this way she defended herself against
the dread of over-stimulation, but at the price of a severe work
inhibition.
Mrs Lake appeared fully able to accept the interpretation of
over-stimulation as being at the core of her problem. And as a
result of this she decided to abandon her ambitious project. The
entries on Durer in all the major encyclopaedias of this world are
after all not going to be rewritten. Like most of her colleagues in
the academic world, she chose to restrict herself to writing the
occasional article. At the same time as she gave up the attempt to
write her book she also approached her old college and was
delighted to realize that she had not been forgotten. On the
contrary, since she had always been an excellent and inspiring
teacher she was offered her old position and returned to the
United States in a composed frame of mind. And when friends
and colleagues suggest that she might after all write a nice little
popular book on Durer, she can now cope with the stimulation
and stem the flood of phantasies—and refuse.

Over-stimulation in the transference

In the analytical process as such, over-stimulation seems above
all to manifest itself in connection with the transference and
probably also the countertransference. In the transference it
seems principally to evolve around an extreme sensitivity to the
closeness of the analytical situation, especially at times when
idealization or projective identification are at their strongest. The
highest goal of the analysand at times is to be as intimate with
the analyst as he possibly can, and the feeling that this wish
could be fulfilled may again be too overwhelming. Subsequently,
the analysand has to defend himself against this dangerous
situation.
The manner in which the analysand experiences the perils of
closeness is naturally highly varied and very subjective. The
sharing of a joke can be as upsetting as the phantasies aroused
SUCCESS, RETREAT, PANIC 57

when a confessing analyst feels he must disclose parts of his

personal life as a reward for frankness, as a consolation, or as a
surrender to more or less subtle emotional blackmail. A chance
encounter outside can give rise to ideas of identical interests or
identical life problems. Pleasure on the part of the analyst, as
indeed his praise, can give rise to phantasies of being the chosen
person, and so on. Behind all these phantasies lies the dread of
being overwhelmed and of losing control as a result of reaching
the unbearable state of intimacy and closeness. This may be
expressed as a fear of being seduced by the analyst—seduction
naturally understood in the broadest sense of the word, intellec­
tual or ideological or theoretical seduction being often just as
dangerous as sexual seduction. Here there is a dread that the
analyst might abandon his self-control and initiate the wished-for
closeness.
Kohut and his followers have pointed out an important fear in
this context—the fear of being swept off one's feet by an
interpretation which hits the centre of things (see, for example,
Goldberg, 1978, pp. 9, 63, 83, 85). This fear has probably at least
two main sources. It is naturally an expression of the fright at
what might happen i f an insight is suddenly achieved and
hitherto unconscious contents are released and engulf the ego
before it has had time to organize its defences. But it also seems to
be a fear of being over-stimulated by the joy at having at last
found a fellow human being who, seemingly by instinct or
intuition or by extreme empathy, can feel the needs and the
plight of the analysand even before he himself understands it.
Many cases of prolonged silence in therapy may probably be put
down to this anxiety, rather than being seen as an expression of
unconscious aggression or defiance.
The following occurrence may illustrate this point.
A couple of years ago I was presented with a copy of the first
edition of T. S. Eliot's Four Quartets. Since I was very happy both
with the book and the thought behind it, I let it lie on a table in
my consulting room, so that I might read a little in i t between
hours. An intelligent woman patient with a strong, rather
dependent transference immediately noticed the book and
remarked on it. As she was very interested in literature I fetched
the book and read the passage about the wounded surgeon to her:
58 PEER HULTBERG

Our only health is the disease

If we obey the dying nurse
Whose constant care is not to please
But to remind of our, and Adam's curse,
And that, to be restored, our sickness must grow worse
[Eliot, 1969, p. 181]
We discussed briefly how Jungian, in fact, these thoughts are,
and this led us, I believed, in a natural way into the hour.
As one too often does when breaking the rule of abstinence, I
thought little of this and merely believed that we had discussed
something of interest to her. I was therefore very much taken
aback when she started her Monday session with a very earnest
request: Would I please, please in future, please never more break
the analytical neutrality and not introduce matters from my
personal life; she was just unable to cope with it. At first I was
perplexed and did not know what she was referring to; I believed
it could only be an anecdote, not even concerning me personally,
which I had produced to drive home an interpretation. Only then
did she explain that it had to do with the poem. It seemed to her
that I had talked about it in a very special way, as if I had felt the
need to communicate something especially private and personal
to her and to her alone, and exactly at this point in her analysis.
She had registered my pleasure in the poem and interpreted this
to mean that I had no one at all with whom I could share my joy
and my interests. In that way I had made her my partner, I had
seduced her, she felt, intimating a loneliness in my personal life,
as well as deep problems, which were parallel to her own
problems and her own loneliness. She had returned home after
the hour overwhelmed by excitement and phantasies that after
all she was the chosen one, that her feelings for me had echoed in
me. She was at the time in a stage in her analysis where she did
not retreat into an overt depressive mood as a result of the
over-stimulation. However, she did feel that she was in danger of
losing control over herself and experienced again a dreadful fear,
almost like a fear of death, of losing herself to me, and thus
entering into one of the fatally destructive relationships which
she had previously known and in which she had entirely given up
her own personality. For a couple of hours she was trembling all
over her body, and it took her a full evening to calm down
sufficiently so that she could write herself out of her excitement.
SUCCESS, RETREAT, PANIC 59

Furthermore, she spent the whole weekend studying Eliot in the

belief that he had been the subject of my doctoral thesis.
The defence and retreat phenomena connected with over­
stimulation in the transference are naturally very varied but aim
predominantly at avoiding the threatening closeness. This may
happen in a phobic way, by increasingly incapacitating anxieties,
for example. Or, especially early on in analysis, it may lead to the
analysis being broken off, often exactly when the analyst feels
that things are going particularly well and a really good
relationship is about to be established. The fear of praise may
lead to snarls at the analyst, who has perhaps indirectly given
vent to his pleasure at the good co-operation. Or the analysand
may ostentatiously, and maybe even in a hurtful manner, forbid
himself any interest in the life of the analyst as a defence against
overwhelming phantasies. He may, as indicated before, appear
drowsy, passive, be silent in a bewildering manner, rather than
dare to expose himself to the friendly warmth and empathic
understanding of the analyst. Or he may defend himself against
being overwhelmed by his own idealization of the analyst by
criticizing him, or seemingly rejecting the school of analysis to
which he assumes the analyst belongs. Long tirades against
Jung, often of a political nature, or the belittling of Freud's
Viennese petit bourgeois background, seem to be instances of this,
as are certain dreams, especially at the beginning of analysis,
the contents of which poke fun at the analyst's theoretical frame­
work or at the analyst as a person.
At this point perhaps one specific type of defence against
hyperexcitement ought briefly to be mentioned: the use of the
age-old depressant, alcohol. When the previously mentioned
young artist was caught by the possibility of a fragmentation of
his personality by his overwhelming, grandiose phantasies, he
retreated at first into an alcoholic stupor. Mrs Lake likewise had,
now and then, to lull herself to sleep with her glass of Dubonnet.
This is almost a parody of the reality-orientated defence against
over-stimulation, which is controlled retreat and organized
withdrawal. But, when the source is internal, it is difficult to find
a place to retire to and to do so in a regulated manner. It appears,
however, that the healthy part of the psyche, in a highly
inadequate way, uses alcohol to defend itself against disintegra­
tion. When people with alcohol problems are faced with deeply
60 PEER HULTBERG

agitating phantasies and are about to be flooded by hyperexcite­

ment, they seem able to quieten the intrusive grandiose
phantasies by drinking. Alcohol appears here to have a certain
ego-regenerating function. The individual is able to retire,
regress and isolate himself, and subsequently to restore his
personality through alcohol. Although drinking may naturally be
the revengeful reaction to a disappointment or an imagined
rebuff, it may also be caused by highly stirring phantasies
released i n the transference, for example, through a misunder­
standing of the analyst's friendly warmth. And the only way,
then, in which the ego seems able to defend itself against such
floodings of joy and excitement is by staging a flooding of its own.
Such a drinking pattern seems, for example, to be the basis of
the alcoholism of one patient who easily became severely
hyperstimulated. On one occasion he was overwhelmed by the
beauty of nature while wandering for days in an impressive
Alpine landscape. His happiness at such splendid scenery was so
great that he just could not contain it. The excitement grew so
painful that i t became unendurable, and he had to have alcohol in
order to calm down: *I just had to drink in order to become a
normal person again, otherwise I don't know what I should have
done for sheer joy', as he expressed it.
I am here reminded of Keats's 'Ode to a Nightingale', where
the poet 'being too happy in thine happiness' wishes for 'a draught
of vintage. . . . That I might drink, and leave the world unseen, /
And with thee fade away into the forest dim' (Keats, 1982, p. 207).
Hyperstimulation seems to have been a psychic reality for many
of the Romantics; and it was, in fact, observations concerning the
Polish Romantic poet Adam Mickiewicz which initially gave rise
to my interest in the phenomenon. In 'Ode to a Nightingale'
Keats also points to the ultimate regression in the face of
hyperexcitement:
Now more than ever seems it rich to die,
To cease upon the midnight with no pain,
While thou art pouring forth thy soul abroad
In such an ecstasy!
[Keats, 1982, p. 208]
Perhaps the equivalent in the late twentieth century to such
sentiments is the experience of a recently married young woman
SUCCESS, RETREAT, PANIC 61

who on a glorious early summer morning drove her open car at

very high speed in blazing sun down a motorway with her
husband at her side. At a certain moment she suddenly became
obsessed with the desire to drive her car straight into the pillars
of one of the motorway bridges: life was so overwhelmingly
beautiful that death seemed the only consequence of her rapture.
It seems important to mention the use of alcohol as a
combatant of over-stimulation, since alcohol is so often men­
tioned in general discussions as the bringer of spirit. This might
lead to a false understanding of some of the problems lying
behind alcoholism or heavy drinking. In cases where over­
stimulation plays a part one may even say that alcohol is used in
its opposite, depressant way, to combat a surplus of spirit, as it
were. And to see the alcohol problem as an expression of a
thwarted spiritual search would be misleading, to say the least.
On the contrary, alcohol here enables the ego to retreat in a
defensive manner and thus withstand the threat of being
swamped by spiritual contents. In other terms, it appears that
just as one talks of anal defence against orality, one might here
talk of an oral defence against an even deeper regression, a
defence against the entire breaking up of the psyche. This
mixture of defences seems clearly illustrated in the last case I will
bring of the man who 'just had to drink to become a normal person
again'.
T was a very meticulous and extremely hard-working and
ambitious natural scientist—a true anal character, as one
usually calls it. He had the habit of working late in the evenings
at his laboratory. At a certain point he would start to drink. This,
he felt, would enable him to work on a little longer. Soon,
however, the quality of the work would be such that i t was quite
useless, and then he just drank on in a rather guiltless state, at
times feeling that he was rewarding himself for being a genius.
Hence he was able to muse about life for some hours, he could
abandon himself to happy phantasies, or he was lost without
anxiety in joy at having found a mistake or a fault in his
calculations. Finally, in an alcoholic haze, he returned home from
the laboratory. In the end his wife refused to accept this as 'the
way scientists work'; she confronted him with the alternative of
divorce or therapy, and this brought him into analysis. Here
there seemed to be a defence against orality which, however, at a
62 PEER HULTBERG

certain point broke through and clearly came to the fore when the
scientist permitted himself a little drink, rationalized partly as a
reward for his industry and partly as an excuse to get the energy
to work on a little longer. At the same time, the drinking itself
defended him against a feeling either of void or, more probably, of
over-stimulation, when, for example, he finally found an insi­
dious mistake; these feelings would invariably have over­
whelmed him if he hadfinishedhis day's work without drinking.
Without drink he would either feel exhausted and start doubting
the meaning of all that he was doing, or he would get carried
away by grandiose and anxiety-inducing phantasies. He had, for
instance, terrifying phantasies of making an absolute fool of
himself when receiving the Nobel Prize from the hands of the
Swedish king. When he drank, however, he was able to control
these phantasies, and they were not experienced as overwhelm­
ing. And rather than being terrified he would, in fact, enjoy them
and could safely abandon himself to them, knowing that they
would wear off as the amount of alcohol increased. Drinking in
T's case is thus not only to be interpreted as a reward for industry
(orality breaking through anal defences); it seems even more to
be a defence against the hyperexcitement induced by phantasy
products springing from what may be called anal industry. In this
connection it also seems possible to argue that the well-known
everyday phenomena of nightcaps and 'unwinding' after a day's
work may be understood in this way. This may be a more fruitful
interpretation than merely seeing them as oral compensations for
the difficulties in life.

Countertransference
As regards the countertransference, a certain parallel seems
observable to the situation of hyperexcitement in the transfer­
ence, although the basic anxiety of attaining intimate closeness
to the analysand may not be so pronounced. However, it can
certainly not be ruled out entirely. There might, for example, be
moments where the analysand is experienced as a parental figure
whose approval and even admiration is sought through a
strikingly correct interpretation or a convincingly good piece of
advice. This may well happen if the analyst as a child has been
SUCCESS, RETREAT, PANIC 63

called upon to advise his parents rather than being advised by

them and to win their acceptance in this way, a situation which
probably is not so uncommon for children who later become
analysts.
In the countertransference two factors above all seem condu­
cive to a flooding of the analyst's ego, admiration and success; and
they may naturally be defended against in many highly different
ways. The analyst may, for example, attempt to keep the analysis
under tight control, guarding himself against getting too much
from the patient, as it were. In this case he may play down the
patient's achievements, either in the sense of not properly
acknowledging material brought to the sessions, or not recogniz­
ing things achieved outside the analysis, either as a response to
the analytical work or directly to gain praise from the analyst.
This control may be rationalized as 'preventing acting out', or
'refusal to give narcissistic gratification'. All in all, such analyses
may seem grey and dull or unduly severe, and the analyst will
continually feel inadequate and complain that he never seems to
achieve anything—feelings which naturally sooner or later will
be picked up by the patient and damp all enthusiasm for the
work.
It also appears that boredom in the analysis may at times
spring from a similar source. It need not only be the analyst's
response to resistances on the part of the patient. I remember a
patient whom I found unbearably boring; I dreaded the three
weekly hours with him and could hardly restrain myself from
confronting him with this. Only when I realized that it was, in
fact, mainly my own problem and that I was defending myself
against archaic idealization on his part, could I cope with my
boredom. This was so much more excruciating, and hence highly
defensive on my part, as the patient's idealization was of the type
which is intensely intrusive, and thus it was felt by me as being
very aggressive. I had simultaneously to defend myself against
something both intrusive and idealizing, and for some weeks that
was too much for me.
I wonder whether the fear of closeness on the part of the
analyst, which may arise as a reaction to a patient's over-stimu­
lating admiration, might also find expression in a certain
apprehension regarding inquiries into the patient's personal life,
or directly in avoidance of phantasizing about him. This would
64 PEER HULTBERG

naturally mean that the analyst was depriving himself of one of

the best tools for interpretation. In any event, it does appear that
fear of over-stimulation can hamper interpretation to a great
extent. The analyst may fear the impact of the correct interpreta­
tion in the same way as the patient, either because of the
consequences which it might have on the patient, or because he is
afraid of the over-stimulating effect on himself of his skill in
hitting the mark. This is a dread that his own virtuosity may
finally bolt away with him and flood him, an anxiety which it
seems is also felt by many artists.
The fear of admiration or of idealization, that is, the fear of
being praised, with the resulting avoidance of closeness, is likely
to lead to rather uninspired analyses where not much happens.
This is often rationalized as steady work on the part of a reliable
analyst. Over-stimulation, however, may also take the form of
fear of being flooded in the case of evident success. This could lead
to an unconscious avoidance of success altogether. One of the
many ways of preventing success is to terminate analysis
prematurely, or even break it off, an act which might again be
rationalized, for instance, by advocating principles of not binding
the patient too strongly to the analyst, of not believing in
over-long analyses, of wishing the patient to take the responsibil­
ity for his own life.
The following example, not of an analyst but of a physiothera­
pist in her early thirties, may illustrate the problem of over­
stimulation in the helping professions, that is, the fears aroused
in the helper by his own powers. Mrs Nielsen was highly gifted in
her field. However, like all people whose skill approaches
virtuosity, she was also an exceedingly hard worker who had
gone to great lengths to improve her skills and training. As a
result of this she was able at times to achieve cures which were
almost miraculous: people condemned to the wheelchair were
able after some months of treatment to get up on their own and
take theirfirststeps; a spastic baby whom everyone had given up
and who had given himself up and turned all but autistic gained
control of his motor apparatus, started smiling at his mother,
expressed frustration and understandable rage, and became very
curious about the world about him. At a certain point Mrs
Nielsen grew frightened of her own powers. The events taking
place in her practice were nearly too much for her to contain or to
SUCCESS, RETREAT, PANIC 65

cope with. They seemed uncanny to her, and she felt that she
possessed almost supernatural powers or, conversely, was posses­
sed by such powers. She was partly fearful lest she should 'grow
into the skies and become a megalomaniac', as she expressed it,
and partly afraid that something fundamental was wrong with
her since she could achieve these stunning results. In her worries
about her successes she was at a point where she wished to put an
end to it all and just become an ordinary run-of-the-mill
physiotherapist. She did not know where the whole thing would
lead to otherwise, she said.
After a thorough discussion of her cures she and I agreed that
there was, in fact, nothing supernatural about them. She had not
consciously or unconsciously entered into a pact with the Devil,
whatever shape he might take in the psyche of a late twentieth­
century woman. Her seemingly miraculous successes sprang from
a combination of conscientious hard work and an uncommonly
good training combined with an excellent diagnostic intuition
based on her trust in her subliminal or unconscious perceptions.
She felt her situation had also become worse during her analysis
because she had achieved an even better contact with her
unconscious. Moreover, her enthusiasm for her work combined
with her confidence in her unconscious, especially in her uncon­
scious observations, gave her pronounced suggestive powers
which contributed further to her fears. She could carry people
with her and awaken their own trust in themselves and in the
possibility of what they had hitherto believed was impossible.
And this naturally was a necessary condition for a cure. Because
of this insight into her inner and outer reality it was possible to
halt her tendency towards retreat in the face of hyperexcitement
at her astonishing cures. She built up a realistic self-esteem
which prevented her from flight in terror from her own successes
or from thwarting them. She no longer saw herself as being like a
faith healer in the grip of mysterious powers which would grow or
wane without her control. She realized that she was simply a
highly-skilled professional woman who had a fine career ahead of
her.
It seems then that the main defence mechanism against
over-stimulation on the part of the analyst is the well-known
device of ego-restriction, be it in the form of a restriction of his
human response, his empathy, his attention and vigilance, his
66 PEER HULTBERG

interpretative skills, or his general performance. However, one

feature might be particularly considered in this context, and that
is the rejection, if not the direct rebuff, of the patient's feelings.
This may take place as a reaction to idealization where the
analyst in the countertransference, for example, may reject
parents who have idealized him as a child instead of letting him
idealize them, thus depriving him of guidelines and leaving it to
him to fend for himself and perhaps for the parents too. But,
naturally, a rebuff of the necessary idealization from the
analysand may also be a question of idealization felt as too much,
that is, as the fulfilment of the most cherished wish. In this
connection one specific aspect of the rejection and rebuff should be
pointed out—the rejection of gratitude.

Gratitude
Melanie Klein was certainly right in emphasizing the importance
of both envy and gratitude for the human being. However, in
general, too little attention has been paid to gratitude for the
human being. This may certainly be felt at times as exceedingly
uncomfortable. In the case of Mrs Nielsen, the physiotherapist,
the worst moments for her came when patients, especially
ordinary simple people, expressed their profuse thankfulness to
her for her remarkable cures. Often these patients were
extremely moved, and she had the greatest difficulty in not
belittling their feelings as well as her own achievements. The
embarrassment was aggravated because, like Mrs Nielsen
herself, the patients had generally no particular religious beliefs.
Hence they could neither thank their God for their cure, nor could
Mrs Nielsen thank hers for her gifts. Her ego had thus to carry
the full weight of the gratitude which in former times might have
been bestowed on God or on a saint as well as on the healer. And
it seemed very understandable that she should cringe away and
retreat from this task with its inherent possibility of gross
inflation.
In the analytical setting, over-stimulating may manifest itself
not only because the analyst senses that he has been successful in
his work with the patient, but also because he fears being swept
away himself if he allows the feeling of gratitude as such to
SUCCESS, RETREAT, PANIC 67

emerge in the analytical situation. Maybe he himself has never

really experienced this feeling, either in his personal life or in his
analysis; hence he is forced to perceive it as dangerous and
threatening to his psychic equilibrium. Perhaps it should be
emphasized that rejection is being discussed in connection with
over-stimulation and the subsequent dangers of flooding of the
ego and not in connection with cases where the analyst thwarts
his own success out of envy of the patient for the feelings which
the patient experiences as a result of his analysis with him. There
are probably quite a number of analysts who envy their patients
their good analysts, in the same way that certain parents may
envy their children their good parents.
The analyst's rebuff of the patient for fear of his own
over-stimulation induced by gratitude may thus have very
serious consequences for the outcome of an analysis. It may again
be rationalized; for example, by advocating conformity to rigid
rules of not accepting tokens of gratitude, of not giving
narcissistic gratification. However, it may be argued that
gratitude is one of the most important feelings to emerge in
analysis.
One of the goals, i f not even the principal goal, of analysis
might be said to be an experience of the feeling of gratitude. It is
one of the feelings associated with the experience of a rela­
tionship to something greater than the ego. It may not
necessarily be the aim of an analysis for the patient to experience
this feeling solely in relation to the actual parents. There will
always be cases in which this cannot be achieved, however
profound the analysis. The parents may have to remain rejected.
But the important thing is that gratitude is experienced at all.
Speaking in Jungian terms, one might say that the feeling of
gratitude is very close to being the feeling equivalent to the
experience of the psychic totality, of the supraordinate personal­
ity, the conjunction, or whatever name one uses. This transcend­
ing factor may initially be projected onto the analyst. But even
thus the feeling of gratitude seems to be a step not only towards
the realization of good inner and outer objects but also towards
self-awareness.
However, the feeling of gratitude also implies a corresponding
degree of ego-awareness. And thus it seems that a relation
between the ego and the self may be built up which is not a
68 PEER HULTBERG

merger of the ego into the self with the corresponding danger of
grandiosity or inflation. Gratitude appears to ensure that the two
psychic instances are kept apart but at the same time remain
intimately related.
Over-stimulation and the related depressive defence may be
observed in connection with a very wide range of psychic
phenomena. It is encountered within analysis but perhaps even
more often outside. The defence, in other words, seems to be
particularly effective, especially perhaps in cultures where
qualities like modesty, self-effacement, non-competitiveness are
considered primary moral values. The defence against hyperex­
citement ranges from shyness and a general tendency to hide
one's light under a bushel, to an attitude of humility on principle,
to fears of healthy competition and fear at one's own achieve­
ment, to severe doubts about the value of oneself and of one's
accomplishments, and it may end in serious work inhibition,
sterile regression, and empty depressivity. The defensive man­
oeuvres may be supported by a whole arsenal of secondary
rationalizations and of references to ethical, social, and religious
ideals; and even psychological self-labelling may be employed,
like references to one's introversion or one's sadistic super-ego.
Jung has called attention to the important phenomenon of the
regressive restoration of the persona. This concept is extremely
valuable when one considers the subsequent reactions to the
defence or retreat against hyperexcitement. Jung has shown how
the walls are rebuilt after a flooding of consciousness by
unconscious contents, and how the individual lives a life on a
lower level than before, being 'smaller, more limited, more
rationalistic than he was before' (CW 7, para. 257). One may,
however, be entitled to ask whether it is possible to observe a
manic defence against the depressive defence against over­
stimulation and against the regressive restoration of the persona.
The question may sound sophistical yet it appears that a
characteristic feature of the regressive restoration of the persona
and of the depressive retreat after, or prophylactically before,
over-stimulation is often an almost compulsive manic activity.
And this hectic activity may then secondarily be used as a
rationalization for avoiding situations which might cause
hyperexcitement. In the cases mentioned above, for example, Mrs
SUCCESS, RETREAT, PANIC 69

Lake entered therapy with heart difficulties as a result of her

exorbitant political engagement, and the young painter also
developed heart problems during his later university career. In
these instances, where it is directed against the depressive state
connected with over-stimulation, the manic defence appears to be
particularly fierce and even virulent. There seems little doubt
that this may be explained only by assuming that it is reinforced
by an intense narcissistic rage of a highly self-destructive nature.
Neither the regressive restoration of the persona nor the retreat
phenomena connected with over-stimulation thus imply a state of
lethargy. On the contrary, appearances may be strikingly
deceptive. Behind the smiling fagade of the astonishingly
energetic but self-effacing individual who merrily labours
himself to death, claiming no reward, there may be a frail and
deeply anxious ego which fears the unmitigated onslaught at any
moment of its own grandiose phantasies, if it has not already
experienced this.

Summary
Over-stimulation is discussed as an endopsychic process, whereby
psychic contents of an inflationary or grandiose nature threaten
to overwhelm the ego thus causing anxiety. The ego under
consideration is, however, able to defend itself more or less
successfully against this anxiety and does not succumb irrevers­
ibly to it. The defensive mechanisms employed by the ego have
the character of a retreat which is experienced as a state of empty
depressivity. This depressive defense is linked with Jung's 1916
concept of the regressive restoration of the persona. The
phenomenon is treated theoretically with reference to Jung and
to the modern American writers on self-psychology, notably
Kohut. I t is illustrated by extra-analytical occurrences, where the
depressive defences seem to function. Subsequently it is consi­
dered as a focal point in analysis, and it is then discussed in the
context of the transference and the countertransference. The
connection with the use of alcohol is specifically underlined. In
conclusion, the concept of a manic defence against the depressive
defence is briefly sketched without being further elaborated.
70 PEER HULTBERG

REFERENCES
Eliot, T. S. (1969). The Complete Poems and Plays. London: F a b e r &
Faber.
Goldberg, A . (ed.) (1978). The Psychology of the Self. New Y o r k :
International Universities Press.
Keats, J . (1982). Poetical Works. Oxford: Oxford University Press.
Kohut, H . (1971). The Analysis of the Self. New York: International
Universities Press.
CHAPTER THREE

A psychological study
of anorexia nervosa:
an account of the relationship
between psychic factors
and bodily functioning
Eva Seligman

In this chapter on anorexia, Seligman shows that she is aware

of the background in family and marital dynamics and how she
works this into her analytical approach. The part played by the
father and by siblings is therefore fully acknowledged alongside a
more internal perspective.
In many respects, the paper serves as an introduction to the
treatment of psychosomatic disorders generally. For in many or
all of these, we can see what Seligman calls 'metamorphosis in
reverse—a move from 'the multi-faceted ostensibly somatic
syndrome to its basic, primary emotional constituents in infancy.'
Though Seligman's use of a teleological approach is implicit
rather than explicit, the reader will see how, for her, any
understanding of the aetiology of anorexic symptoms is bound up
with a consideration of the unconscious purposiveness of the

F i r s t published i n The Journal ofAnalytical Psychology 21:2, i n 1976.

Published here by k i n d permission of the author and the Society of
A n a l y t i c a l Psychology.

71
72 EVA SELIGMAN

illness: what is the anorexic aiming at, desiring, trying to

achieve?
A.S.

sychosomatic illness constitutes a cry of despair and of

hope, and may represent an unsuccessful attempt at a
JL. search for wholeness. It points to a division within the
individual, and any therapeutic confrontation needs therefore to
attempt to encompass all aspects of the patient. When a
psychosomatic disorder such as a severe eating disturbance
manifests itself, and could threaten the continuance of life, the
pressure on the analyst to focus primarily on the symptom may
become difficult to resist.
A scanning of current psychiatric literature on anorexia
nervosa is a herculean task. Psychiatric Briefs, 8:1, 1975, alone
contains eleven extracts from the most recent publications on this
topic. In the present cultural environment, and at a point in time
when sylphlike slimness is at a premium, eating disorders foist
themselves as a socially acceptable manifestation on to the
disturbed psyche of the individual. Furthermore, the very real
danger to health, and, indeed, to survival, together with the acute
distress that these patients cause their relatives and medical
practitioners, is matched by their resourceful guile and cunning
in sabotaging traditional medical and psychiatric measures.
Their scheming to resist a 'cure' is equal to that of alcoholics.
Though 'behavioural' and 'conditioning' techniques are widely
favoured because, ostensibly, they produce a considerable percen­
tage of 'successful cures', I am inclined to suspend judgement on
their long-term efficacy and retain the view that it may be futile
to aim only at a cure of the physical condition, which masks a
fragmented, stunted personality. As Jung and others have shown
us, a heart ailment, for instance, need not arise from the heart
only; it can also arise from the psyche of the sufferer, and then its
resolution may evolve from symbolic growth, that is, a gradual
inner transformation. Meier concludes that healing can take
place only through the constellation of a symbol, or the archetype
of totality (Meier, 1963).
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 73

My own interest in eating disorders was triggered off when I

found myself working simultaneously with four patients whose
ostensible central preoccupation was with food. Their lives were
taken over by incessant compulsive eating rituals of alternate
starving and gorging, often followed by vomiting. They went
through either acute phases of elation, or feelings of guilt and
worthlessness, and I need hardly add that all four were
alarmingly underweight or overweight at times. I will now quote
you a standard psychiatric textbook description of anorexia
nervosa.
Anorexia nervosa occurs typically in girls in their later teens
and in young unmarried women; it is doubtful if the same
syndrome is found in men. A typical triad of symptoms is
anorexia, amenorrhea and loss of weight. Vomiting is common,
representing repressed disgust; it is rapid and easy, occurring
without nausea. The illness has an emotional basis.
These girls tend to come from families with a history of
nutritional disturbances, obesity and anorexia. There is a
refusal to take an adequate diet, or phases of compulsive
overeating countered by vomiting and excessive purgation. A
remarkable feature is tireless activity in spite of emaciation.
The patient may declare that she is perfectly all right. She
may exhibit the belle indifference of the hysteric. Depression
may be prominent, with feelings of guilt and isolation and
suicidal thoughts. Obsessional, anxious and hypochondriacal
traits are encountered. There are food fads and alimentary
preoccupations. There may be a severely disturbed mother/
daughter relationship, the patient being at one and the same
time unduly dependent and rebelling against maternal
domination. The prognosis is poor; only 10-20 percent recover.
[Henderson & Gillespie, 1969]
What heightened my interest was the fact that only one of my
four patients appeared to fit the above description closely, though
even here not only the mother but the father too entered
significantly into the constellation of her illness. This, my first
case, concerns Alice, a young unmarried woman in her early
twenties. I had known her parents on and off for approximately
five years in connection with marital problems.
The mother was as thin as a beanstalk, had many physical
illnesses, and was remote and detached. She gave the impression
74 EVA SELIGMAN

that she felt in some strange way triumphant about her

husband's marital and sexual deviations. On the other hand, she
had an unusually close relationship with Alice. For instance, they
used to bathe together and to scrub each other's backs. The
intimate marriage seemed to be between mother and daughter
and not between the parents. Not surprisingly, it was Alice's
father who contacted me on this occasion, whereas before he had
come only reluctantly and under duress from his wife. He told me
that Alice had recently returned from her first stay away from
home, depressed, ill and with severe eating difficulties; she had
lost four stone in weight and her periods had stopped.
Hilde Bruch, in her book Eating Disorders and the Person
Within, stresses the importance of involving the family in the
treatment process (1974). She further points out that whatever
the anorexia patient does is not for herself but for her parents'
sake, though i t can never be sufficient to please them. It
frequently happens that the patient's mother is dissatisfied with
her marriage and endows the child with the task of compensating
for her own disappointment. Thus she suffocates her daughter's
pull towards independence. Both parents conceal their deep
disillusionment with each other. Secretly, they carry on a
sacrificial competition. Each desires the sympathy and support of
the child, whose energies go towards satisfying the competitive
claims of the parents so that too little is left over for investment
in her own development. A quote from a recent article emphasizes
these points:
It appears that ultimate progress for the patient is importantly
related to the initial levels of psychoneurotic status of the
parents. The overallfindingsin the study support the view that
anorexia nervosa is often importantly and dynamically related
to parental and family psychoneurotic morbidity and stress the
importance of investigating the illness in terms of the family
pathology and the probable related importance of involving
parents in the treatment programme. [Crisp, Harding &
McGuinness, 1974]
To return to Alice: when her father suggested that he and his
wife should come and discuss their daughter's illness with me, I
thought this device of excluding Alice might prejudice any
prospect of my working with her and her parents in the future,
and so I proposed that all three come together. From previous
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 75

contact with them, I had a hunch that a conjoint technique might

be the most appropriate. I knew this approach had been used
successfully by many other therapists in the past, as this abstract
suggests:
The marital relationship was inadequate, allowing J. to be
inappropriately involved in the parents' affairs. The family's
pattern of functioning was characterized by over­
protectiveness, lack of privacy for individual members, denial
of the existence of any problems other than J.'s illness, and a
failure to resolve marital conflicts which remained concealed
by the parents' preoccupation with J. Her symptoms were
therefore reinforced within the family circle. [Liebman,
Minuchin & Baker, 1974]
Alice looked like a Giacometti sculpture: emaciated, with­
drawn and distraught. Her father was noticeably depressed and
agitated, as if in some way he felt to blame and implicated. Her
mother once again seemed least affected, almost as if exulting in
the catastrophic manner in which Alice had returned to the fold.
Most of the talking was done haltingly by Alice and her father.
The dominant theme was Alice's acute guilt and agitation about
having left her mother in pursuit of a life of her own. Father
seemed only too well aware of his neglect of his wife, and how he
had handed over responsibility for her to Alice.
I explained that guilt tends to produce illness with the
unconscious purpose of restoring the status quo. In the process,
inevitably someone is made to suffer. I pointed out to them how
the family problems were being passed around between them like
a parcel. As usual, the weakest link i n the chain, Alice, had
become lumbered with the parcel, not daring to unwrap it or to
pass it on. She had become the casualty, while her father, in spite
of his depression and feelings of blame, was still able to keep up
appearances and to function in the world.
Towards the end of the interview the mother mentioned
casually that, at their request, their family doctor had referred
Alice to a Psychiatric Outpatients' Department. Why, then, I
asked myself, had they come to see me at all? In retrospect, I
think it was to find absolution, and not a resolution. I could not,
because of the arrangements they had committed themselves to,
continue with them, and this I told them. The unconscious
conspiracy to treat the symptom and to neglect the person within
76 EVA SELIGMAN

had won the day and sabotaged a potentially favourable

prognosis engendered by this first family session.
Within a week, and before she had been seen at the
Outpatients' Department, Alice's mother sent me a letter from
which I quote: 'Alice is looking better; some of the strain is
leaving her face and she is eating more normally. Her weight is
increasing. I feel she is being repaired.' Some nine months later,
however, I heard from mother again. Alice had had a course of
electro-convulsion therapy and was on anti-depressants and
tranquillizers. Mother and father were also being treated with
drugs. Alice had regained some weight but was still depressed
and not menstruating, nor able to function in any facet of her life.
She was continually asking, 'When will I be allowed to talk to
someone?'
This brief and frustrating encounter with Alice has had a
happier sequence; she recently telephoned me out of her own
motivation, asking for therapy. Just two years after our first
meeting I have seen her once and plan to take her on regularly.
I was struck by her frail beauty. She looked like a fairy-tale
princess, waiting for her prince to awaken her, and as if made of
fragile precious china,
Alice told me that she had become dissatisfied with her
treatment, was still on drugs and receiving five minutes'
follow-up therapy fortnightly at the Outpatient Department. She
felt annoyed when told that her parents were narrow-minded
Christians, and that she should take herself off and have sex. Her
weight, however, has stabilized at 114 lbs under the threat of
hospitalization i f it falls below 112 lbs.
Her parents have meanwhile moved to another city and have
set her up in an apartment in the house of an elderly couple who
stand in for them. Alice is lonely, having no friends of her own
age, is doing a rather low-grade job well below her capacity, and
is still depressed and feels too fat.
I should here like to quote an abstract from another article on
this topic, entitled 'Mind over matter':
The more accessible material suggested that all dimensions of
psychic life were experienced in terms of the quantity of their
flesh and the oral activities directly related thereto. All
described a deliberate decision not to eat based on the dual
concept that they were too fat and that eating was bad. Their
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 77

attitude towards feeding others was much more accepting. ...

The patients were encouraged to lose the fear of pleasure from
which many of them clearly suffered. [Galdston, 1974]
Alice has bouts of stealing food from the couple that she lives
with, and has carbohydrate binges, stuffing herself with 'forbid­
den' food. On the other hand she has difficulties about eating in
company, is afraid she may be pressed to eat starch—yet steals it!
She is also afraid of being cheated of her due, of being denied that
to which she feels entitled, and is touchy about being offered a
smaller helping or else forgotten altogether. These contradictions
pinpoint my view that food is a stand-in for love and caring. Alice
also finds herself acutely critical of what other people eat, a
manifestation of her resentment of her parents.
She feels 'unattractive and babyish', obsessed with and
anxious about feeling left out and of not being given enough. Her
mother, who is a poor housekeeper and cook, encourages Alice to
spend her weekends with her parents, preparing their meals for
them. Yet Alice feels her parents are 'not really there' and, most
of all, not there for her, being still very entangled with her
mother, whom she sees as lonely and not appreciated, although
father has told her 'mother is stronger than you think'. In spite of
struggling to distance herself from her parents, their mutual
entanglement is still very strong; Alice sees herself as the only
one who really understands how her mother feels.
Alice avoids involvement with other people, ostensibly because
she would then have to eat with them. If, nevertheless, she
becomes attracted to a man or makes 'a conquest', she persuades
herself that she has become 'bored' with him. Her acquaintances
are married couples, and she befriends the husband on an
intellectual level which she feels 'safe'. At 25, she continues to
feel that no one takes her seriously, or cares enough to show true
concern either for herself or for her mother. Whenever she allows
herself to think about all of this, she gets profoundly upset on
behalf of the mother in her, and of her baby self.
I recently came across an article in the American Journal of
Psychiatry on the effectiveness of 'Family therapy in the
treatment of anorexia nervosa (Barcal, 1971). The author's
9

experiences accentuate my own. Thus, he describes how the

anorexia families he has worked with manifest concern and
interest for one another while denying personal wishes and
78 E V A SELIGMAN

interests. Family members had to guess in order to determine the

other's wishes; a direct expression of need was taboo, thus
creating flux states of involvement together with abandonment.
Their bodies were strange and alien to them. He further stresses
that the families were living under an umbrella of falsehood; a
person who is unable to differentiate between hunger and other
needs becomes anorexic as a perverse way of solving conflicts. He
points out the necessity for 'peace at all costs', engendering guilt
and an abdication of responsibility, isolation and a power
struggle for control. The aim of his therapy was to enable the
patient to take over the responsibility for herself, and to
neutralize the eating symptoms. If successful, an inadvertent and
alarming reaction tended to occur in the other family members,
as was the case with Alice, whose parents were not only an
important component of her illness, but subsequently became so
disturbed that they too received drug therapy at the Psychiatric
Outpatient Department where Alice was being treated.
In a paper entitled 'Hungry patients: reflections on ego
structure' (Plaut, 1959), the author outlines the basic problems of
patients who were predominantly occupied with food and eating,
and I will summarize the gist of his article as follows: somatic
symptoms have a psychic basis. Hungry patients have not yet
acquired the capacity to relate to whole persons or images, but
only to parts. There is an absence of ego boundaries, i.e. a stage of
magical identity in which there is no distinction between I and
you. The aim is to unify the ego sufficiently to distinguish
between itself and the other, between an inner and an outer
world. Experiences of wholeness remain exclusively linked with
the object which stands proxy for the patient's own ego. Bodily
experiences in infancy have not been satisfying.
Personally I should go even further, and describe my own
patients as more than hungry; they are craving not for food but
for love. The state of magical identity referred to above appears to
have become one of the primary identity, i.e. anorexia patients try
to achieve an imaginary state of bliss and contentment associated
with the original fusion between subject and object, between baby
and mother. This illusory primary object is the ever-nourishing
breast—they are obsessed with it. The exclusive, inexhaustible
supplier of nourishment comes closest to how they would like to
perceive themselves. This identification temporarily enhances
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 79

their tenuous self-esteem and promises the approval of others. It

gives them a sense of power and achievement. To maintain it,
however, they must ensure that they are in absolute control as
the sole manipulator of all nourishment dispensed, withheld or
rejected. Thereby their mother is divested of her positive, feeding,
loving qualities; she is, as it were, dethroned, i f not mutilated.
This engenders acute guilt in the patients, and fears of mother's
hatred and revenge. Thus the idealized breast has been trans­
formed into the terrible one, and the powerful, manipulating
patient sees herself as the perpetrator of the deed. This complex
cycle leads to an intolerable psychological trap in which the
patient revolves from a temporary state of bliss and effectiveness
to becoming a depleted and greedy monster. In fact, both the
subject and the object have turned into monstrous breast-witches,
and the identification is so complete that it cannot be disen­
tangled.
At this point, we have moved closer to some understanding of
why these particular patients appear to become fixated at the
primary oral level rather than develop other forms of neuroses. In
all my four anorexia cases, the patient's actual mother is seen as
precisely fitting the fantasy monster/breast just described. There
is an uncanny correspondence between the internal fantasy and
the external reality, the one reinforcing the other. Their mutual
stranglehold takes on archetypal proportions, not mediated by
redeeming personal experiences.
One way out for patients in these situations is to retreat into
a state resembling an intra-uterine, conflict-free shelter, a de­
pressed withdrawal. There are two alternatives—to starve until
they almost disappear, or to seek relief in an eating binge in
which they once again get on to the bandwagon, creating for
themselves an illusory ever-full breast. But then their excessive
greed evokes revulsion, anxiety and shame, and the vomiting
mechanism usually becomes active at this point. The whole
syndrome is cyclical and repeated endlessly. Indeed, I have
observed that those of my anorexic patients who have children of
their own perpetuate this pattern in the next generation, both
over-indulging and excessively controlling them, while plagued
by fantasies of ridding themselves of them for good and all.
I am quite convinced that inadequate and unsympathetic
mothering experiences set the stage for the subsequent pathology
80 E V A SELIGMAN

of anorexia. Wilke (1971) also stresses the predominance of the

mother-complex and any immaturity of personality in heart
neurotics. I n the same way anorexia patients have never been
able really to depend on anyone, and even in infancy lacked the
experience of a need being adequately met. Thus they fail to
differentiate other signals of discomfort from pangs of hunger,
and food provides a temporary relief, whatever the source of
deprivation or anxiety. Severe love bereavement leads to
mistrust of the legitimacy of all other feelings and ultimately has
an annihilating effect. There is therefore a desire to become
larger and larger, or else to disappear and, perhaps, to have a new
beginning, a rebirth.
Other psychosomatic disorders and psychosexual problems
frequently accompany anorexia. I n any encounter with the
opposite sex, for instance, an overpowering craving for affection
clashes with fear and revulsion. During an erotic act, their fragile
sense of personal ego consciousness disappears, sweeping with it
the last vestige of an identity of their own. The encroachment of
the partner's ego is intolerable, yet longed for.
Two of my four patients suffered from migraine and attacks of
dizziness, which I understood as a shrinking from a longed-for,
yet feared, sensation of autonomy. The connection between
asthma and migraine makes good sense in this context. These
symptoms exemplify opposites—the fear of the suffocating
mother and the complementary dread of separateness from her.
One of my migraine patients has an asthmatic child. Kierke­
gaard's words spring to mind: 'Freedom looks down into its own
possibilities, and then grasps desperately for limitations i n an
attempt to survive.'
The basic task for the analyst with anorexia patients, as I see
it, is to focus on their real needs, and not to focus on the illness.
Any attempt to persuade the patient to eat or not to eat should be
avoided; the underlying disturbances, however, have to be
brought into the open whenever possible. Any dwelling on
vomiting or other somatic symptoms only leads to a neglect of
vital but hidden aspects. As suggested earlier, the analyst will try
to find a way to stand proxy for the missing ego in lieu of the
person with whom the patient is identified. As the ego boundaries
grow stronger and more flexible, interpretations become
increasingly possible and certainly necessary. The emphasis
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 81

needs to be on the implicit regression to earlier levels and on a

reconstruction of them. In the main, however, therapy with these
patients consists in listening to them, an experience they have
missed out on. The therapist who presumes to know the answer
plays into his patient's belief that somebody else has the magical
solution, in the same way that mother purported to have.
My next case is an example of the atypical within the familiar.
Barbara displayed the usual somatic manifestation of anorexia;
in fact, after two previous analyses she had become, and was
determined to remain, a chronic case. She was already in her
fifties but looked even older and haggard; she was married and
had had children. In addition to her eating problems, she
demonstrated another characteristic feature of anorexia, namely
the pathological envy of whoever is perceived as the best-loved
within the family setting—most often it is the sibling of the other
sex. In her case, these acute feelings of envy culminated in
murderous attacks on the one she perceived as her parents'
favourite son, or else in futile attempts to become like him, and
even to surpass him.
A negative prognosis was determined from the start, when she
insisted she could only come once a week. It was clear to both of us
that her resistance to change was paramount; all my interpreta­
tions on this point were stonewalled by her. Nevertheless,
because of the empathy between us I became a perfect foil for her
anorexia nervosa mechanisms. Whenever something incisive had
taken place in a session, she vomited it out in the form of a
meaningful but almost illegible scrawl which she posted to me,
telling me in substance that she had been fed too much, so that it
had turned bad inside her, and she would starve, herself by not
coming next time. In this self-defeating manner she wasted my
time and her money, while remaining craving and desperate. The
only time that she felt any good was when she could produce a
dream; however innocuous the dream might be, i t provided her
with a sliver of confirmation that she possessed some inner life
that was her own.
In an early session she drew my attention to an arrangement of
wild flowers in my room. She disapproved of my liking for
'rubbish', as she called it. She also seemingly disapproved of my
liking of her. The next day she wrote as follows: ' I was offended
when you told me in connection with these weeds that every­
82 EVA SELIGMAN

thing, however apparently valueless, can be accepted and treated

as something t h a t has meaning. I want so m u c h from you, yet I
get nothing. Good things i n excess turn b a d / Not surprisingly,
she was a compulsive, self-induced vomiter.
A few sessions later she wrote: 'Loving feelings are dangerous
and obliterate boundaries. T h e y make one take other people
inside one's self a n d get mixed up with them, and one has to get
rid of them, suddenly, violently. I have to spoil things to protect
them from the murderous feelings inside me. T h e n I become an
empty shell without life. I don't know where I begin and end. I am
drained and impaired.' Her one relief was strenuous and endless
wailing to the point of exhaustion.
H e r mother w a s seen by her as dominant and insecure,
narcissistic, a ' V i r g i n Queen', and childish. Mother had food fads
and starved herself on a nature cure diet. F a t h e r was seen as only
interested in mother, and never stood up for Barbara. Mother
constantly criticized Barbara, calling her greedy, fat, ugly,
awkward, stupid, and frequently pointed out to her that her
mouth was permanently open, and that she was ashamed of her.
B a r b a r a had h a d thirteen governesses i n twelve years! She
further described h e r mother as a 'jealous prima-donna' who
never accepted a n y 'nice' feelings from her. She remembered an
occasion when she borrowed her mother's bicycle without
permission and slightly damaged it. Her mother rejected her plea
to be allowed to r e p a i r it, and instead pulled Barbara all the way
home by her h a i r .
Barbara's eating habits followed the characteristic pattern:
she ate too much of the 'good' things and vomited, or she starved
herself, or she ate the 'wrong' food. 'Greed takes over', she said,
'and I feel ugly.' S h e also had the typical distorted body image
w h i c h I hope shows i n the little primitive self-portrait she drew
(Figure 2). I t shows a scarecrow-like person with a tiny
pinched-in waist, two minute appendages instead of legs, no
hands, but greatly magnified buttocks. Behind this figure it is
j u s t possible to detect another, a portrait outline of a timid­
looking young g i r l . I felt this depicted her undeveloped young
self.
Barbara did not know how to use her hands, and was prone to
say that it was as i f she had none. She explained 'words are
better'; she read greedily but could never retain any of it. When I
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 83

FIGURE 2

interpreted to her that she dared not use her hands because of her
murderous impulses engendered by her envy, she remembered
confirmatory data. She had tried her utmost to be a tomboy—a
tougher and better boy than her brother. On one occasion in her
teens when her brother taunted her with being 'jelly-muscled',
she throttled him until he was blue in the face, and then bashed
him so hard that she broke his nose.
Barbara left me abruptly when a distressing event occurred in
her life, and when she could have done with maximal support.
She bequeathed an unpaid bill as the surviving bond between us.
Munch's "The Scream' haunted me while I was gestating this
paper. I feel it projects cogently the agony of the anorexia nervosa
patient confronted by the monster within and without, and
catches the expression I have often seen in the faces of these
patients.
Both Eileen and Douglas, my third and fourth cases, have now
moved in the direction of integration. They have had long
analyses with frequent sessions, though interestingly their
84 EVA SELIGMAN

anorexia symptomatology only became prominent in certain

phases of their therapy. Eileen, like Barbara, was atypical in that
she was married with children, and she was menstruating
regularly, though with much accompanying disturbance. Her
relentless pursuit of thinness is a recent development, and follows
many years of frequent and acute attacks of migraine, severe
phobic states and hypochondriacal preoccupations, as well as
compulsive over-eating with obesity and numerous psychosexual
difficulties. She was obese when she first came to see me, and
subsequently did a complete turn-about. I shall be confining my
comments to her starvation phase from which she is in the
process of emerging.
She was the daughter of a suffering mother who was said to
have conceived Eileen in her sleep, and who sobbed her heart out
when she gave birth to a girl; to be female was a catastrophe! It
meant a life of misery. Eileen had to be her mother's perpetual
'sunshine', so had never really been a child; she never played, was
always called 'sunshine', and never heard her own name. I f she
was like a small child, mother would become ill and suffer. She
was smothered by her mother. Everything that happened was
said to be Eileen's fault. She felt compelled to be what her mother
needed of her and felt incessantly watched, assessed and judged.
To be unhappy would have implied an insult to her mother's
supposed superiority. Thus Eileen acquired the fagade of ade­
quate functioning and learned to mistrust the legitimacy of all
her own feelings, suffering severe love deprivation, for which she
attempted to compensate by a promiscuous phase in adolescence
which revolted her and made her ashamed. Unable to live a life of
her own, she lived by proxy through other people.
I quote a relevant extract from a recent publication:
From the psychodynamic point of view, the reduction in food
consumption is an expression of an unconscious revolt of the
anorexic patient against her own body.. The condition is
associated with an abnormal affective relation between mother
and daughter; the former is excessively anxious and concerned
about the well-being of the latter, who feels that her growing
body frustrates her unconscious desire to remain a child
[Rolandi, Azzolini & Barabino, 1973]
As already described, a sense of hollowness within can be
temporarily ameliorated by filling up with food; the eating stands
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 85

in for satisfaction of needs in other areas, and provides a

momentary sense of spurious power. With Eileen, elation,
however, did not last, and she would soon say that she wanted to
disappear, or at least to have a boy's figure like her brother so as
to be admired. She would then make herself vomit by putting her
finger down her throat. Her eating habits became so highly
ritualized and followed such a precise sequence that they acted as
an anaesthetic. She was weighing herself several times a day,
and each fresh loss of weight gave her a sense of triumph; it was a
'bonus' which made her feel superior because it proved her powers
of self-control, but i t was never good enough, and she set herself a
yet lower target than before.
Her distorted body image which, like Barbara's, was of bizarre
proportions was, however, gradually becoming more realistic,
and her anorexic symptoms were beginning to phase themselves
out. To achieve this she had to go back and begin again as a baby
with a different mother figure—that is, myself.
The aim of the first phase of therapy is to continue the role of
the mother with the exclusion of the negative aspects. A
'transference' can be achieved only by attempts to break
through the voluntary self-isolation of the patient. [Schenk &
Deegener, 1974]
In fact, when Eileen made insistent demands on me to be
treated as a baby, I felt the vital turning point towards health had
begun. Even so she still felt too large, all bulk without appeal,
useless, with ugly hands, neither in nor out of the womb. ' I am a
stone walking about, a stone feels nothing.' She would avert her
eyes, looking without seeing, and imagining like a baby playing
hide and seek that she would not be seen either.
Nevertheless, her face that she has hated has become less fixed
and staring, her mouth less pouting and sulking, and she has
learned to smile as well as to become very sad, because she has
relinquished her exclusive living through others. She has become
alive and rebellious:
Why should I do what is expected? As long as I have a
beginning I can persevere. It's my turn now; it has never been
my turn. I have been crippled, and feel the pain of a crippled
child. When I am I , you can be you! I am detaching myself
inside myself. I want my own face which I don't know yet. I am

P—D
86 EVA SELIGMAN

growing up, and am experiencing and beginning to like my

body. I want to be me now.
Gradually, she started crying from her guts; for years she had
shed invisible tears. She explained; 'When I howl there is so much
inside me. I feel myself getting smaller and smaller, three years
old, and then only four weeks old, and then I begin to exist as me.'
She often now eats normally, no longer having to starve or to
gorge herself constantly, and to make herself sick, and no longer
feels constantly watched, assessed and judged. She is finding
herself and how to be alone without a sense of intolerable
rejection.
Douglas, my last case, is also atypical in being a man, and in
his sixties. He has come perilously close to death on several
occasions—accidents in which he seems to have had to test out his
own resources for survival to the ultimate point. He is still
alarmingly emaciated, and he used to sprawl on the chair as if he
had no body structure at all. He had been totally controlled by his
mother, the more so after his father had died when Douglas was
only three. Recently it has become noticeable that Douglas sits up
tall and becomes more of a person when an interpretation goes
home and reaches his core. Latterly he has had two crucial
dreams. In one he shouted, 1 have had enough of interfering
women!' He then 'forgot' to come for his subsequent session, in
spite of his over-meticulous time-keeping; his dependence/
rebellion conflict in relation to me as his mother had become too
much for him. Shortly afterwards he had a dream in which his
mother's hands were round his neck, and she had a stranglehold
on him from behind. He bit her and shouted, 'Let go of me!'
Attacks of uncontrollable vomiting have recently only occurred
when he goes out for a meal and eats in public; then he again feels
dependent and controlled, or guilty and anxious because of his
greed and extravagance, or else overcome by his frustration and
rage because the food or the service have not come up to scratch.
Attacks of migraine and dizziness, frequent at one time, have
become spasmodic. They have always been linked with his having
it too good, some achievement or success for himself which was
not of immediate benefit to his current mother figure, or with an
increasing sense of new-won freedom which frightened him. He is
now almost ready to terminate his analysis but scared to death of
A PSYCHOLOGICAL STUDY OF ANOREXIA NERVOSA 87

an ending which, in his case, actually coincides with the after­

noon of his life.
I will now summarize my main points. I had originally called
my paper 'Metamorphosis in reverse', because the transition
which will hopefully take place is not from the simple to the
complex, as in nature, but from the multi-faceted ostensibly
somatic syndrome to its basic, primary emotional constituents in
infancy.
With anorexic patients a distorted attitude towards, and an
abnormal preoccupation with, food is central to their lives and
constitutes a regression and fixation to an early oral level of
development. The nutritional function is used in an attempt
to solve or camouflage complex emotional and interpersonal
problems.
The triggering-off point for the subsequent syndrome appears
to be the mother's inappropriate response to her infant's needs
from birth into adulthood, and one must hypothesize that
unsatisfying feeding experiences occur together with continuing
distortions of communications on other levels. These factors lead
to a stunting or deformation of the ego structure, a distorted body
concept and arrested psychological growth. Because of these
defects, the patient's eating disorder constitutes a futile attempt
to be in control of his own life. The symptoms constitute a
pathological attempt at acquiring some identity and trying to
fulfil the insatiable craving for seemingly unobtainable love.
I have drawn attention to the uncanny degree of correspon­
dence between the subject and the object, i.e. between the patient's
fantasy image of herself as a powerful menacing breast/monster
and her experience and perception of her actual mother. A
mutual stranglehold situation results in which both the child and
the mother reject each other, while being indispensable to one
another, thus engendering murderous feelings in both. The
fathers in all my cases did not intervene or rescue the child.
Sibling rivalry is more than usually acute, the sibling of the
opposite sex always being perceived as the favourite child, and
the patient unsuccessfully endeavouring to demolish the rival, to
surpass him, or to turn into him by changing shape.
Psychosexual disturbances, other psychosomatic symptoms
and a preoccupation with death as well as the longing for a new
start are encountered. The anorexia patient attempts to become
88 EVA SELIGMAN

omnipotent and indestructible by over-eating, or else tries to do

a w a y with herself by starvation and shrinkage, i n the hope of
resurrection as the best loved. I f therapy fails, she w i l l eventually
die, but hopefully she will survive and evolve towards experi­
encing herself as a person to be cherished.

REFERENCES
B a r c a l , A . (1971). F a m i l y therapy in the treatment of anorexia nervosa.
American Journal of Psychiatry 128:3.
Eating Disorders and the Person Within.
B r u c h , H . (1974). London:
Routledge & K e g a n Paul.
Crisp, A . H . , Harding, B., & McGuiness, B. (1974). Anorexia nervosa—
psychoneurotic characteristics of parents: relationship to prognosis. A
quantitative study. Journal of Psychosomatic Research 18:3.
Galdston, R. (1974). Mind over matter: observations on 50 patients
hospitalised with anorexia nervosa. Journal of the American Academy
of Child Psychiatry 13:2.
Henderson, D. K . , & Gillespie, R. D. (1969). Textbook ofPsychiatry (10th
rev. ed.). Oxford: Oxford University Press.
L i e b m a n , R., Minuchin, S., & B a k e r , L . (1974). T h e role of the family i n
the treatment of anorexia nervosa. Journal of the American Academy
of Child Psychiatry 13:2.
Meier, C . A . (1963). Psycho-somatic medicine from the J u n g i a n point of
view. Journal of Analytical Psychology 8:2.
Plaut, A . (1959). Hungry patients. Journal ofAnalytical Psychology 4:2.
Rolandi, E . , Azzolini, A., & Barabino, A . (1973). Present possibilities of
neuroendocrinal study i n anorexia nervosa. Report of a clinical case.
Archives E. Maragliano, Pat. Clin. 29:1.
Schenck, K . , & Deegener, G . (1974). Therapy of anorexia nervosa.
Medizinische Welt, 25:24.
W i l k e , H - J . (1971). Problems i n heart neurosis. Journal of Analytical
Psychology 16:2.
CHAPTER FOUR

Object constancy or constant object?

Fred Plaut

In this iconoclastic chapter, Plaut challenges the mental health

values of both psychoanalysis and analytical psychology—object
constancy and individuation, respectively. He feels that there has
been an idealization of both of these concepts which excludes
other paths to psychological fulfilment, less sanctioned by
psychotherapeutic criteria.
Actually, Plaut points out, in analytical psychology a place has
been made for a valuing of the less than whole, less than perfect,
less than fully object-relating. Provided there is a cultural
context (often of a religious nature), then the shared dimension
brings in a qualitative change so that graffiti-like imagery has to
be understood as having an unconsciously sacral intent.
Plaut challenges the illusion that we ever 'master* our objects.
To some extent, then, he disputes the very idea ofpsychopathol-

F i r s t published i n The Journal of Analytical Psychology 20:2, i n 1975.

Published here by k i n d permission of the author and the Society of
A n a l y t i c a l Psychology.

89
90 FRED PLAUT

ogy. On the other hand, I do not think he wishes to be heard as

arguing for the mental health value of all schizoid phenomena.
A.S.

P
sychoanalytic theories of child development employ the
useful concept of object constancy, which forms a milestone
in the relations between the developing ego and its images,
technically referred to as objects. When for one reason or another
this milestone, which is also a formidable hurdle, has not been
passed, the crucial question arises whether the person can
nevertheless make progress towards a viable mode of living,
including stable relations with others. Some of the differences
between psychoanalytic theory and analytical psychology may be
semantic rather than fundamental: when it comes to the
application and aims of therapy, the similarities may well
outweigh the differences and incompatibilities of theory. There­
fore a mutually acceptable model of child development may well
emerge.
There is however one aspect in which analytical psychology
may claim a uniquely different orientation and point to an
alternative mode of development. I shall refer to this as the
constant object, in contrast to object constancy.
For the newly-born a need-satisfying union is established
between mouth and nipple (or teat of feeding bottle). To this must
be added a number of other sensory modalities, such as warmth,
skin contact, smell, surrounding arms and gazing eyes, all of
which create a secure situation required for satisfactory nourish­
ment and growth. An object-less phase of fusion has been
postulated to begin with, but some measure of differentiation
soon occurs. For example, the infant will notice that not every
feed and contact is equally satisfying, and he begins to
distinguish between good and bad experiences, which become
internalized (introjected) and charged with corresponding affect.
It is assumed that in the earliest stages the emerging ego is
unable to link good and bad experiences, to maintain a continuity
between opposite affects and also to associate these with one and
the same organ, the nipple, which is his first part object. Later on,
OBJECT CONSTANCY OR CONSTANT OBJECT? 91

when the manifold sensory impressions have coalesced, it is

possible for the infant not only to focus on the nipple but to
become aware of its connection with a whole body, a person and a
specific person: his mother. But, for the time being, good and bad
are experienced as totally disparate qualities without continuity,
functioning on an all-or-nothing principle, even if the oscillations
from one extreme to the other can occur quite rapidly. It is not
difficult to understand that such a division into opposite qualities
and affects comes naturally to an immature ego and that it
requires effort and pain to link the two. When for some reason the
growing infant or child cannot make this connection, we say that
an ego defence, splitting, has been called into operation. It looks
then—and this can happen right throughout life—as if opposite
experiences could not possibly stem from the same source. If the
source is thus perceived as divided, the T which responds
affectively is divided too. No division of objects, without division
of ego. Or, as Hartmann wrote, 'Satisfactory object relations can
only be assessed i f we also consider what it means in terms of ego
development (1964, p. 163).
The next developmental step comes about with the help of our
increasing capacity—given favourable environmental condi­
tions—to create continuity out of memories, which leads to a
dawning awareness of the inseparability (and relative unpredic­
tability) of good and bad feelings within ourselves and in relation
to objects. Thus a precariously balanced state of constancy is
established in the relation between ourselves and our objects. The
acceptance of this state of affairs presents a harsh reality because
it requires the surrender of a comforting illusion whereby every
experience could be made into a good one and all pain and
frustration counteracted and avoided by means of splitting. The
time of the first giving up of this illusion in return for object
constancy coincides with the Kleinian 'depressive position',
during which ambivalence and despair change into the ability to
feel sad. The reward, i f one may so call it, for the sacrificed
illusion of an only good (idealized) object is a reduction of anxiety.
For while the bad object was repressed it also became persecutory
in the unconscious, and, conversely, the ego retaliated with
punishing sadistic fantasies and subsequently expected similar
treatment from the split-off, bad object. Once object constancy has
been achieved, the good and bad aspects of one and the same
92 FRED PLAUT

object are no longer denied. A degree of fusion of characteristics

has come about and with it 'object constancy'.
It cannot be over-emphasized that this developmental attain­
ment is slow and remains permanently threatened by the impact
of extremely good or bad experiences at any age: regression to
splitting remains a lasting human propensity both in individuals
and in human groups. Jung recognized this when writing about
the dissociability of the psyche (CW 8, paras. 365-366) and the
child's struggle for an ego (CW 8, paras. 771-773). Within the
present frame of reference object constancy is seen as the
prerequisite of all human relations which are based on 'reality'
rather than on idealizations and projections. It results from the
ability to reconcile opposite qualities both within ourselves and i n
others.
The burden of this constant struggle is rewarded when the
outcome is 'the establishment of lasting emotional relationships'
(Jacobson, 1965, p. 63). But there exists an additional aid in the
form of an intermediate area in which the boundaries may be
blurred and where play, experiments and illusions have their
rightful place; it is the area which Winnicott referred to as
transitional-phenomena and -objects to which we have recourse
throughout life (1958, pp. 224-242). Art and religion are, from
the psychological point of view, the grown-up counterpart of the
child at play, a situation in which he is partly inside and partly
outside himself. (Here one may see an obvious parallel with
Jung's technique of active imagination.)
Let us suppose that despite varying terminologies and vested
interests in theories, the above represents a widely acceptable
although incomplete outline of intra-psychic development lead­
ing to desirable and satisfying relationships. The question
remains whether object constancy could also be attained in a
different way, and could indeed have a different meaning. Could a
part object, in the absence of a steady enough environment but
given suitable cultural conditions, find symbolical expression and
thus act as a focal point of reference and meeting place for people
of a similar cast of mind? And, if so, could this part-object-become­
cult-object lead to lasting relations between people, not primarily
because of the balance of good and bad feelings established in the
course of each individual's development, nor because of a
stabilizing social structure, like the family, but because of shared
OBJECT CONSTANCY OR CONSTANT OBJECT? 93

celebrations of a cult based, for example, on the mythical

elaboration of phenomena i n nature or events in history?
The answer to such questions could have far-reaching conse­
quences on psychotherapy, but it cannot be given in a sweeping
way. In order to reach a point of view, let us consider some illustra­
tions of part objects in Jung's work. Differently put, the question
is whether the development of object constancy is the only valid
stepping-stone to personal relations and individual development
or whether there are indications that alternatives have existed in
other cultures which are (under various guises) still with us
today.
Among the illustrations i n Jung's Symbole der Wandlung, 4th
and final edition (1950), which have been omitted from its
English translation as Symbols of Transformation (CW 5), there
are two in particular which I reproduce here as being relevant to
my theme.
Figure 3 appears in the text of the general chapter heading,
The hymn of creation'. Jung's footnote, which gives a reference to
the phallus worship here depicted, is affixed to a sentence in
which he states that religious experience in antiquity was
frequently conceived as a bodily union with the deity (1950, p.
113).
Figure 4 appears in the introduction to the second part of the
volume. Here Jung speaks of the creative deity and refers the
reader back to figure 4. (As both pictures have been omitted from
CW, the cross-reference cannot, of course, appear either.) He adds
that the phallus was thought of as independent, 'an idea that is
found not only in antiquity, but in the drawings of children and
artists of our own day'. This independence with which we are
sufficiently familiar through graffiti could simply be regarded as

P—D'
94 FRED PLAUT

FIGURE 4

expressions of infantile sexuality, were it not for the wings, which

are a striking feature of both illustrations.
Just as light is a standard symbolic device for depicting
awareness, so wings, when attached to a human or animal shape
(other than birds), are widely used to indicate the divine or
daemonic nature of a creature (Interestingly enough, our first
illustration is meant to convey worship, while the second is an
amulet or charm worn to avert evil.) Of course, light, especially in
the form of a shaft of light, lightning or a halo and wings, often
appears in combination, as we know from numerous mythological
or religious paintings that symbolize impregnation by a divinity.
The difference is that the wings in our illustrations are
attached not to a whole human figure, but to a part. Nevertheless
the reader familiar with Jung's interest in transformation of the
libido from lower instinctual to higher spiritual levels will also
remember the picture series that Jung used to illustrate his
Psychology of the Transference (CW 16). Figure 5 of that series
shows the king and queen having intercourse beneath the water.
In figure 5a entitled Termentatio', the alchemical analogy of a
psychological process, the queen is preventing intercourse, and
OBJECT CONSTANCY OR CONSTANT OBJECT? 95

both she and the king are now bewinged, indicating that a
'higher' development is on its way. The series ends, as will be
remembered, in the winged hermaphrodite, the new composite
and complete being. (Cf. CW 5, plate 38a, for an illustration of a
numinous but terrifying breast.)
I have previously drawn attention to the extraordinary
intensity with which part objects are experienced, and therefore
suggested that they are comparable to luminosities (Plaut, 1974).
Although we know that their brilliance and fascinating quality
stems from reflected light (projections which are re-introjected),
the part object is nevertheless perfect to the beholder. Such
perfection does not vary; it is constant for the devotee. I t differs
markedly from the completeness which, according to Jung, is an
attribute of the self archetype imposing surrender of ego power
and suffering. The encounter with the self therefore makes the
same demands on the individual as the surrender of omnipotence
when object constancy is realized. But whether he responds to the
luminosity of an apparently perfect object or to the demand for
tolerating the reality of complete rather than ideal relationships,
the individual's ego has to find an appropriate attitude towards
the 'master' whom he is going to serve. In either case he is forced
to abandon the illusion of mastery over his objects.
In the paper referred to I pointed out that although the
breast-penis is the first part object, i f no object constancy (in the
sense described above) develops, other objects may take the place
of earlier ones. Thus the miser is more or less possessed by his
money, the alcoholic by the bottle, the addict by the drug, the
artist by the medium in which he works and the religionist by the
deity he worships.
In the winged phallic images reproduced here we are, no doubt,
dealing with idolatry. Omnipotence has been surrendered but is,
in the form of endless creative power, attributed to the part
object. This is magic and from the theological point of view
heresy. But as psychologists we have to admit that in practice the
boundary between it and superstition on the one hand and the
worship of religious objects on the other is hard to define.
Wings and light are not the only symbolic devices by which the
unvarying (constant) power for good inherent in an object can be
portrayed. Several others spring to mind. Within the field of
^ visual representation we find various other images of part objects
96 FRED PLAUT

but in abstract form, such as the Lingam and Yoni statues of

India which are garlanded and worshipped. There is also the
ritualization of sex in the stylized and elaborate forms and
techniques of Tantra art. The power of the object is constant;
sexual organs are in constant tumescence, god and goddess in
constant copulation. The power is always for the good (but not
good in the sense of pleasurable; see Kali as slayer of man), but
for good in terms of renewal of the life cycle, an affirmative,
creative power.
The idea that the sexual act as such can be sacral is by no
means dead in our civilization, as the following quotation from an
important writer, Heinrich Boll, a Catholic, shows:
It is impossible for me to despise what is erroneously called
physical love; it is the substance of a sacrament... there is no
such thing as purely physical or purely spiritual love, both
contain an element of the other, even if only a small one. [Boll,
1962, p. 12, translated by the present author]
If for physical love we were to read union of sexual parts,
regardless of the personalities involved, we could not avoid the
comparison with a part object relationship. Such pre-object
constancy (promiscuous) encounters which do not lead to the
development of personal relationships are nevertheless credited
by Boll with spiritual potentialities. Jung refers to the frank
eroticism of the coitus pictures and almost apologizes to the
reader, whom he reminds that the pictures were drawn for
mediaeval eyes and that the analogy of this illustration is 'a little
too obvious for our modern taste, so that it almost fails of its
object' (CW 16, para. 460). Since he wrote these words nearly
thirty years ago, pornography has spread, and 'modern taste* is
used to even stronger meat. But one wonders whether the
capacity for understanding sexual symbolism, without which, as
Jung says, the sphere of the instinct becomes overloaded, has
grown at all. (The omission offigures3 and 4 from the Collected
Works edition may indicate that the editors or publishers had
little confidence in the readers' comprehension of symbolism.)
Be this as it may, the perfection with which part objects
(incomplete by definition) can be endowed seems characteristic
of specific life styles. Thus we find people who with single­
mindedness devote their lives to a deity, a muse, or an ideology.
We may therefore come to the conclusion that they have elected
OBJECT CONSTANCY OR CONSTANT OBJECT? 97

to serve a constantly good object. But the persons concerned may

prefer to describe the situation as having resulted from a call, a
vocation. At this juncture one could ask whether what I called the
constant object is identical with the Kleinian 'good internal
object* which 'forms the core of the ego and the infant's internal
world' (see Segal, 1964, p. 57). This question cannot be answered
by theorizing, but two practical points arise from the comparison:
i f the ego-core with its 'good internal object' were resilient
enough, there would be no reason why object constancy with all its
subsequent socializing benefits could not be attained. Secondly,
because 'good' means a great deal better than 'perfect' or
'idealized', are we able to supply such goodness and bring about a
fundamental change which did not happen at a critical phase of
development, by means of analytical endeavours? The answer to
such questions is of practical interest but must remain open. For
while it is all too easy for us to attach pathological labels to people
whose life is ruled by a constant object and who have not achieved
object constancy, clinical observations make me wonder whether
we do not idealize object constancy.
Whether we look at some individual's relations or the state of
our civilization there must surely be some doubt as to our
enduring capacity to combine 'good' and 'bad' feelings towards
one and the same object. The suffering involved is so frequently
expressed in disease and even violence that one may question
whether 'good' relations and the stability of our family-based
society can lay claim to being the standard model of mental
health. So what is pathological?
Jung writes in 'The stages of life': 'The meaning and purpose of
a problem seem to lie not in its solution but i n our working at it
incessantly' (CW 8, para. 771). What really matters is whether
analysts can keep an open mind towards patients whose capacity
to develop along the path of object constancy is severely limited.
Given some talent such patients may have for expressing their
devotion to a constantly good object, they may nevertheless lead
satisfying lives. For them the alternative, which I called the
constant object, may be therapeutic, as I outlined in my earlier
paper under the subheading, 'Devotion versus addiction' (Plaut,
1974).
Does this mean that individuation is out for such persons? In
order to arrive at an answer we have to consider briefly by what
98 FRED PLAUT

psychodynamic changes we move towards individuation. I f the

answer is that without object constancy there can be no ego
constancy, and that without a sufficiently coherent ego the
completeness required i n personal relationships cannot come
about, the conclusion is obviously negative. If, on the other hand,
we hold that acts of devotion to an apparently perfect object—in
whatever form it may appear—are i n themselves arduous and
demand the surrender of personal ambitions for the sake of a
common or ultimate good, then even a divided (pre-constant) ego
may be held together by a n apparently perfect (albeit) part object.
A life led under such auspices could potentially be rich and
fulfilling.
It is likely that this alternative path of development where
there is very little ego cohesion is charged with the dangers
of inflation, paranoia and depression. Yet it is of practical
importance to make allowance for this alternative path rather
than to insist that without object constancy there can be no
integration of the personality.
Analysts w i l l probably agree that combinations, compromises
and diurnal fluctuations between object constancy and constant
objects are more commonly found in practice than the word 'or' in
the title suggests. However, a theoretical standpoint is best
stated i n extremes. C l i n i c a l examples have been omitted here,
and considerable detail would be required to give flesh and blood
to the present outline. Words like 'perfection', 'completion' and
'wholeness' are large counters, and the small change of clinical
examples is required to illustrate their meaning.
O n the other hand the question which this paper poses
constitutes only one aspect of the still more fundamental problem
facing depth-psychology: to what extent and by what means can
we supply or make substitution for what was lacking or went
awry i n the history of a n individual's life? Being somewhat less
tied to a psychogenetic theory of neuroses and personality
disorders than psychoanalysis, analytical psychology is i n a
favourable position to show how the wider problem could be
broken down into smaller, more answerable questions.
To s u m up: Object constancy implies the ego's ability to
combine opposite qualities and affects in one object. Conceptually
this does not seem difficult. I n practice, however, the demands
thus made on the unfolding and even on the developed ego are so
OBJECT CONSTANCY OR CONSTANT OBJECT? 99

exacting that i t is regarded as impossible to fulfil the desiderata

of object constancy at all times and in all circumstances. Perhaps
we should take our limitations more to heart, in Eliot's phrase:
'Human kind cannot stand very much reality/ Therefore, a
relatively constant object, even if it is derived from, and bears the
hall-marks of, a part- as well as cult-object, is a valuable and
necessary standby. This can serve as a focal, concentrating point
for a personality that would otherwise be in danger of disintegra­
tion. Provided only that the ego does not become totally absorbed
by it, the constant object offers the person a viable alternative, a
chance to integrate around an alternative core.
A third factor which is not an inherent aspect of personal and
social relationships stands as a central point of reference outside
it: the constant object cannot be classified as either 'good' or 'bad'
in the Kleinian sense. It is fascinating and awe-inspiring—in
short, numinous. As such, it may be identical with Jung's self. If
so, my contribution does no more than highlight a specific way in
which the psyche may find a viable alternative form of
development which combines physical and spiritual qualities.

REFERENCES
Boll, H . (1962) Brief an einen jungen Katholiken. K o l n , B e r l i n :
Kiepenheur & Witsch.
Hartmann, H . (1964). Essays in Ego Psychology. London: Hogarth.
Jacobson, E . (1965). The Self and the Object World. London: Hogarth.
Jung, C. G . (1950). Symbole der Wandlung. Zurich: Rascher.
Plaut, A . (1974). 'Part-object relations and Jung's 'luminosities'. Journal
of Analytical Psychology 19:2.
Segal, H . (1964).Introduction to the Works of Melanie Klein. London:
Heinemann. [Reprinted 1988, London: K a r n a c Books.]
Winnicott, D. W. (1958). Through Paediatrics to Psychoanalysis. London:
Tavistock.
CHAPTER FIVE

Narcissistic disorder
and its treatment
Rushi Ledermann

This chapter is one of a series by Ledermann on the aetiology,

phenomenology and treatment of pathological narcissism. It
exemplifies the way in which sensitive application of psycho­
pathological understanding serves, rather than injures, an
approach to the patient as an individual For, as Ledermann
points out, the manifestation of apparent ego strength could
easily convince the clinician that she or he was confronted with
neurosis rather than with a serious personality disorder. If that
were to happen, then the well-thought-out understanding of the
analytic needs of such patients, as described by Ledermann,
would not take place.
Ledermann combines insights from psychoanalysis with the
developmental theories of Michael Fordham. From Jung, she
takes the notion of the inevitable presence in the unconscious of

F i r s t published i n The Journal ofAnalytical Psychology 27:4 in 1982,

Published here (with revisions) by kind permission of the author and t h e
Society of Analytical Psychology.

101
102 RUSHI LEDERMANN

something opposite to what is presented on the surface. It is this

conviction that enables her to hold on to hope in a fraught
situation, such hope being available for the patient to draw on
when he or she is ready.
Ledermann's technique is notable for the use in tandem of
interpretation and a flexible response to the patient, which
departs from a strict adherence to the ^rules'.
A.S.

Introduction

B
efore discussing the treatment of narcissistic disorder, I
shall outline my view of its nature, since I believe that
this syndrome differs from other personality disorders.
Some points I made in my previous papers on the subject will
recur. Psychoanalysts and analytical psychologists are well
known to disagree, in some respects, about the nature of nar­
cissistic disorder. Both consider it to be a disorder of the self, but
they work with different concepts of the self. According to the
Shorter Oxford English Dictionary (1944), narcissism is 'a morbid
self-love or self-admiration'. In fact, narcissistic disorder is the
inability truly to love and value oneself and hence the inability to
love another person. As I said in my previous papers, narcissistic
patients suffer from severe defects in their object relations, which
make them appear self-absorbed. They are fixated on an early
defence structure that springs into being in infancy—when, for
whatever reasons, there is a catastrophically bad fit between the
baby and the mother, frequently compounded by the lack of an
adequate father and by other inimical experiences in childhood.
Babies, thus deprived, grow into persons who lack trust in
other people. They replace mature dependence by spurious
pseudo-independence and delusions of omnipotence. They experi­
ence their lives as futile and empty, and their feelings as being
frozen or split off. In severe cases these patients feel themselves
outside the human ken and suffer from a terror of non-existing.
This terror and emptiness are frequently covered over by a
superficially smooth social adaptation, sometimes by feelings of
aloofness and superiority, at times even by grandiose ideas about
themselves.
NARCISSISTIC DISORDER AND ITS TREATMENT 103

In my previous papers I have discussed how Fordham's theory

of deintegration and of the earliest defences of the self in infancy
has helped me to understand the origin of narcissistic disorder. I
speculated that with such early defences the process of deintegra­
tipn is defective from the start. This leads to a badly formed ego,
in my view, which is an essential feature of narcissistic disorder. I
was interested to see that Kohut also speaks of self-nuclei not yet
stably cohesive in what he terms borderline patients (quoted in
Schwaber, 1979, p. 468). It is remarkable how close he comes to
Fordham's theory of ego formation, but it is beyond the scope of
this paper to elaborate this point.
A baby who, in phantasy, does away with the mother, has the
experience of, one might say, being himself baby and mother,
lonely and omnipotent. He does not expect any good to come from
the outside world and cannot put his trust into anything good
that even an unsatisfactory mother provides. Moreover, as he has
abolished his noxious mother in infancy, he sometimes feels as if
he had killed her. If his mother is incapable of being a mother to
him and appears to be impervious to his demands, or, if an inborn
defect in the baby makes it impossible for him to use her
motherliness, then the delusion that he is murderous gets
reinforced. Such a baby, of course, lacks the foundations of object
relations which are based on his relationship to his mother. It is
not surprising that such patients have enormous resistance
against relating to the analyst. I have further postulated that a
baby with stunted oral deintegration also suffers from patholo­
gical deintegration at the anal stage of development. Moreover,
deintegration at the anal stage is not object-related because he
has 'abolished' the object. The healthy mother of a healthy infant,
as i t were, detoxicates her baby's angry faeces that, in phantasy,
he expels into the part-object, the breast. The narcissistically
damaged baby has intense destructive impulses. But as he cannot
(in phantasy) discharge them into the mother, he expels them
into what he experiences as nothingness or outer space. There
they are uncontained, undetoxicated, and they become enor­
mously threatening. This, it would appear, is why narcissistic
patients feel so bad and so persecuted and at the same time deny
their personal hate. This unrelated aspect of the anal phase
reinforces the experience of the stunted oral phase: that of arid
power.
104 RUSHI LEDERMANN

Clinical manifestations
A description now follows of the main clinical manifestations of
narcissistic disorder; I shall divide it and discuss i t in six sections.
Needless to say, these divisions are interconnected and overlap­
ping, hence somewhat artificial. Some of the material appeared in
my previous papers in a different context. The six sections are:
1. the barrier against the analyst; power in place of eros;
2. the negative non-humanized archetypal experience of the
analyst;
3. an insistence on turning the clock back;
4. massive splitting defences against disintegration;
5. difficulty in symbolizing;
6. pathological defences of a deformed ego.
Some or even all of the first five features may be manifest also
in other personality or borderline disorders. It is the sixth
feature—the way in which a narcissistic patient forms and
defends a pathological, at times quite strong, ego—that gives
narcissistic disorder its specific character.

1. The barrier
Narcissistic patients tend to experience relationships in terms of
power only. Mrs B, a patient whose psychopathology was also
discussed in my previous papers, was haunted for years by a
gruesome vivid dream; i t illustrates the terrible sado-masochistic
situation in infancy which she relived in the transference.
There was a very weak man who was attached to, and totally
dependent on, a big cruel sadistic man. The big man wanted to
destroy the weak man. He gouged his own eyes out and
extracted his teeth, so as to induce the weak man to do the
same. Despite these destructive actions the big man became
increasingly strong and the weak man increasingly weak until
he waned away.
This dream also indicated that Mrs B imagined her psychotic
mother 'feeding' on her when she was a totally helpless baby. This
NARCISSISTIC DISORDER AND ITS TREATMENT 105

gravely weakened the baby but made the mother stronger and at
the same time increasingly self-destructive, like the man in the
dream, until she had to be taken into a mental hospital in a
strait-jacket. I felt in the countertransference that her libidinal
attachment to me and her murderous impulses against me had
not separated out. In severe cases patients see the analytic
situation as an issue of killing or being killed, because they have
the phantasy that they have abolished their mother and that
their mother has demolished their existence as a person. Hence
they put up a barrier against the analyst, all the more, as
'feeds' (sessions) with him are experienced like those of the
noxious infancy mother. The more severe the disorder is, the
more difficult it is for the therapist to penetrate this barrier. It is
as if these patients came to sessions with a big poster in front of
them saying KEEP OUT. Yet it is remarkable that none of them
ever stopped coming.
In the early years of therapy those patients could not relate to
me either with love or hate. Mrs B pulled her cardigan over her
head in almost every session and kept her eyes averted from me
for months. At times she was gasping for breath and terrified that
she would suffocate if she breathed the air in my consulting room.
She seemed either to experience the air as an extension of the
noxious analyst/mother, or tofleein phantasy into an impersonal
airless womb. As I mentioned in a previous paper (Ledermann,
1979), she said to me for months, like a gramophone needle stuck
in a groove: 'You are a stupid useless monster and if you don't
help me I shall kill you and then myself.' This was said with icy
detachment and despair.
Less severely ill narcissistic patients talk about the abyss or
the unbridgeable gap between them and me. Another patient
expressed the narcissistic barrier and the fear of his murderous
impulses by a severe stammer. He also had breathing problems,
as i f he, too, retreated into the inside of an archetypal mother.
These breathing difficulties contributed significantly to his
stammer. Even a much less severely disturbed narcissistic
patient cut herself off from me. When I referred to the couch as an
extension of the analyst's body, she said: The couch has nothing
to do with you; i t is my couch and the rug is my rug.' She could not
'feed' in my presence with her eyes, with her ears or with her
tactile senses. After two years of analysis she still claimed that
106 RUSHI LEDERMANN

she had no idea what my hall or my consulting room looked like,

nor what I wore. Whenever I made an intervention, she gave the
impression that she had not heard it. When I commented on this,
she said: *I put it in my pocket and use i t at home when I am by
myself/ It is interesting that, as a child, she stole food from the
larder although there was plenty to eat at mealtimes. She also
resisted the tactile experience of the couch and experienced
herself as suspended a quarter of an inch above it. She frequently
seemed to escape from me into the inside of an impersonal
mother. In her outside life she could not understand why, when
shopping, she frequently had to hurry home suddenly for no
apparent reason. We understood this as her flight back into an
archetypal womb.
Some patients dare not use the couch at all and want to be
barricaded in the armchair, which becomes their fortress. Others
experience the couch as their impenetrable castle, with me on the
other side of the moat. Both, whether called fortress or castle,
seem to represent the archetypal mother into whose inside they
retreat. When such patients feel the slightest danger of becoming
more intimate with me, they panic and in phantasy send me
flying to the other end of my consulting room. This barrier is also
expressed by images in patients' dreams: the patient is locked in a
castle, or in a room with all the shutters down. All these patients
complain about feeling 'dead'. In my previous paper there was a
reproduction of the gruesome picture of a 'dead thing' drawn by
Mrs B (Ledermann, 1979). It had no mouth, ears, hands or feet to
connect with the analyst. The patient with the severe stammer
frequently pointed to his abdomen and said that he had a dead
baby inside him, hence found it difficult to relate to me. He was
told by his mother that, as a baby, he used to nestle in the hollow
of her shoulder instead of feeding at her breast. Another patient
had felt as an infant that she could not expel her anger into her
mother. This made her imagine that her faeces were deadly
dangerous. She re-lived this experience in the transference. For
quite some time, an hour or so before setting out for the session,
she had violent abdominal pains and had to defecate several
times before she could risk the journey to me. In this session,
whenever an angry feeling threatened to come up, she fled to my
lavatory to deposit her 'anger' by defecating. She felt that she
could not put her anger into the 'analytic breast'. She also held
NARCISSISTIC DISORDER AND ITS TREATMENT 107

back her tears of anger and grief for years, and could only cry at
home when nobody was present. Mrs B was also unable to cry in
the analysis for several years.
Another manifestation of the barrier is that narcissistic
patients frequently experience the analyst as non-existent, like
the abolished mother of their infancy. It would appear that a baby
that denies the existence of his mother's body feels as if he,
himself, also had no body. This is repeated in the transference.
The patient feels disembodied, and I become a 'mother-hole', 'a
shadowy outline without a body', as one patient put it, or
'animated clothes walking around', as another patient said.
Furthermore, I wondered whether a baby that has been unable to
latch on to the mother lacks the experience of being moored and of
having gravity, because two of my patients had the terrifying
experience of floating in space forever, unable to land. The
borderline patient experienced separation from me as i f I had
'snipped the string, and she was a balloon floating away into
nothingness'. Similarly, the patient with the stammer said, 1
have a balloon in my abdomen. I try to keep it moored to the
couch as otherwise I would float away and disappear forever.'
Although these are, of course, phantasies, they are pre-symbolic
and have an almost delusional quality for some patients.

2 . Non-humanized archetypal experiences

The second feature of narcissistic disorder is the failure of the
mother to humanize her baby's archetypal experience of her. As is
known, the baby has inborn potential for archetypal Great
Mother images. In health, the images both of the good mother and
his archaic love for her and of the devouring witch-mother and his
murderous feelings towards her become humanized, mediated
and modified by the actual mother who is loved and wanted by
her baby and, on the whole, satisfies his needs. When the mother
is not able to do this for her baby, hefindshimself in the hopeless
situation of feeling emotionally threatened and flooded by
archetypal images, in particular that of the devouring witch­
mother. One patient, when a young nun, was terrified of going
into the Reverend Mother's room because she imagined that her
cupboards were full of half-eaten nuns. Similarly, the patient who
had to defecate before she came to the session told me that,
108 RUSHI LEDERMANN

whenever she experienced me as gentle and motherly, an

experience she longed for, she simultaneously felt as i f she were
being pushed into shark-infested water. The terror of being
gobbled up can, of course, be seen as a reversal of the baby's
unconscious phantasy of scooping out the mother. In narcissistic
patients it also seems to relate to the memory of early childhood
when the patient felt as if both parents devoured him in that they
did not allow him to exist in his own right. *I was not allowed
me-ness', one patient said.
In the transference I frequently become the witch-mother who
lures the patient into her dark evil realm. Sometimes these
terrors are displaced on to a copy of a Cezanne landscape that
hangs above the analytic couch. It becomes populated by evil
monsters and black sinister witch-like creatures or huge black
bottoms that represent faecal breasts. Thus the present analytic
situation, like the original environment in infancy, is experi­
enced by patients as non-human and persecutory; pain and terror
of their non-modulated destructive impulses reign supreme.
Needless to say, they do not experience the analytic situation only
as bad and dangerous; otherwise they would not come with great
regularity and persistence. But the good experience is denied for
a long time.

3. Putting the clock back

This brings me to my third point, the patient's unconscious wish
magically to turn the clock back and be a baby, with the analyst
as his ideal infancy mother. Because narcissistic patients'
experience of the analyst as the devouring witch-mother goes
hand-in-hand with a desperate yearning for the archetypal
all-good mother, they hate the analyst for not fulfilling this
longing. Together with the longing goes a strong impulse to set
up the original bad situation of infancy so as to blame and punish
the analyst for it. The narcissistic patient has felt bad—in serious
cases, bad beyond redemption—throughout his life. He has the
almost delusional belief that he could only feel good i f he could
demonstrate to himself and to the analyst that it is the analyst
who is bad. This would prove to the patient that it was the mother
who was bad and not he, the baby. This is how the patient's
argument seems to go: if I set up the infancy situation, then I , the
NARCISSISTIC DISORDER AND ITS TREATMENT 109

good patient/baby, suffer under the bad analyst/mother who

leaves me for twenty-three hours every day and for weekends and
holidays. Hence it is evident that the analyst/mother is hard,
uncaring and unreliable, and I am able to believe, for the first
time in my life, that I am good. Moreover, I can punish my mother
by making her feel thoroughly bad and useless, as I have always
wanted to do (a 'useless stupid monster').
The argument continues: when I have succeeded in making the
analyst/mother feel bad, then I can make her feel guilty and
remorseful about what she had done to me. This will make her
wish to repair the damage by doing everything I want her to do. It
makes patients believe that they can only get better if they put
the clock back or 'rewrite history so as to give it a happy ending',
as one patient put it. Such patients often set up this sado­
masochistic situation also in their outside life. Two of the patients
mentioned were married women. In the early stages of their
analysis they experienced themselves as the victims of their
husbands, whom, like the analyst, they considered to be bad
and cruel. Both patients believed that they must leave their
husbands, as they could not stand their marriages any longer.

4. Splitting defences
The fourth characteristic of narcissistic disorder is the collection
of massive splitting defences that such patients develop, so as to
ward off disintegration. These defences now operate in the
transference. This is well illustrated by the following childhood
incident which a patient reported. As a little girl one day she
threw her favourite china doll high up into the air in the presence
of her family. The doll of course was shattered to pieces, and the
patient was inconsolable. Everyone, including the patient, was
bewildered by this inexplicable action. In the analysis we came to
understand that the doll represented her brittle self and that she
had desperately wanted proof that her family could save her from
disintegration by catching the doll. By telling me this story she
expressed her fear as to whether I should be able to save her from
shattering. Many narcissistic patients feel hollow and empty, and
they frequently compare themselves with wooden Russian doll
toys. The experience of hollowness, in my view, is due to the fact
that they have split off and denied their basic feelings and drives.
110 RUSHI LEDERMANN

In infancy they seem to have only minimally related to objects

with love, hate, greed, rage, jealousy, envy and the need to
depend. Hence their elemental impulses are unintegrated, and
their inner world feels devoid of healthy objects. They fear that
they might 'collapse like a house of cards', as one patient put it.
The absence of internal objects also contributes to the feeling
that they have no body, as mentioned earlier. They feel
two-dimensional. Alternatively, such patients feel that they have
bizarre, freakish objects inside them: their grossly defective
relationship to the breast was of a bizarre nature. Hence they
sometimes experience themselves as a 'gargoylish monster' or as
a 'diluvian monster full of warts trampling about mindlessly', as
one patient described herself.
Alongside the denial of the patient's own feelings goes the
denial of the analyst's good feelings. This further contributes to
the experience that the analyst, when not felt to be downright
bad, is experienced as cold and indifferent; the session is a
business transaction for the purpose of making money. The
analyst's good intentions are denied or, if acknowledged, deemed
to be utterly useless.

5. Difficulty in symbolizing
The fifth facet of narcissistic disorder is the patient's very limited
ability to symbolize. As I said, narcissistic patients could not
internalize their primary object and their impulses towards i t in
infancy. Owing to this disability they appear, for a long time, to
be unable to internalize the symbolic maternal care of the
analyst. Even when a patient gradually lets go of his defences and
develops some trust and good feelings for me, for a long time he
lacks the capacity to 'keep me alive' when he leaves the session.
Moreover, the patient has to deny the analyst's existence when
away from him because he is too terrified of his impulse to destroy
him when he is not reassured by the analyst's living presence.
Also, for a long time the patient is convinced that he needs a
mother and not an analyst. Thus he is outraged that the analyst
is not always present when he wants him. In severe cases, the
patient finds the hours away from the analyst painful, dehuman­
izing and terrifying. 'When you leave me you force me back into
NARCISSISTIC DISORDER AND ITS TREATMENT 111

a living death', Mrs B used to say for years. I think this accounts
for the narcissistic patient's adhesion to the analyst. I use the
term adhesion to denote clinging in place of depending.

6. Pathological defences of a deformed ego

Finally I come to my sixth point: pathological ego defences.
Patients suffering from non-narcissistic personality disorders
frequently have a weak ego. The ego of narcissistic patients has a
certain strength in the way it manipulates and controls the
outside world; but it feels located in the head and is a highly
pathological ego (see Ledermann, 1981). With this deformed ego
such persons often make a superficially good adaptation to the
outside world, but, of course, they cannot enter into real
relationships with people. A pathological ego tends to produce
pathological defences in childhood and adolescence, superimposed
on the pre-ego defence of the primal self in infancy. These
defences can manifest themselves in a stammer (or at least
contribute to the formation of this symptom) or in a work block
(defence against feeding). They can lead to grandiose ideas about
themselves—two of my patients initially considered themselves
to be geniuses. Or the defences can take the form of exaggerated
social compliance. Some narcissistic patients express this particu­
lar pathological ego defence by exaggerated striving in social and
work situations as a defence against a strong desire to drop out
altogether. Two such patients defended their deformed egos in
childhood by creating an unfeeling, computerized robot personal­
ity which I have discussed in another paper (ibid.). With this
robot, one of these patients achieved good adaptation to the
outside world. Another patient, when she left home in adoles­
cence, changed from being a sulky, messy, awkward, badly
performing child into a witty, entertaining, highly efficient
young girl. She even changed her name at that time, so as to
leave the hated child behind for good. In the analysis she
recognized that i t was essential for her to make contact with the
discarded miserable child, as this was a vital part of her real self.
As mentioned before, these typical narcissistic defences, protect­
ing a specifically deformed ego, differentiate narcissistic disorder
from other serious personality disorders.
112 KUSHI LEDERMANN

Ovid's myth of Narcissus

Various authors who have written about narcissistic disorder
have used this term because of the many parallels with the myth
of Narcissus as related by Ovid in his third book of Metamor­
phosis. Jung stressed the fact that myths can be helpful guides
in analytical treatment as they express deep universal and eter­
nal truths about men; also, the parallel between the myth of
Narcissus and clinical manifestations that I observed in narcis­
sistic disorder emphasizes that this disorder has an archetypal
dimension. Gordon also drew attention to this myth in one of her
papers on narcissism (1980). I am indebted to the psychoanalyst,
Padel, who has pointed out some inaccuracies in my presentation
and interpretation of the myth in a previous version of this paper
(1988, pp. 164-165).
I now present a new version of these parallels. (I am
paraphrasing F. J. Miller's translation of the Latin text.)
'Narcissus had reached his sixteenth year. ... Many youths and
many maidens sought his love; but in this slender form was pride
so cold that no youth, no maiden touched his heart.' This relates to
the spurious pseudo-independence and the delusions of omnipo­
tence in narcissistic patients which I mentioned. Narcissus calls
to the nymph Echo: 'come ... here let us meet', and Echo 'comes
forth from the woods that she may throw her arms around the
neck she longs to clasp. But he flees at her approach and fleeing,
says: "Hands off! Embrace me not! May I die before I give you
power o'er me!'" Thus spurned, she withdraws into the woods and
'lives from that time on in lonely caves.' As I have pointed out, the
essence of the plight of the narcissistic patient is that he has
enormous fear of and resistance against letting himself depend on
anybody, which includes the analyst. I have shown in my clinical
material that narcissistic patients, from infancy onwards, have
displaced depending and relating—that is, eros—by a striving for
power and control (unrelated anality). This is so because
depending means a partial abdication of power; the needed person
has power over the needy one, and in infancy this proved to be
disastrous. Hence, like Narcissus, the narcissistic patient feels
that he would rather die than give the analyst power by
depending on him.
Later on, the myth tells us that, so as to punish Narcissus for
mocking nymphs and men, one of the scorned youths cries out 'So
NARCISSISTIC DISORDER AND ITS TREATMENT 113
may he himself love, and not gain the thing he loves!' We know
that as Narcissus lies down by the pool, 'he is smitten by the sight
of the beautiful form he sees [his own reflection in the pool]. He
loves a hope without substance; he believes a substance is there
which is only a shadow/ Although the myth calls it 'love', this
kind of love clearly relates to the narcissistic patient's morbid
self-absorption and self-aggrandisement, which look deceptively
like self-love. One could say that, like Narcissus, he 'loves a hope
without substance; he believes a substance is there which is only
a shadow/ Equally, the narcissistic patient feels disembodied,
because, like Narcissus, he tries to mirror himself instead of
being mirrored by the mother/analyst in the way I described. This
special mirroring is an essential prerequisite for residing in one's
body.
In the myth Narcissus pines away. Narcissistic patients speak
of their terror of non-existing, of being in a 'living death'. One
patient described herself as belonging to the 'undead dead';
psychologically such patients pine away unless they get help. It is
interesting that Narcissus' parents already foreshadow an
important aspect of the narcissistic problem: power in place of
eros and relatedness. His father, 'the river-god Cephisus,
embraced the Nymph Liriope and ravished her while she was
imprisoned in his stream.' The issue of this rape was the child
Narcissus. The seer Tiresias, when asked whether this child
would reach well-ripened age, replied 'If he ne'er know himself/
The narcissistic patient thinks that he knows himself and that he
does not need the mother—analyst to help him to discover his real
self. Only if he can be enabled to give up this delusion can he,
with the help of therapy, hope for real and meaningful living.

Treatment
I hope that I have described my view of the nature of narcissis­
tic disorder sufficiently to demonstrate in what way treatment of
this disorder differs from that of ordinary neurosis. In my
experience the treatment of narcissistic disorder does not differ
basically from the treatment of any serious personality disorder.
But as narcissistic patients have a distorted ego and frequently
have such strong, albeit pathological, ego defences, there is a
114 RUSHX LEDERMANN

great danger that the nature of the disorder is not recognized and
that the patient is treated as i f he suffered from a neurosis.
To simplify the exposition I shall describe therapy as falling
into two phases; as the two phases overlap, however, we are
concerned more with an emphasis than with a strict division.
The first phase, which in severe cases may last for several
years, has similarities with the treatment of any serious
personality disorder. As narcissistic patients have minimal trust,
the basic aim in this phase is to create an empathic warm
analytic environment in which trust can grow. Moreover, the
purpose of this containing environment is to enable the patient to
continue the deintegrative processes that were so badly impeded
in his infancy. As Fordham says: The patient's self must become
active' (1980, p. 315). Since the narcissistically unsatisfied baby
scarcely gets into the relation with his mother that would be
essential for healthy deintegration, libidinal and destructive
impulses appear to remain fused. They exist as potentials inside
the baby's primary self. This is reminiscent of Freud's concept of
primary narcissism, of which Fordham reminds us in his paper
'Primary self, primary narcissism and related concepts' (1971).
According to Freud, it is a state in which libidinal and aggressive
energies are not yet defused. In Jungian terms, these instincts
exist as archetypal potentials in the primary self but have not
become active in the baby's relationship with the mother. Hence
such patients have large areas of the primal self not yet
deintegrated. Their deintegrative processes are severely stunted.
To help the patient to defuse his libidinal and aggressive
impulses by bringing him into relation with the analyst in the
transference seems to be the first task in treatment. This will
gradually lead to a state when the patient can relinquish
unrelated power and by relating to the analyst can form healthy
internal objects. To achieve this he must be helped to recognize
his extremely destructive power which he dreads and denies yet
which is instrumental in making him feel desolate, unanchored
and unlovable. This recognition also eventually releases his
loving feelings for the analyst. Furthermore, the analytic
environment must provide the integrative function that the
patient so badly lacks; the glue, as i t were, to join together the
deintegrates—or, as Gordon says, 'the links between the various
internal objects' (1980). This will gradually change his deformed
NARCISSISTIC DISORDER AND ITS TREATMENT 115

ego into a healthier one. I t will also slowly transform his

pathological ego defences, his 'survival kit', as one patient called
it, such as the robot, the false fagade, or the grandiose ideas, into
healthy ego defences. It will enable the patient eventually to
experience in the transference the impulses of which he has been
terrified all his life and that he has encapsulated, split off, frozen
and denied.
The analyst must remain in a state of syntonic countertrans­
ference, using Fordham's term, and at the unconscious level,
whenever possible, feel alongside the patient. This could be seen
as mirroring the patient. However, it differs from Kohut's concept
of the mirroring transference (1971) defined as the 'therapeutic
reactivation of the grandiose self. I do not fully agree with
Kohut's view, but to elaborate this point goes beyond the scope of
this paper. Mirroring, in Winnicott's sense, means 'a long-term
giving the patient back what he brings' (1971, p. 117). Although
this is essential for the narcissistic patient, it is not sufficient.
The analyst needs to detoxicate the patient's predominantly bad
feelings, cut them down to size and give them back to him in a
form that he can handle; furthermore, as Meltzer puts it, the
analyst must 'modulate the patient's mental pain' (1981, p. 181).
The syntonic countertransference may encourage in the
patient a feeling of merging with the analyst, which, again,
somewhat relates to what Kohut says when he speaks of the
narcissistic patient merging with the self-object. His view, like
Neumann's, is that the neonate is without a self, and that the
baby's self develops through interaction with various self-objects
(Kohut & Wolf, 1978). Here I agree with Fordham's view that the
baby does not experience his mother as self-object for any length
of time but gets into relation with her (1971; 1980). Likewise, a
patient needs to be helped not to experience the analyst as a
self-object; on the contrary, he urgently needs to develop object
relations to the analyst.
It is true that some patients experience me as if I were part of
them: initially they are in a state of adhesion instead of
dependence. However, I have come to see this adhesion as a
pathological defence, namely their imagined safeguard against
destroying me with their elemental infantile 'pre-ruth* love and
hate. ' I f the therapist is not a separate person, I can neither
gobble him up nor kill him', so their argument goes. Obviously
116 RUSHI LEDERMANN

one needs to work through this defence and not collude with it.
The resulting prolonged syntonic countertransference may raise
hopes in the patient that the analyst will become his infancy
mother. Hence for a long time many patients consider me as
thoroughly bad (1) because I am not always there when they want
me to be, (2) because I have no physical or sexual relationship
with them. What they really mean, of course, is a concrete
relationship with the infancy mother's body, not adult sex. These
apparent failures of the analyst contribute to the phenomenon of
the barrier that I have described and to the patient's feeling of
hopelessness. Another difference from ordinary analytic practice
is this: whereas a neurotic patient may feel strengthened by
being confronted with his denied or repressed aspects, the
narcissistic patient should, to begin with, only gently be made
aware of his split-off, denied impulses. His resistance and his
defences should be interpreted only gradually. For quite some
time the patient needs to feel resistance and pain as an
alternative to feeling nothing. Schwaber, in her paper On the self
(

within the matrix of analytic theory' (1979) quotes the psy­

choanalyst Gedo who also makes the points: (1) that the patient
prefers his pain to the experience of nothingness, and (2) that in
resisting help the patient feels more real. He puts it succinctly:
Nego, ergo sum—I resist, therefore I am (Gedo, 1975). This seems
to be the adult equivalent of the baby's resisting the mother for
the sake of survival, hence confirming Fordham's theory of the
defences of the self (1976, p. 91). For a very long time in such
cases the analyst must tolerate the patient's negative therapeutic
reaction, like being called a useless stupid monster. Schafer in his
paper The idea of resistance' also notes: 'unless we identify also
the affirmations implied by apparently negative behaviour we
are committed to using the idea of resistance pejoratively' (1973).
When one begins to interpret, one should do so only
reconstructively. The patient must for some time be held in his
delusional transference and be allowed to see his bad bits in the
analyst. The importance of refraining from premature interpreta­
tions of the patient's denied impulses and of his bad bits was
brought home to me many years ago: a narcissistic patient had
persistently warded off my interpretations by saying, Tou are
like a bloody Spitfire, te, te, te, te, shooting your interpretations
at me. I am longing, one day, to vomit all your breast muck on to
NARCISSISTIC DISORDER AND ITS TREATMENT 117

the tiles of yourfireplace*.He had been stuck for some time, and
when I stopped interpreting he began to progress. Also, I learnt
from Mrs B that when I interpreted these denied impulses too
soon, she returned into a state of icy isolation.
Instead of confronting the patient it is essential to give him
repeatedly, and over a long time, insight into the genetic roots of
his present experiences. Again Schwaber, in the paper mentioned
(1979), came to the same conclusion. She says, 'One must always
analyse from past into present'. Such genetic interpretations are
essential as they help the patient to feel understood and
gradually lead him to understand himself, as he is bewildered by
his inability to use the analyst.
Another important principle in the first phase of treatment
consists in not confronting the patient with reasonableness or
reality, as he does not live in the real external world. Similar
findings have been reported by Kohut (1978, p. 423) and by
Schwaber (1979). For example, when I go on holiday a patient
must be allowed to be in a delusional transference. Mrs B said for
a long time on such occasions: Tou are sticking a knife into me;
you go on holiday because you think I am rubbish and because
you enjoy torturing me'. Even in a situation where a patient has
to miss sessions for reasons of his own he will, like a young child,
blame the analyst for not being there. This must be sympatheti­
cally understood and not analysed away, so to speak, by stressing
the reality of the situation. Moreover, as I have explained,
blaming the analyst is also intended to make him feel bad so that
the patient can feel good. The therapist must be able to receive
the patient's bad feelings lovingly. For a long time bad feelings
are predominant. The patient loathes to acknowledge any good in
himself and in the therapist. When he has a good experience he
takes fright and withdraws: he thinks that, like in his infancy,
good milk always turns sour. Indeed, with a part of himself he
makes the analytic experience turn sour so as to reconstitute the
familiar situation.
It is important that the analyst always greets the patient with
warmth and openness, irrespective of what had occurred in the
preceding session. This loving acceptance, I think, corresponds to
Kohut's idea that the narcissistic patient needs to see the gleam
in the analyst's eye; the gleam that he, as a baby, did not see in
his mother's eye. I only partly agree with this: a patient does not

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118 RUSHI LEDERMANN

benefit from praise or reassurance, but from affirmation,

recognition and acceptance of his good and bad aspects. I should
add, moreover, that the narcissistic patient initially also needs to
see the beam in the analyst's eye, namely, the projection of the
patient's own unacceptable impulses. This creates painful coun­
tertransference feelings that have to be endured. The wish to
ward them off by interpretations must be resisted. However, to
understand what the patient is doing makes the countertransfer­
ence more bearable.
The analyst knows Jung's theory of opposites: the patient must
also have some love, hope and trust hidden away somewhere, and
this needs to be communicated to him. It makes the patient's
often prolonged hopelessness more tolerable both for analyst and
for patient. Moreover, the analyst must enable the patient to feel
that his bad feelings also have value if he learns to handle them.
Indeed, it is to be considered a therapeutic achievement when the
patient finally reaches his personal hate for the analyst. On the
other hand, whenever the analyst perceives a glimmer of trust or
of a loving feeling in the patient, he needs to point this out to him.
It gives the patient the hope that, after all, he is not all bad. A
third important aspect in the first phase of treatment is that, as
justice needs to be seen to be done, so does the analyst's loving
care need to be seen to be done. By this I mean that the analyst
must, in severe cases, be willing to make considerable sacrifices:
for example, curtail holidays and be prepared to offer weekend
sessions. He must be available on the telephone, in extreme cases
even at night, although narcissistic patients seem to abolish the
analyst to such an extent that it is usually impossible for them to
telephone when in distress. Furthermore, I found that in the
early stages narcissistic patients are unable to make demands as
they dread the enormity of their greed. Whereas ordinary
patients gain by being enabled to handle frustration, narcissistic
patients must not be expected to cope with more than minimal
frustration in the first phase of treatment.
I think that, occasionally, there are times when the patient
needs to be given a token: a symbolic equivalent of a feed, to use
Hanna Segal's term; e.g. a drink, as Frieda Fordham (1964)
pointed out, or a cushion to take home. I do not consider this
therapeutic in itself, but it can be seen as a 'rescue operation'
when the patient feels flooded by a fear of going mad and is in
NARCISSISTIC DISORDER AND ITS TREATMENT 119

utter despair. At the same time the analyst must give an

explanation of this action to the adult part of the patient. Some
patients are creatively finding what they need, not unlike a baby
that finds a transitional object. When Mrs B had reached the
stage when she could ask for something, she brought a packet of
sweets to the session. She asked me henceforth to give her one of
them at the end of each session to take home so that she could
remind herself in the evening that I go on existing for her.
Although she had had this idea and she brought the sweets, I was
to give them to her. This is also the beginning of symbolizing, the
'as i f or 'let's pretend' stage of the child. For a long time such a
patient will attack the analyst with his insistence that he can
only get better if the clock is turned back. This causes great strain
on the analyst's capacity to handle his countertransference hate
and at times his exasperation.
I fully agree with Kernberg who says (in his book, Borderline
Conditions and Pathological Narcissism, 1975) that seriously
damaged narcissistic patients require a therapist 'with a true
capacity for object relations and a great deal of security in
himself. He needs to be non-self-centred and self-accepting and
must be in control of his hostility. Unresolved narcissistic
problems in the analyst are an unfavourable prognostic element
for the treatment of such patients' (Kernberg, 1975). This may be
a somewhat idealized picture of a therapist, but it is important to
strive towards it. With such patients the therapist must be a real
person and, occasionally, step out of his analytic shoes. By this I
do not mean that the analyst should ever show his anger or make
personal confessions. This would burden and not relieve the
patient, as he desperately needs a calm, unruffled therapist who
does not get alarmed or anxious on account of the patient. What I
mean by the analyst being a real person is shown in the following
example: Mrs B had a psychotic mother who had never cooked a
proper meal for her as a child. At times Mrs B found i t impossible
to cook for her family; she had an overpowering yearning to be
the child for whom the mother should make the meals. After she
had come to see why she had this problem, we used two sessions to
make menus for a week, and she wrote all the dishes down. Since
then she has felt that at home the analyst/mother is inside her to
help her with the cooking, and she has not reported any more
difficulties with it. On another occasion she brought her guitar
120 RUSHI LEDERMANN

and overcame her extreme nervousness by playing it. Since that

occasion she has derived pleasure and solace from this activity.
As a narcissistic patient's relationships to people are so
defective, I think that such patients sometimes need help to find
pathways for emotional communications. One of my patients
persistently complained that she could feel neither anger nor
hate for me, yet we both knew that these feelings were 'some
place inside her*, as she put it. She could not find them. At this
point, after about four years of treatment, she made a creative
suggestion which again had an element of a transitional
phenomenon. She said that she could never express her despair­
ing anger as she imagined that I , like her mother, would not hear
it. She needed to make a big noise, like a hammer on an anvil. It
occurred to me that I had an old anvil and a hammer in my
garage. At this stage I had enough trust in her to know that she
would not smash up my room, although she had occasionally
expressed the wish to do so. She brought a tin for baking buns to
the next session and set about flattening the breast-like shapes of
her t i n with my hammer on my anvil. She made a deafening
noise. This continued through several sessions, until finally the
cast-iron anvil broke in two under her violent blows. It helped her
to have found this pathway for her anger and to test out whether I
would accept it. Also, her hammering released a scream in her for
the first time; something she had been longing to do. But she said
despairingly: This is impersonal anger; I cannot yet feel anger at
you. I fear i f this should happen it would have the destructive
power of an atom bomb, and neither of us would survive'. It was
another year before she could reach her hate and anger at me.
In severe cases the anger, when finally reached, is at times
expressed in pre-verbal noises like roaring, hissing, screaming,
howling and growling. I think that after a time the patient
benefits if the analyst puts into words for him what these noises
communicate. The analyst needs to indicate that he is affected
but not damaged by these communications. Also, narcissistic
patients need help to find a way to express their grief and
enormous pain. I mentioned a patient who could not cry in my
presence. She felt that her tears were frozen, as in infancy and
childhood she had not been able to deposit her pain and anger
with her mother. These frozen tears could be understood as
anaesthetized grief and anger. The analyst's warm acceptance of
NARCISSISTIC DISORDER AND ITS TREATMENT 121

the patient, however despondent he may be, will thaw his frozen
tears. He will be increasingly able to 'dump his grief and rage
with the analyst', as one patient put it.
I mentioned that the analyst's voice should never be raised.
Whenever there is an edge to my voice, my patients distance
themselves and become once more cold and withdrawn. It is
important that the therapist gives audible responses to every­
thing the patient says. The analyst's silence causes terror in the
patient.
Now I come to the second phase of treatment that gradually
evolves out of the first phase, a process that with serious cases
may take several years. With patients who have only areas of
narcissistic disorder the first and second phases seem almost to
coincide. The second phase is much more like analysing patients
who have a fairly viable ego. Often a patient will at this stage
still be intent on turning the clock back in order to become a baby.
But now I interpret this defence, and we persistently work
through it. The patient's trust in the goodwill and competence of
the analyst will have grown, and his paranoid feelings will have
lessened. His capacity to feed and to symbolize is increasing.
Analytic work can now proceed with the usual transference
interpretations. The patient can now be helped to own and to
integrate his formerly split-off impulses and to modify their
infantile absoluteness.
Patients gradually become able to bring love and hate together
and no longer insist 'that you cannot have a black and a white
slide in your projector simultaneously', as one patient used to say.
Frozen tears are now thawing, and, for example, Mrs B cried for a
whole year throughout every session. The patient who had
imagined herself suspended above the couch unable to feed could
now sink into the couch and take in the room and the analyst. It
was moving when this woman, who formerly could not 'hear' my
interpretations, said: *I now find interpretations very helpful.
They give me the stamp of existing.' Patients are now able to
benefit from symbolic feeds and gradually understand that they
need an analyst and not a mother. They are much less intent on
using the unrelated power of their infancy, pseudo-omnipotence
and pseudo-independence, to manipulate the analyst. By realiz­
ing that he has an impact on the analyst, the patient discovers
that he has genuine potency. This makes it possible for him to
122 RUSHI LEDERMANN

allow the a n a l y s t also to be potent and effective. The patient can

gradually let go of his pathological ego defences, such as the robot
and the false fagade, and have a more realistic appreciation of
himself as a h u m a n being, more good t h a n bad. We can now work
through the depressive position and through oedipal feelings.
A l l the patients mentioned i n this paper have become
increasingly creative i n their work and i n their relationships.
Mrs B visited her overseas home last summer to forgive her
psychotic mother whom, for a very long time, she had wanted to
kill. She also made peace with her father, who had left the family
when she w a s little. B u t she has still some way to go i n daring to
contact fully her colossal destructive anger. Considerable
improvement was brought about in the patient who stammered
and was blocked i n his work. He is now sought-after as an author
and lecturer. T h e two patients who, at the beginning of analysis,
had been about to dissolve their marriages now have a viable
relationship w i t h their husbands. Indeed, the husband of one
patient, who h a d been impotent, is now intermittently potent on
account of the change i n her. However, another patient, not
mentioned i n this paper, who had a deformed ego and characteris­
tic narcissistic defences, suffered a collapse of his ego as a result
of having to move from his familiar surroundings, his home town,
his family a n d friends. A s it was not possible for him to have
therapy more t h a n once or twice a week, he could not be helped by
analytical treatment.
I shall end by illustrating a patient's development in the
course of the first three years of her analysis, describing the
progression of child images as they revealed themselves in her
dreams. T h e archetypal child can be seen as representing a
person's potential future. I n the early stage of the analysis the
patient dreamed that she was nursing a friend who was dying of
cancer of the womb. T h i s friend, although married, had in reality
had an abortion because she had felt too deprived herself to be the
mother of a child. T h e friend was an aspect of the patient. Instead
of a live c h i l d there was a cancer in h e r psychic womb, and she
was i n danger of psychic death. T h e n a n actual child appeared i n
a dream, but it was disguised so as not to look like a child. She
still tried to deny the existence of her inner child as she denied
her infantile impulses. T h e n her dreams contained undisguised
images of babies and young children. A t first it was a deformed
NARCISSISTIC DISORDER AND ITS TREATMENT 123

baby, blue and nearly frozen to death in the far corner of a room.
It could not cry. The patient thumped and kicked the baby in
order to bring it to life. Then she picked it up and cuddled it and
warmed it back into life.
In another dream the baby had a blemish, and its parents
wanted to discard it. It was soaking wet, having been left
unprotected in the rain. This time again the patient wrapped it in
a blanket and hugged it. But she was worried that the baby was
unable to kick. It will be obvious that this dream represented her
inner child rejected by the mother as she had felt in her childhood.
The rain might have represented the inimical environment
and/or her at that time unexpressed tears. The baby could not
kick as her aggression was still inhibited. Also, the patient was
still the do-it-yourself mother. I was not yet permitted to help her
inner child. Unrelated power was still replacing eros, relatedness.
This is illustrated by another dream: a little child on a sledge was
magically going up a snow-covered hill backwards. There was
nobody pulling the sledge. It landed inside a hut that was
guarded by a black dog. The patient ran up the hill, tackled the
dog and freed the child. Again we have the magic omnipotence of
the child that does not need anybody to pull it up the hill. The
patient felt that going backwards was a retrograde movement,
and the snow depicted that she still experienced the analytic
environment as cold. The black dog, her fierce aspect, tried to stop
her from making contact with her child qualities. But she
overcame the dog and reached her inner child.
Then she dreamed of a child that fell over the balustrade of a
high balcony into a river. The patient panicked and called
ambulance men who saved the child from drowning. The patient's
being too high up and separated from the child represents her
arrogant aloofness, a characteristic narcissistic defence. The river
can be understood as the lethal archetypal womb into which the
child falls. However, it is now no longer her omnipotent self that
saves the child, but ambulance men—an archetypal representa­
tion of the analyst.
As my patient made more contact with her infantile impulses
and began to latch on to me she dreamed of a frenzied destructive
little child; but when his mother picked him up he calmed down
and was content in her arms. It is again no longer the patient
herself but this time *the mother* who holds the child—a tentative
124 RUSHI L E D E R M A N N

recognition of the analyst. T h e n she dreamed of a rubber-like

puppet child that lived locked up by her father in a castle with all
its windows covered by dark shutters. A woman clowned so as to
amuse the child. T h e patient urged the father to open the shutters
and let the s u n and a i r i n . I t is beautiful outside', the dreamer
said, 'and it will do the child good.' Clearly the castle with all
the shutters down is her narcissistic barrier; the father, her
controlling non-relating aspect that locks her inner child away;
the clowning woman one of her narcissistic defences which I
mentioned. Y o u w i l l remember that she used to amuse people by
clowning and being witty. B u t here is the recognition that letting
sun and air i n w i l l be good for the child. The environment inside
and outside the analysis is no longer experienced as hostile.
The patient's development, like all psychological development,
went in a spiral movement. She dreamed again of a three-year­
old-child—the age of the analysis at that time—that was only
half alive. It was unaware of its surroundings, leaned over the
edge of a canoe and fell flat on its face into the water. The
dreamer saw this happening from a window, again high up on the
second floor of a building. She r a n down and screamed, 'A child is
drowning!' A woman helped her to save the child. The patient was
still too high up and divorced from her inner child that was not
fully alive nor aware of reality. It is saved by a woman, but again
she dare not yet identify the woman with the analyst.
I see one of her recent dreams as giving the quintessence of her
development. I n this dream she walked on the South Downs and
saw a horde of invaders coming towards her. She thought that
they were hostile and dangerous and fled into a cave. Then she
realized that the invading army was friendly and on her side. I n
the cave she saw a tiny child with a woman. She thought the
woman looked like me. The child shot down some stairs as if
propelled by a n invisible force. T h e r e was no holding it back', she
said; the stairs were a n exit into the sunny world outside. This
seems to me to depict a k i n d of birth of her inner child. She had
once more fled into the womb of the archetypal mother, the cave,
because she had experienced the analytic invasions into her
psyche as hostile. B u t h e r trust i n me had become established; the
dream tells her that the invading forces are her allies. The child,
in the presence of the analyst, can enter into a world that is now
experienced as w a r m a n d sunny. The patient is well on the way to
NARCISSISTIC DISORDER AND ITS TREATMENT 125

recovery. A person suffering from narcissistic disorder has

usually a fairly strong but deformed ego that arose from stunted
deintegration in infancy. This has resulted in replacing eros, i.e.
relatedness, with ruthless power. This pathological ego is
experienced as being located in the head. The patient develops
specific defences to guard against going to pieces.
In the treatment I consider it essential to create an analytic
environment in which further deintegration can take place. The
analyst must enable the patient to release in relation to him the
impulses that have been split off and denied. He must refrain
from interpreting those destructive impulses per se since it is, as
yet, too difficult for the patient to take responsibility for his evil
aspects. All he can tolerate at this stage is a reconstructive
interpretation about his destructiveness in the light of his
severely defective infancy situation which he is re-living in the
transference.
In the second phase of treatment the usual analytic interpreta­
tive work can proceed.

REFERENCES
F o r d h a m , F . (1964). T h e care of regressed patients and the child
archetype. Journal of Analytical Psychology 9:1.
F o r d h a m , M. (1971). 'Primary self, primary narcissism and related
concepts'. Journal of Analytical Psychology 16:2.
(1976). The Self and Autism. L i b r a r y of Analytical Psychology,
Vol. 3. London: K a r n a c Books.
(1980). T h e emergence of child analysis. Journal of Analytical
Psychology 25:4.
Credo, J . (1975). O n a central organizing concept for psychoanalytic
psychology. Journal of the American Psychoanalytical Association,
Spring.
Gordon, R. (1980). Narcissism and the self: who a m I that I love? Journal
of Analytical Psychology 25:3.
Kernberg, O. (1975). Borderline Conditions and Pathological Narcis­
sism. New Y o r k : Jason Aronson.
K o h u t , H . (1971). The Analysis of the Self. New York: International
Universities Press,

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126 RUSHI LEDERMANN

Kohut, H . , & Wolf, E . (1978). T h e disorders of the self a n d their

treatment: a n outline. International Journal of Psychoanalysis 59:4.
Ledermann, R. (1979). T h e infantile roots of narcissistic personality
disorder. Journal of Analytical Psychology 24:2.
(1981). T h e robot personality i n narcissistic disorder. Journal of
Analytical Psychology 26:4.
Meltzer, D. (1981). T h e K l e i n i a n expansion of Freud's metapsychology.
International Journal of Psychoanalysis 62:2.
Metamorphoses. Loeb
Ovid [Publius Ovidius Naso] (ca. A . D . 2). Classical
Library: 42/43, 1916.
Padel, J . (1988). Theoretical concepts: narcissism. A commentary on the
British Journal of Psychotherapy 4:2.
series.
International Journal of
Schafer, R. (1973). The idea of resistance.
Psychoanalysis 54:3.
Schwaber, E . (1979). O n the self w i t h i n the matrix of analytic
theory—some clinical reflections a n d reconsiderations. International
Journal of Psychoanalysis 60:4.
Winnicott, D. W . (1971). Playing and Reality. London: Tavistock
Publications.
CHAPTER SIX

Reflections on introversion
and/or schizoid personality
Thomas Kirsch

Kirsch's chapter is noteworthy for several reasons. First, he is

attempting to clarify differences and similarities between the
terminology of analytical psychology and psychoanalysis. He
notes that what may be conventionally pathologized as 'schizoid*
overlaps with what Jung termed 'introversion' (see below). But he
has also formulated ways in which the two states are different.
Second, what he has to say about the matching of types in
analysis speaks to the issue posed by Edwards (and mentioned in
my Introduction): the whole question of a fit between patient and
analyst. Here, as elsewhere in the chapter, Kirsch is quite open
about his changing views. Third, Kirsch shows how the personal­
ity of the analyst influences his interpretive stance—and does so
with a wealth of clinical detail
For some readers, typology may be an unfamiliar subject. It is
a system developed by Jung to demonstrate and ascertain

F i r s t published i n The Journal of Analytical Psychology 24:2, i n 1979.

Published here by k i n d permission of the author and the Society of
A n a l y t i c a l Psychology.

127
128 THOMAS KIRSCH

different modes ofpsychological functioning in terms of 'psycho­

logical types . Some individuals are more excited or energized by
9

the internal world and others by the external world: these are
introverts and extraverts, respectively. But, in addition to these
basic attitudes to the world, there are also certain properties or
functions of mental life. Jung identified these as thinking—by
which he meant knowing what a thing is, naming it and linking
it to other things; feeling—which for Jung means something
other than affect or emotion: a consideration of the value of
something or having a viewpoint or perspective on something;
sensation—which represents all facts available to the senses,
telling us that something is, but not what it is; and, finally,
intuition, which Jung uses to mean a sense of where something is
going, of what the possibilities are. A person will have a primary
or superior function: this will be the most developed and refined
of the four. The other three functions fall into a typical pattern.
One will be only slightly less developed than the superior
function, and this is called the auxiliary function. One will be the
least developed of all. Because this is the most unconscious, least
accessible and most problematic function, it is referred to as the
inferior function.
Using the two attitudes and the superior and auxiliary
functions, it is possible to produce a list of 16 basic types. Several
psychological tests exist, based on Jung's hypotheses. These are
used by some analytical psychologists clinically and also have
educational and industrial application. There is a difference of
emphasis in analytical psychology between those who welcome
the scientific tenor of typology and those who use it as a
rule-of-thumb approach, the value of which lies in providing an
overall assessment of a person's functioning.
Jung worked on his typology as a means of understanding the
differences between himselfand Freud (to put it concisely, he felt
he was introverted and Freud extraverted). It seems to be the case
that interpersonal dysfunction can be understood in terms of
typological difference.
A.S.
INTROVERSION AND/OR SCHIZOID PERSONALITY 129

his chapter is in large part an outgrowth of a previous

paper (Kirsch, 1980) on an extravert's approach to dream
J _ interpretation. In that study I examined my work with
people who did not know I was a Jungian analyst. I found that I
tended to relate their dreams to outside reality rather than to the
subjective contents of the unconscious. I attempted to discuss
some differences in dream interpretation depending upon the
psychological type of the analyst. By contrast, Jungian studies
tended to emphasize the introverted subjective aspects of dream
interpretation. Early in my professional life I had tended to agree
with that approach, yet through my own analysis I came to
realize that my own natural extraversion needed another way of
approaching dreams.
A further interesting facet emerged from this previous study in
that I found that, in my practice, there existed a large sub-group
of introverted women. As a group these women were generally
successful in their chosen careers but felt extremely isolated in
their interpersonal emotional life. It was the latter that usually
led them to seek analysis, since their emotional isolation brought
on various forms of depression. That I seemed to work well with
women of this group I attributed to two basic factors: (1)
psychological type differences, and (2) orientation towards the
mother complex.
As an extraverted intuitive-feeling type I could do most of the
work in bridging the relationship and, therefore, help the
analysand feel more at ease. I was able to 'sense* intuitively
certain feelings which these analysands would have and present
the possibilities to them. This tended to open up various affects
and emotions that they were unaware of. I had to be careful about
these 'hunches' because, at times, I would be wrong and then be at
complete odds with the patient. Furthermore, analysands have an
ambivalence to exposing these feelings, so defences would arise.
It would feel to them as if they were being invaded by something
quite alien to their own natures. I have become aware that one
must be extremely careful with one's intuitive feeling hunches
because they can cause as much harm as good. Clinical examples
of this phenomenon will be given later.
A l l these introverted women had a deep negative mother
complex which was a primary factor in their emotional isolation.
130 THOMAS KIRSCH

They were usually profoundly self-critical and full of negative

judgements towards themselves, and they generally viewed the
world in a pessimistic fashion. The future was bleak, and it was
felt that nothing could change to make life more meaningful. My
own orientation towards the mother complex was positive, and I
saw life as full of possibilities and growth. At first I was
extremely naive in my overall optimism. Often, therefore, a
polarity was constellated between the patient and me which had
to be thrashed out in each individual situation. As my life went
on and my analytic experience grew, I realized that it was not
correct to label all the behaviour patterns of these women as
introverted. There was something other than introversion at
work, and it was more than a matter of helping shy women to
ovecome their shyness, introversion or whatever. In other words,
there was clearly a pathological complex at work, and I found
these people could best be described as schizoid. A conflict arose
for me at this point between the psychiatrically oriented
nomenclature of the schizoid personality disorder and Jung's
description of psychological types based on normal psychology.
For instance, much of what is described as schizoid by psychiatry
analytical psychologists would consider to be normal introver­
sion. In Freedman and Kaplan's Comprehensive Testbook of
Psychiatry (1967), the authors describe the schizoid in terms of'a
tendency to avoid close or prolonged relationships with other
people. A corollary of this is the tendency to think autistically ...
the cornerstone of the adaptive defensive system in this instance
is withdrawal. ... In his isolation, he may invest his energies in
non-human objects and with sufficient talent and persistence ...
[to] provide an adaptably useful structure for his life.' Some of
these attributes may just as well describe the introvert.
So wherein lies the difference between the two terms? Is it
important to make the distinction? But I think that there is a
great difference between normal introversion and schizoid
personality disorder. The difference lies in the fact that the
introvert is able to make a meaningful interpersonal connection
when he chooses, whereas the schizoid person is unable to do so.
Clinically, one may ask, what difference does it make?
Analytical psychologists in general are not greatly interested in
diagnostic categories, and if the analysis works, such categories
do not matter. But I have found that it is important for me to have
INTROVERSION AND/OR SCHIZOID PERSONALITY 131

some formulation in order to assess better where the patient is.

Some of these patients have done extremely well in analysis, but
others have been among my most outstanding failures. Knowing,
therefore, w h a t can be seen as introversion and what can be seen
as schizoid h a s been most helpful i n the analytical work.
Furthermore, w i t h i n the category of schizoid it has been most
helpful for me to assess the degree of isolation. Often these
patients present a thick barrier through which it is extremely
difficult to penetrate. I t is the degree of isolation which,
ultimately, determines whether analysis is possible or not. A
colleague ( M e l v i n Kettner) has described this sort of person as a
'workable schizoid'. I have seen a large number of such women,
and I t h i n k they are d r a w n to a J u n g i a n analysis because they
see i n J u n g a legitimization of their psychology. Jung accepts the
reality of the inner experience and does not reduce it to a
pathological entity.
I should now like to present some clinical examples of such
schizoid persons.
One case i n w h i c h the analysis did not work well was a young,
single w o m a n i n her mid-twenties. She had become interested in
J u n g i a n a n a l y s i s through t a k i n g a course. She had been seeing a
married m a n w i t h whom she felt quite involved, although he did
not appear to reciprocate her interest. I n the initial phase of
analysis we discussed this relationship extensively, and she
expressed m u c h affect, crying frequently and seemingly feeling
vulnerable. S h e came to see herself as playing the little girl role
vis-a-vis the m a n and eventually was able to disengage emo­
tionally from h i m . Over a period of twelve months her outer life
became stabilized. H e r job went satisfactorily; she was involved
in courses and had a few friends and the analysis seemed to go
well. She presented dreams which m a i n l y centred on her
childhood home.
H e r history revealed that she was born of a Jewish father and a
Catholic mother, both of whose families had emigrated from
Europe. S h e h a d always been competitive with her mother and
favoured by h e r father. H e r background through high school did
not seem u n u s u a l , but at college her life became somewhat
chaotic. S h e changed colleges each year until graduation, after
which she went to Europe for several months. I n Europe she
became unable to cope on a n emotional level, and her mother had
132 THOMAS KIRSCH

to bring her back home. After several months of recuperation she

obtained a job and gradually found herself involved in one
short-term relationship after another.
None of these had been particularly significant until the one
which brought her into analysis. I felt that the therapeutic
relationship was good. She expressed warm, positive feelings
towards me, and I liked her. The analysis was working. Then she
became genuinely involved with a man ten years younger than
herself—she was 29, and he was 19. She felt it was crazy, but they
were both in love. Life was going better for her until he began to
pull away from her because he wanted more independence. She
began to withdraw more into her shell, and all my extraverted
feeling could not bring her out. She reported fewer dreams and
then began to leave the sessions early. She claimed that she had
nothing to say, and after a few attempts on my part to get her to
talk more, I began to let her go early. This pattern continued for a
year until after I returned from a summer vacation. She came to
the first session after my return extremely heavily made up,
which was unusual for her. She announced that she was going to
stop therapy, that it had reached the point of diminishing
returns. I urged her to continue and see if we could work through
the block, but her decision was final. At the last session she was
on the verge of tears throughout the session, but she would not
give in to them.
I have reflected on this case because it concerned a type of
patient with whom I have usually done quite well. Furthermore,
the initial phases of the analysis had progressed favourably.
After two years of therapy with this patient I had dreamt that I
was married to her. I had taken this as a positive sign that I was
deeply connected to her, but I did not understand the further
meaning. Now I think it has to do with the schizoid aspect of my
own anima seen in projection on this patient and which I sought
to bring into more intimate relationship with my ego. With the
actual patient there had only been a partial resolution of that
schizoid nature. She did make many changes in her psyche over
the four years of therapy; but she was not able to break out of a
certain schizoid isolation which remained untouched. She became
more comfortable in her professional life, but she was not able to
form a meaningful relationship, either to a man or a woman.
INTROVERSION AND/OR SCHIZOID PERSONALITY 133

Perhaps it is too early to say, but I do not think that she will
return for further therapy.
Another example follows in which the problem of distinguish­
ing schizoid personality from introversion became important.
The patient, a woman i n her mid-thirties, married, but with no
children, came to me after she had been in therapy with another
man for three years. Her previous therapist had a bio-energetics
orientation, and a conflict had developed between them about his
approach. She decided to leave him in favour of someone with a
Jungian orientation, since she thought Jung's approach would
validate her more readily. She particularly liked his theory of
psychological types, and she saw herself as an introverted
thinking person.
Her early history showed that she had grown up in a small
town with an intact set of parents and two older brothers. The
family was extremely poor during her youth, but the parents
always put on a good persona for the community. She never felt
close to her mother, and the father had had serious brain surgery
during her adolescence.
The initial three months went quite easily, until I made some
comments about masculine and feminine aspects in one of her
dreams. Before the next session I received a long letter, a warning
of sorts, not to label things in masculine or feminine terms. I tried
to explain how Jungians use these terms and that they represent
attitudes and are not specific to one sex or the other since we all
have both. We were able to come to some sort of agreement in that
I would be careful how I used the words masculine and feminine,
as they were so loaded in the general culture.
The next major issue was my interpretation of a dream. She
had dreamt that she was going to a doctor's office in a clinic; she
was going to tell him a dream. She did not tell the dream to the
doctor, however, but went to the next office where her husband
was. I saw this dream as presenting a major problem. In reality
she was telling dreams to her husband before she brought them
into the analytic hour. I experienced the energy as going away
from the analysis rather than coming into it. I suggested that she
tell the dreams to me first, and then talk them over with her
husband i f she wished. She reacted extremely negatively to my
suggestion.
134 THOMAS KIRSCH

We began a battle that lasted for the remainder of the therapy.

She felt that since it was her analysis she could do whatever she
wanted, whereas I tried to explain my orientation in terms of the
alchemical container, where it is important to keep the material
contained and not have a leak, which dilutes or drains the
content. In actuality, she found that it made a big difference
whether she told me or her husband the dream first. If she told
him the dream first, most of the energy would be dissipated by the
time she came for the analytical session. A related issue was that
she would only talk about dreams that were weeks or months old.
She would not relate recent dreams that she had not yet herself
assimilated. She required a certain distance from me, and I felt
that I was working too close for her comfort.
Another major issue concerned the use of tranquillizing
medication. She required tranquillizers to calm her diffuse
anxiety. She was taking more than the recommended dose, and I
felt that she was becoming psychologically and physically
addicted to them. My medical conscience would not allow me to
prescribe such large doses for her. Again it was the issue of who
was in control of the therapy. I ended up by writing the
prescriptions, cautioning her, at the same time, of overuse.
A further issue was money, but not in the usual way that it
came up as a problem. She and her husband were not in the best
of circumstances financially during much of the time of the
analysis. As a result I did not raise her fee when I made a general
overall rate increase for my practice. When I made a second rate
increase, I hesitatingly asked her for the first increase. She
became furious with me for not telling her about the first
increase. Why did I take it out of her control and decide
unilaterally not to raise her fee the first time? She ended up by
paying me retroactively so that her fee was like that of everyone
else.
These vignettes highlight the issue around control in which we
were engaged. It appeared that she had a solid wall around her,
her schizoid character, which I , with my extraverted feeling, was
unable to penetrate. I felt genuinely supportive towards her and
that I wanted to help her. In other words, my anima functioned
generally positively in relationship to her. She did not want to let
me in because that would have been too threatening. As I saw it,
she could not allow me to enter her world with her, and I was
INTROVERSION AND/OR SCHIZOID PERSONALITY 135

always outside. Behind the defensive armour there seemed to be

extremely positive feelings towards me. She always came
punctually, gave much time and thought to the analysis, and she
did not wish to end with me. However, after three years I found I
had worked to the limit of my tolerance of being excluded from
the process, and felt that we were locked in an endless and
destructive power struggle which was not helping either of us. I
suggested termination, with referral to another Jungian thera­
pist, a woman. This was done, and I understand she is now doing
much better.
If I look back and wonder what went wrong, I think it has to do
with the two factors I had thought would be helpful with this type
of patient. It seems that both my extraverted intuitive feeling
responses and positive mother complex threatened her. She felt
attacked by my reaching out or wanting to give to her. Instead of
helping her to come out from her shell, it made her retreat more
behind her defensive armour.
A third and less complicated example concerns a woman,
married, in her middle thirties, with a successful career as a book
editor. In addition to being quite isolated interpersonally, she had
phobic symptomatology, such as not being able to be in crowds,
stores and so on. In the early phases of treatment she had several
dreams in which she tried to meet me, but something would be
wrong, such as the time or the place of meeting. I felt that this
had to do with a resistance to the analysis. In thus failing to make
a connection with me in the dreams, she was unable to make a
connection to herself as symbolized by me.
Initially, her ability to express affect of any kind was quite
limited. Dreams and crying were her major modes of expressing
anything deeper than personal issues. For instance, during this
phase of the analysis she would enter each session and cry for the
first ten minutes without being able to say why. I t seemed as if a
dam were breaking, which had been holding her emotions in
check by only the greatest of efforts. The dreams centred mainly
upon family matters, particularly relating to childhood. In many
dreams she was in her childhood home with her five sisters and
mother and would be unable to talk because there was too much
noise in the room. She sensed that she was caught in the
'participation mystique' of the family and could not express her
individual needs. She felt completely implicated in the sub­
136 THOMAS KIRSCH

liminal demands, attitudes and expectations of the family, and

hence she could not find an individual mode of expression. The
family values were typically mid-western and caught her up in an
extraverted life. We were able to trace the sense of isolation that
developed in spite of her being surrounded by the rest of the
family. Many dreams included an interaction with her mother,
wherein the analysand felt duty-bound by the wishes and
expectations of the mother. These dreams were most helpful in
the reductive aspects of the negative mother complex.
The analysis progressed more or less smoothly for several
years, until a crisis situation developed. In the marriage the
pattern had been for her to take all the initiative. She planned all
social events, even made her husband's appointments with his
doctor and generally took charge, though in not too overbearing a
manner. The crucial time came when her husband had to decide
about a change ofjob. His local office was closing, and he expected
to be transferred. In a subliminal way she was being asked to
make a decision for him: should he move with the company or
look for another job locally? She became quite anxious and
phobic, with a return of many of her initial symptoms. After
several months of indecision we threw an / Ching on my
suggestion. The result was 'Waiting' with no changing lines. It
seemed that she needed to wait and let events happen as they
would. She should not try to influence her husband in any way.
Difficult as i t was for her, she did wait and let him make the
decision. On the last day of his old job he found work in another
division that was not being re-located, and they remained.
Shortly afterwards she had a dream which indicated that she
was ready to finish therapy. She dreamed that I was visiting her
home, and she was showing me her kitchen. Afterwards we
walked through the hallway into the living-room, and then I
walked out. After all those early dreams in which we did not
connect, she had finally brought the symbolic me into her house. I
suggested that it was time to terminate therapy, and, after her
initial surprise, she concurred.
My extraverted intuitive-feeling approach proved most helpful
with this schizoid woman, who was also an introverted sensation
type. She had gradually been able to drop many of the
extraverted expectations placed upon her and accept her own
more natural introverted way. My intuition had raised numerous
possibilities where her own associations were quite sparse. She
INTROVERSION AND/OR SCHIZOID PERSONALITY 137

had been able to pick on those possible interpretations that

seemed to be right for her and was then able to continue with her
own associations: a meaningful dialogue ensued. She had also
needed my feeling function and positive mother complex to help
her feel comfortable. Of the three examples this one had by far
the most favourable outcome.
Analytical psychology generally does not place much emphasis
on clinical diagnosis. We speak rather in terms of psychological
type, or the activation of a particular complex. When I began
analytic work I tended to over-use the terms 'introvert' and
'extravert' as a way of describing certain of my analysands. It has
become important for me to be more specific, especially in
relationship to the over-use and over-evaluation of the term
introversion. In each of the three cases described there exists a
schizoid element above and beyond normal introversion. An
important consideration is whether this schizoid element can be
changed or not. In each of the three cases presented that element
has been analysed with varying degrees of success. I have
pondered what effect my own psychological type and positive
mother complex has had on the process. A t first, I thought that
my being able to reach out would have a helpful effect. It has
turned out that the results have been mixed. Some schizoid
introverted women can respond to my extraverted feeling,
nurturing approach, whereas for others it is pure poison. The
deciding question is whether I am able to reach behind the
barrier and tap into the emotional isolation. I f I can, then such
women become the 'workable' schizoid. Thus, contrary to my
original notion, my psychological type is not always as helpful as
I originally thought. These clinical reflections have been
extremely important to me since the variations on this theme of
introversion-schizoid account for approximately one-quarter of
my practice.

REFERENCES
Freedman, A., & K a p l a n , H . (1967). Comprehensive Textbook of
Psychiatry. Baltimore: W i l l i a m s & W i l k i n s .
K i r s c h , T . (1977). Dreams and psychological types. I n I . B a k e r (ed.),
Methods of Treatment in Analytical Psychology. Fellbach: Bonz.
CHAPTER SEVEN

Reflections on Heinz Kohut's

concept of narcissism
Mario Jacoby

Jacobys aim is not to stress that many contemporary ideas in

f

psychoanalysis concerning narcissism and self-psychology have

been anticipated by Jungians. Rather, he is exploring similarities
and differences between two major strands of theorizing. As he
says, he is, if anything, looking at analytical psychology through
the eyes of Kohutian self-psychology.
A further interest of the author's is to consider the implications
for technique. It can be seen that Jacoby, a training analyst in
Zurich, is quite clear that attention to transference-counter­
transference processes is a central feature of analysis. When first
reading the paper, I was struck by the sensitive and self-aware
way in which Jacoby dealt with his patient's idealization—not in
a manner that dismissed it as 'defence', but somehow managing
to allow for growth inherent in such a transference (along the
lines of Kohut's model).

F i r s t published i n The Journal of Analytical Psychology 26:1, i n 1981.

Published here by k i n d permission of the author a n d the Society of
A n a l y t i c a l Psychology.

139
140 MARIO JACOBY

Finally, what Jacoby says about the 'Jungian self repays

study.
A.S.

here is much diversity in current psychoanalytic litera­

ture, but for many years now my attention has been
X particularly drawn to Heinz Kohut's works on narcissism
(1966,1971,1972,1977). Kohut has struck me in many ways as a
kindred spirit, his views being akin to my own on psychology and
his therapeutic approach similar to mine, which, in itself, is
closely related to C. G. Jung's analytical psychology. While
reading Kohut's often microscopically subtle, descriptions and
interpretations, traits of various analysands, including the
analysand I am for myself, would immediately come to mind. I
was also struck again and again by how close Kohut seemed to
analytical psychology, even in the way he sees the basic problem
of psychological theorizing. Because he firmly believes that 'all
worthwhile theorizing is tentative, probing, provisional—con­
tains an element of playfulness' (Kohut, 1977, p. 206), Kohut is
tolerant about possible inconsistencies in psychological theory.
As he writes, ' I am using the word playfulness advisedly to
contrast the basic attitude of creative science with that of
dogmatic religion' (ibid., p. 207). Here we have a striking parallel
with Jung, who, in his memoirs, complains about Freud's
dogmatism with the following words, 'As I saw it, scientific truth
was a hypothesis which might be adequate for the moment but
was not to be preserved as an article of faith for all time' (Jung,
1963, p. 148).
Furthermore, Kohut postulates, for example, that so-called
'narcissistic libido' goes through a progress of formation and
transformation and can, in the course of a lifetime, stimulate the
maturation processes of a personality. The results of this
maturation he calls empathy, creativity, humour and wisdom.
This view is quite contrary to that of classical psychoanalytic
theory, according to which in healthy development narcissistic
libido always transforms into object libido. In contrast, Kohut
believes that so-called narcissistic libido has its own capacity
HEINZ KOHUT'S CONCEPT OF NARCISSISM 141

for transformation and maturation. Such an observation im­

mediately makes us wonder i f Kohut is not using this rather
prejudiced term to refer to the phenomenon that would be called,
in Jungian terminology, introversion, or, even more specifically,
the urge towards individuation. Moreover, in his most recent
book, The Restoration of the Self (1977) Kohut dares to introduce
a theory that reaches far beyond the bounds of traditional
psychoanalysis: a new theory of the self as centre of the
psychological universe. This is a big step within psychoanalysis,
an essential innovation of great consequence. The analytical
psychologist is then faced with the obvious question of whether
Kohut's self centre of the psychological universe, corresponds to
the psychic experience that Jung describes and ascribes to the
self. In order to answer this question we have to investigate first
of all exactly what Kohut means by the term self
Generally speaking, we have to remember that as time went
on psychoanalysis could not avoid introducing the concept of the
self. Heinz Hartmann was the first to use the term self in
psychoanalysis, in 1950, and to suggest a conceptual differentia­
tion from the term ego. In contrast to the ego which is only one
instance within the psychic apparatus, the self refers to 'me as a
whole person'. It means ' I myself, the way I experience myself
and the ideas I consciously or unconsciously entertain about
myself. And thus, the specific term 'self-representation* is used,
which means the way my being is, as it were, represented i n my
own mind—in contrast, for example, to the way objects are
represented. This inner image of myself may be realistic enough
and form the basis of tolerant and constructive self-evaluation.
But it can also be distorted, exaggerated, superior, inferior,
unreliable or labile. In the latter case my self-perception or at
least my sense of self-esteem is in some way disturbed.
For many psychoanalytic authors this concept of the self is a
content of the ego. In analytical psychology my image of
myself—to the extent that it reaches awareness—would also be
attributed to the ego. But the unreflected parts of this image
belong to my personal unconscious and are related to my life
history. Thus, i t seems that analytical psychology could also
attribute this notion of the self to the psychology of the ego.
However, experience has shown that the way a person sees
himself can have intense emotional effects and tends to colour his
142 MARIO JACOBY

entire outlook and the basic feeling tone of his personality. This is
a condition that is beyond the control of ego consciousness and
cannot be easily modified by deeper insights. We must therefore
assume that the feeling tone underlying self-perception and
self-evaluation has deep archetypal roots. Thus it might be
related to the self in the specific Jungian sense.
But Kohut does not seem to be completely satisfied with the
psychoanalytic concept of the self either. As I mentioned above,
he is taking a step which he tries at great length to justify: side by
side with the self concept in the 'narrower sense' accepted by
psychoanalysis—as a content of the ego or of the whole psychic
apparatus—he places an enlarged concept of the self, as the
centre of the psychological universe.
The consequences are varied and decisive. The drives and their
vicissitudes, considered by psychoanalysis till now as primary,
become merely a part of the self in formation and serve in its
development. The self is an independent configuration, greater
than the sum of its drives. What classical psychoanalysis calls
drive fixations and their respective defence mechanisms would,
in Kohut's view, be products of decomposition due to momentary
or chronic instances of disintegration of the self. Thus, the
disorder in the coherence of the self would be primary and the
drive conflict secondary. This is a tremendous innovation within
psychoanalysis.
It is natural for Kohut as a psychoanalyst to go on to
investigate the genesis of the self and its disorders. Always basic
for the formation of the self is the 'empathic' presence of so-called
self-objects. By this Kohut means, for example, a mother who is
experienced by the infant in fusion with her as a part of his self.
As he writes,
The crucial question concerns, of course* the point in time
when, within the matrix of mutual empathy between the infant
and his self-object, the baby's innate potentialities and the
self-object's expectations with regard to the baby converge. Is it
permissible to consider this juncture the point of origin of the
infant's primal, rudimentary self? [1977, p. 99]
This hypothesis seems quite similar to Neumann's concept of
the primal relationship: an instance when the self, or rather the
functional sphere of the self, is incarnated in the mother (1973, p.
18). The mother is thou and self at the same time.
HEINZ KOHUT'S CONCEPT OF NARCISSISM 143

The earliest primal relationship with its mother is unique

because here and practically only here the opposition between
automorphous self development and thou relationship which
otherwise fills all human existence with tension does not
normally exist [Neumann, 1973, pp. 14-15]
According to Kohut, a coherent self evolves in the following
way. First of all the infant's magical feelings of omnipotence and
his spontaneous 'exhibitionistic' activity must be greeted with joy
and empathic mirroring by a maternal self-object. The gleam in
the mother's eye' has become a sort of formula which Kohut
repeatedly uses to decribe this necessary condition. With the
inevitable step by step frustration of its boundless needs, the
child slowly learns to recognize its limitations, and thus its
phantasies of omnipotence and need for admiration can gradually
mature to become realistic ambitions and an adequate sense of
self-esteem. When there is optimal frustration, the mother who
(in accordance with her function as self-object) mirrors in an
empathic way is progressively internalized and gradually
becomes what Kohut calls a 'psychic structure'. In other words,
optimal maternal empathy lays the foundations for a healthy
feeling of self-esteem that allows one to take and protect a 'place
in the sun' corresponding to one's personality; one is then neither
obsessed with ambition nor inhibited, ashamed nor plagued with
guilt about being 'seen', about being exposed. The need to be well
'regarded', to be someone of 'regard' in the world and to enjoy
'distinction' makes me think of how this need is originally related
to 'the gleam in the mother's eye'.
We are all in continual need for recognition, of having our
existence and our own worth acknowledged by others. As Eric
Berne humorously formulated it, we need a certain measure of
'strokes' or 'stroking' (1964). Kohut is right in comparing
emotional resonance with the oxygen we need for survival (1977,
p. 253). When, however, someone is all too dependent on
continual approval and admiration, when he becomes addicted to
unceasing narcissistic supplies, then we can no longer speak of
healthy narcissism. This rather indicates that his sense of
self-esteem is unstable or disturbed and that a tendency to
narcissistic vulnerability predominates; in such a condition the
sense of the coherence of the self can from time to time be
threatened.
144 MARIO JACOBY

The developmental lines of self formation that vitally need the

empathic mirroring of a maternal self-object are what we
normally consider as narcissistic. They are connected with the
vital question of "self-approval'.
But Kohut believes that something else also occurs during the
formation of the self. Not only does the developing self want to be
admired by the self-object; in its turn, it also admires the
maternal or paternal self-object and experiences it as omnipotent
and perfect. But as the self-object is hardly differentiated from
the self s own world, its perfection also entails the self s own
perfection. There is fusion with the idealized, seemingly omnipo­
tent and perfect self-object. Progressive disappointment about the
real parents' omnipotence, omniscience and perfection can, as we
have said above, lead to their 'transmuting internalization'
(Kohut, 1977). This is an important process that makes possible
the formation of psychic structures forming the matrix of future
ideals.
Whether an infant can survive physically and emotionally, can
feel valued and 'whole', thus depends essentially on a good
enough empathic attitude on the part of the self-object. The
necessary process of gradual liberation from this dependency
finally reaches its end when the system of parental values has
been internalized in the structure of the super-ego—Kohut calls
this 'the idealization of the super-ego' (1971)—that is, when the
Oedipus complex has been overcome.
In other words, self esteem can also develop and be sustained
when, out of fusion with the idealized self-object, ideals have been
born that stimulate worthwhile commitment. There are, for
example, always people engaged in minor or major tasks that
transcend their immediate, personal needs, people who are
completely devoted to greater or higher aims. Their conscious
intention is by no means to raise their own sense of personal
worth; rather, their devotion to greater matters—be they
scientific, artistic, religious or social—seems to give their lives a
certain transpersonal meaning. The fact that these matters
might have their infantile roots in the idealization of a self-object
is probably responsible for a well-known phenomenon: often these
higher aims appear in personified form, embodied, for instance, in
an admired and idealized person or in all kinds of charismatic
leaders. Certainly commitment to matters transcending one's
HEINZ KOHUT'S CONCEPT OF NARCISSISM 145

personal needs does not sound like what we normally call

narcissism—on the contrary. And yet, the main purpose of such
endeavours is maintaining narcissistic equilibrium. I feel,
however, that the prejudiced term 'narcissism' is a bit out of place
here. I n his most recent book, Kohut replaces the expression
'narcissistic equilibrium' with a preferable term, 'the coherence of
the self. Thus we would say, the coherence of the self can also be
attained by fusion with an idealized self-object; and, it can be
maintained via the formation of ideals.
Jung i s no doubt referring to similar phenomena when he
speaks of the search for transpersonal meaning and of neurosis as
the 'suffering of a soul which has not discovered its meaning' (CW
11, para. 497).
According to Kohut the archaic grandiose self and the archaic
phantasies of omnipotence are gradually transformed. In a
favourable development the result i s the emergence of realistic
ambitions and mature ideals. The self that emerges at the end of
this development has to be considered as bipolar. There is, on the
one hand, a pole of ambitious initiative that strives for
admiration and, on the other, a pole consisting of meaningful
goals and ideals. The tension span between the poles is regulated
by the talents and skills a person possesses. This means that
ideally both poles of the self operate together when vigorous,
spontaneous energy is directed toward goals that the person feels
are meaningful and worthwhile. I t is, therefore, understandable
that narcissistic personality disorders are often marked by a loss
of energy, a sense of inner emptiness and general lack of interest.
Is then what Kohut considers 'the self, as centre of the
psychological universe' the same as what analytical psychology
understands under the concept of the self? At first sight it hardly
seems so. Kohut's idea of the self seems more personalistic, close
to what Jung means by ego, compared with what he means by
self. And yet I must point out here that Kohut also speaks of what
he calls 'cosmic narcissism' (1966), which transcends the bound­
aries of the individual: here wisdom would consist in reflecting on
the finiteness of all being and on the transitoriness of individual
existence. Furthermore, in Kohut's view, there is no original or
primal self present at the time of birth (cf. Fordham, 1976, p. 12).
According to Kohut the self has slowly to develop its coherence
from a state which Freud called 'primary narcissism'. Here
146 MARIO JACOBY

Jungian psychology would rather say that the self is the

imperceptible, central ordering factor responsible for psychic
development, transformation and, at the same time, psychic
balance. This might be the essential difference, if Kohut did not
go on to say, among other things, that man's ultimate goal might
be 'the realization, through his actions, of the blueprint for his life
that had been laid down i n his nuclear self (1977, p. 133). And
so we see that Kohut believes that the nucleus of the self has to
do with a blueprint for life. And we are thus once again quite close
to the Jungian idea of the individuation process. The parallel
becomes even more apparent with Kohut's statement that 'the
self, whatever the history of its formation, has become a centre of
initiative: a unit that tries to follow its own course' (1977, p. 245).
Furthermore, we have to remember here that Jung at different
times considered the self as both the psychic totality including
the ego and the archetypes and as also being the central archetype
of order, distinct from the ego and perhaps from all the other
archetypes. According to Fordham, those are two incompatible
theories of the self that do not form an essential paradox, but
merely create unnecessary confusion. He therefore suggests that
a distinction be made: the term self would only be used to refer to
psychic totality; otherwise the term central archetype of order
would be preferred (Fordham, 1973).
I must admit that I am not quite sure whether those two
theories of the self belong together as a paradox or not. Logically
they are mutually exclusive, but we know that this has little
meaning when we are dealing with the reality of the psyche. The
distinction suggested by Fordham has the advantage of clarifying
matters, but it has the disadvantage of separating out things that
we may experience as belonging together. Yet Fordham argues
that he is referring only to the place of the self in the theoretical
model of the psyche and not to the contents of the self, which can,
in accordance with experience, be stated paradoxically (1973, p.
34). For Jung, an essential aspect of the nature of the self lies in
the fact that i t cannot be clearly defined. And here again we find
that Kohut has come to the same conclusion when he writes at
the end of his book, The Restoration of the Self,
My investigation contains hundreds of pages dealing with the
psychology of the self—yet it never assigns an inflexible
meaning to the term self, i t never explains how the essence of
HEINZ KOHUT'S CONCEPT OF NARCISSISM 147

the self should be defined. But I admit this fact without

contrition or shame. The self is ... not knowable in its essence.
[1977, pp. 310-311]
For Kohut too, then, the self is many-faceted, and thus it more
or less escapes definition. But in comparison with Jung, what is
lacking is the wealth of symbolism and any direct reference to the
religious experience which might be inherent in the self as
God-image. For all his insights, Kohut remains here within the
psychoanalytic tradition. Jung arrives at his insights mainly
through his experience with, and amplification of, the wealth of
images from the unconscious. Kohut's method is based on
introspection and empathy with his patients' experience. It is,
therefore, especially in the feeling realm of analytic practice that
I find Kohut's observations, with the special attention they pay to
transference—countertransference phenomena, most valuable.
But also here there are parallels with Jung's views. Kohut, for
example, believes that the termination of analysis can be
considered successful even if 'not all structural defects have been
mobilized, worked through, and filled in through transmuting
internalization' (1977, p. 48). Compensatory, creative solutions
are also possible; as he says,
I have observed a number of patients who began to devote
themselves during the terminal phase to some deeply absorbing
creative endeavor. The evaluation of the analysand's total
behaviour pattern—especially an attitude of quiet certitude—
led me to the conclusion that the creativity of such patients ...
is not a manifestation of a defensive manoeuvre meant to
prevent the completion of the analytic process, but rather an
indication that these analysands have at least preliminarily
determined the mode by which the self will from now on
attempt to ensure its cohesion, to maintain its balance, and to
achieve its fulfilment. [1977, p. 38]
Fine and good, the analytical psychologist may say. Finally, a
great psychoanalyst has come to realize what Jung discovered
over fifty years ago. He may also get a bit angry and find it unfair
that Jung is not even mentioned here. Is Kohut an opportunist
who does not mention Jung for fear of stirring up his psychoan­
alytic colleagues' prejudices against his ideas? In not mentioning
Jung is Kohut dressing in borrowed finery? I feel we should be
148 MARIO JACOBY

careful in making such accusations. At any rate, we have to

recognize the author's courage, the courage it takes to step
beyond the relatively tabooed boundaries of psychoanalytic
theory. And I feel we can believe the author when he says that
there would have been 'only one way out of the morass, of
conflicting, poorly based, and often vague theoretical speculation*
(1977, p. xx). The only way to progress was 'the way back to the
direct observation of clinical phenomena and the construction of
new formulations that would accommodate [his] findings' (ibid.,
pp. xx-xxi). Kohut wanted to present these findings without
having first to compare them with other theories of psychology. In
a similar vein, Jung says that in the lack of orientation he faced
after his separation from Freud, he decided first of all, before
formulating any hypotheses, to wait and see what the patients
had to say for themselves (1963, p. 165). I am impressed by the
closeness of the parallel.
I personally find Kohut's works so interesting precisely
because he does not simply repeat Jungian ideas: but, rather,
with a completely different approach, he comes up with similar
results. This is much more valuable for the analytical psycho­
logist; it is encouraging and stimulating at the same time.
In any case, Kohut's theoretical views lead to innovations in
psychoanalytic techniques that partially coincide with, or at least
can be correlated with, those of analytical psychology. From
Kohut'sfindingsit becomes clear that empathic understanding of
the patient's concerns is the most important therapeutic agent.
Such a view seems to stand in contradiction to Freud's famous
dictum that analysts should 'model themselves during psychoan­
alytic treatment on the surgeon, who puts aside all his feelings,
even his human sympathy' (1912, p. 115). In order, to relieve the
psychoanalyst of any and all guilt feelings he may have when not
following this dictum, Kohut quotes passages in Freud's later
correspondence where he informally expresses views that are
clearly at variance with the injunction cited above (1977, p. 255).
Kohut rightly feels that neutrality on the part of the analyst is
not to be equated with minimal response. In his opinion, a lot of a
patient's resistances may be due to a 'certain stiffness, artificial­
ity and strait-laced reserve' in the analyst whose attitude does
not provide the essential 'empathic resonance' (ibid., p. 255). The
extent to which this empathic resonance is of greater concern to
HEINZ KOHUT'S CONCEPT OF NARCISSISM 149

Kohut than adhering to any strict and sancitifed rules can be

seen i n the following quotation:
If, for example, a patient's insistent questions are the
transference manifestations of infantile sexual curiosity, this
mobilized childhood reaction will not be short-circuited, but, on
the contrary, will delineate itself with greater clarity if the
analyst, by first replying to the questions and only later
pointing out that his replies did not satisfy the patient, does not
create artificial rejections of the analysand's need for empathic
responsiveness. [1977, pp. 252-253]
As I have already said, I find comparisons with Kohut that
merely stress the superiorities of Jungian psychology of little
interest. Instead of pointing out how unoriginal all of this is and
how much has already been said by Jung—at least fifty years
beforehand—I feel that Jungian psychology is basically open
enough to be able to integrate some of the results of Kohut's
findings. I have found this to be a profitable way of refining one's
own therapeutic procedure. (This is obviously true not only of
Kohut but also of various other approaches according to the
specific needs of each individual case.)
In practice I particularly see the usefulness of the two
transference-countertransference models related to the bi-polar
self. As is well known, Kohut differentiates between mirror
transference and idealizing transference. In the first case the
analysand expects the analyst to provide empathic resonance to
his very being, a yearning for 'the gleam in the mother's eye'. The
idealizing transference, on the other hand, stems from the
analysand's need to merge with the seemingly omniscient and
omnipotent self-object projected on to the analyst.
I would like here to give a practical example of how these two
transference-countertransference configurations can be experi­
enced. During three consecutive sessions with an analysand, a
woman of about forty, I felt so tired that I had to fight off sleep.
The 'ideal analyst' in me did not like this at all, but the fact that it
happened three times made me realize that it was probably a
syntonic countertransference reaction (Fordham, 1974). But what
did i t mean? The problem could not have been what my patient
was talking about. The subjects were interesting enough, even
though they were presented in a bit too much detail.

P—F
150 MARIO JACOBY

W h e n this incidence of fatigue occurred, my patient had been

in analysis with me for four years. She had come because of a
symptom that was extremely embarrassing for her: she could not
pick up a glass of wine, a cup of coffee or a spoon i n the presence of
other people without her whole arm's starting to tremble. T h i s
made her feel terribly exposed and flooded w i t h shame; conse­
quently, she tended more and more to avoid being w i t h people.
She was increasingly afraid and ashamed of being exposed and
getting into such a state.
A n d yet, my patient was greatly gifted i n listening to and
understanding others; her empathy—a trait which K o h u t usually
finds lacking in narcissistic personality disorders—was very well
developed. T h i s gift must have been furthered by the fact that,
from her earliest childhood on, she had been forced to develop an
extreme sensitivity i n order to adapt to her mother's constant
expectations; it was the only way she could get at least a
minimum of vitally needed attention from that obviously
narcissistically disturbed woman. Later on in life she continued
to give other people's needs priority over her own; whenever she
could not fulfil someone's expectations, she was tormented by
very intense guilt feelings.
I n analysis too she tried to adapt to 'my expectations', and she
tremendously idealized my 'spiritual side'. For her this idealiza­
tion meant having to provide me with important dreams and
interesting subject matter. Whenever she failed to do so, she felt
very frightened, ashamed and inferior, and had a sense of inner
emptiness. At such moments it was clear that fusion with the
idealized self-object, i.e. with the so highly prized 'spiritual
principle', had failed once again. On the whole, my patient
showed a lively interest i n the analysis, co-operated well, was
intelligent and had a highly differentiated feeling for psycholo­
gical connections. A s she was such a tactful person, her
admiration for me did not feel too intrusive. The stress laid on the
spiritual was not too obviously a mere defence against the erotic
component, but seemed to correspond to a genuine need i n her.
And so, in the countertransference thus far I had felt on the whole
animated by her presence and full of ideas for possible
interpretations. Occasionally, however, I found m y s e l f delivering
lengthy, very knowledgeable explanations. Still m y analysand
seemed to feel nourished and enriched by such discussions,
HEINZ KOHUT'S CONCEPT OF NARCISSISM 151

although she sometimes feared that on her way home she would
forget all the interesting things she had learned.
As far as her symptoms were concerned, with time there was
definite improvement. But we were both aware of the fact that
her continuing tendency to feel easily hurt and embarrassed still
prevented her from being really spontaneous. I must add here,
however, that at this stage of the analysis she no longer hesitated
to expose herself to a large team and even to her superiors
whenever she felt she had to stand up and fight for an important
cause. At such times she had the feeling she was borne on by some
transpersonal, spiritual ideal—probably a sign of fusion with an
idealized self-object. But going to a restaurant and drinking a cup
of coffee with the same people still cost her tremendous efforts in
trying to overcome her fears of exposure.
I could not shake off her idealizing transference and interpret
it as 'mere compensation'; it was a matter of too vital concern for
her. Kohut finds it important for the analyst to embody the
idealized transference figure for a certain time. The analysand's
disappointment that the analyst does not correspond to the ideal
phantasy figure, and that has to take place gradually, stimulates
the process of transmuting internalization. In Jungian terms we
would say the analysand can take back the projections: the
projected content is recognized as intra-psychic and can be
partially integrated. My analysand too began to express some
criticiism towards me; from the standpoint of the therapy I
welcomed her new courage.
But what did my repeated attacks of sleepiness mean? The
third time this countertransference reaction occurred, I decided
not to fight i t off, but to discuss i t in some way with my
analysand. Given her vulnerability, I obviously could not state
the problem directly and tell her she evidently bored me to the
point of sleep. What I did ask her was if at the moment she might
have the feeling that she was far away, or even isolated from me.
And, in fact, she was then able to say that she had the impression
she was babbling about completely uninteresting things and
could naturally not expect me to be interested; consequently, she
felt more and more unsure of herself. What she said meant, in
other words, that when she did not have my empathic resonance
she felt rejected and worthless. Further analysis of our situation
showed that she found herself constantly having to fend off an
152 MARIO JACOBY

ever-increasing need: a deep yearning for a mirroring self-object.

This need had been deeply buried and was now slowly coming to
light. It was a need to be seen and admired—that is, to experience
'the gleam i n the mother's eye'. However, as it was connected
with early traumatic memories of disappointment, it was coupled
with fear and had had to be repressed. Therefore, a l l she could
consciously experience at this stage of the analysis was intensi­
fied fears of not meeting up to my expectations and boring me. A s
my sleepiness shows, she did manage to bore me and thus to t u r n
me into the unempathic, rejecting maternal figure; at the same
time she was unable, even by the most timid of signs, to
communicate to me her real need for a mirroring self-object. O u r
efforts at interpreting the emerging mirror transference helped
her to express herself more freely whenever she felt that I had
misunderstood her, hurt or rejected her. T h i s was the beginning
of further progress on the way towards self-assertion and
overcoming her symptoms.
Generally speaking, it must be said here that in our society the
need for praise, recognition and admiration is usually m a s k e d
and can only be expressed indirectly. Narcissism is considered as
something negative. A s the saying goes, 'self praise is no
recommendation'; one should be meek and humble i n the true
Christian way. Narcissistic needs often have something embar­
rassing about them, and most people today can speak more openly
about their sexual problems than about their narcissistic ones.
Those who do not hesitate to show off and are not shy i n
displaying narcissistic enjoyment therefore often attract typical
shadow projections—a combination of rejection, envy and secret
admiration. I n keeping with its nature, narcissistic 'orgasm' is
triggered by the beautiful self-image i n the mirror, that is, by
admiring applause. T h a t is the reason why it tends to seek
release not i n the intimacy of a quiet little room, but i n public.
But 'public orgasm', i f I may call it that, can only be r e a l l y
enjoyed by true exhibitionists; a lot of narcissistic orgies are only
allowed to exist i n the secret realm of phantasy. As a n example of
the conflict involved i n narcissistic enjoyment, I can t h i n k of a
relatively well-known playwright with a nearly insatiable greed
for narcissistic supplies of praise and admiration, who w a s at the
same time extremely touchy about the slightest criticism. O n e
day a work of his was performed at a very important festival.
When it had been duly applauded, he stood in the artists' box,
HEINZ KOHUT'S CONCEPT OP NARCISSISM 153

anxious for admiring attention. And yet, when people congratu­

lated him on his success, he was so embarrassed that he could not
look them in the eye. This, in turn, was not very encouraging for
those trying to congratulate him. Another playwright once told
me i t always took him weeks to recover from a success and the
emotional turmoil i t brought with it, and to find himself again. It
seems to me that in such cases we can speak of what Kohut calls
the discomfort caused by an 'influx of narcissistic-exhibitionistic
libido' (1971).
For an analyst, also, i t is not necessarily easy to cope with the
boundless admiration he receives in idealizing transferences. On
the one hand, such transferences tend to constellate the analyst's
fears of beingfloodedi n an embarrassing way with his own latent
phantasies of omnipotence (Kohut's 'grandiose self). On the other
hand, he may feel under great pressure not to disappoint his
patient's idealized expectations. Thus, the analyst may in his
turn unconsciously experience his patient as a self-object whose
idealizing admiration he needs intensely for his own narcissistic
balance. In addition to this, i t can be extremely embarrassing for
the analyst to have to realize the tremendous pleasure he gets
from being seen as such an admired and idealized person. This
does not mean that he cannot at the same time be narcissistically
hurt when the patient's disappointment slowly leads to the
withdrawal of projections and the analyst finds himself no longer
so deeply loved, admired and needed. However, as this is usually
a good sign for the analytic process, the analyst's narcissistic
needs can find a certain compensation in the form of heightened
professional self-esteem.
This might be the reason why training candidates are often so
reluctant about even raising the subject of the transference with
their patients. They are afraid their patients might find them
conceited and narcissistic; unconsciously they often confuse their
possible importance as a transference figure with their personal
importance. Consequently, there is a lot of beating about the bush
on this matter. This is perhaps not the case for candidates of the
London group, where the interpretation of the transference is 'the
fulcrum of analysis' (Gordon, 1974). And yet I can imagine that it
takes a lot of narcissistic investment to attain such a high level of
sensitivity in dealing with the transference; keeping at bay
feelings of grandiosity or inferiority must, therefore, also
somehow be involved. One cannot deny how important i t is for an
154 MARIO JACOBY

analyst to come to terms with his own narcissistic needs and

phantasies, lest they become counterproductive for his patients.
In the attempt to find a modus vivendi with one's grandiose self, I
can favourably recommend another one of Kohut's suggestions,
namely the development of humour. I truly believe that tolerant
humour is the best way to deal with the drive-like demands of the
grandiose self. If I can accept with a good portion of humour the
side in me that would so much like to be omniscient, omnipotent,
world-famous and loved by all, then a great deal of inhibiting,
complex-laden embarrassment can be overcome. I then acknowl­
edge the existence of such phantasies and, to a certain extent, let
them have their due; at the same time, however, I can consider
them with a certain measure of humorous detachment.
It must also be noted here that in numerous places in his
writings Jung shows a rather negative, even moralistic, attitude
towards narcissistic needs—for example, where he says,
The more we become conscious of ourselves through self­
knowledge, and act accordingly, the more the layer of the
personal unconscious that is superimposed on the collective
unconscious will be diminished. In this way there arises a
consciousness which is no longer imprisoned in the petty,
oversensitive, personal world of the ego, but participates freely
in the wider world of objective interests. This widened
consciousness is no longer that touchy, egotistical bundle of
personal wishes, fears, hopes, and ambitions which always has
to be compensated or corrected by unconscious counter­
tendencies; instead, it is a function of relationship to the world
of objects, bringing the individual into absolute binding, and
indissoluble communion with the world at large. [CW 7, para.
275]
One of the ideals of Jungian analysis is, therefore, overcoming
and outgrowing this personal, touchy 'ego world' as quickly as
possible in order to get onto the real, deep and numinous
dimensions of the self in the collective unconscious. Analysts and
also patients who have read Jung often work with this ideal i n
mind. They consider i t less important to analyse contents that
seem to belong 'only' to the personal unconscious and are
seemingly unaware of the consequent danger: that these contents
actually remain unconscious and intensify the shadow problem.
In Kohut's terminology the goal of this ideal of Jungian
analysis would be bringing to life the compensatory structure of
HEINZ KOHUT'S CONCEPT OF NARCISSISM 155

the self via fusion with an idealized self-object. In other words,

what usually happens is fusion with an idealized 'Jung* and his
ideas about the wonder world of the collective unconscious. It is
true that in many cases the compensatory structure can
contribute to a certain 'restoration of the self. But often it seems
rather to be a defensive structure against the primary defect. At
any event, we know that people who have, for a long time, been
moving in 'the deepest waters of the unconscious' do frequently
still show notable signs of narcissistic vulnerability.
In this chapter I have attempted to investigate some trends in
the practice of analytical psychology from the standpoint of
Kohut and not the opposite, i.e. to examine Kohut's theses in the
light of Jungian psychology. I think that travelling is very
important, in so far as one can do so with open eyes and not with
blinkers that only help to prove how much better everything is at
home. Travelling makes comparisons possible, offers new per­
spectives that can help one to see the specific traits of one's own
country more clearly. My approach does not mean that I
completely identify with Kohut—at least I hope not.
There has already been one attempt at interpreting Jung's
personal psychology as well as his ideas on psychology largely in
the context of Kohut's concepts (Homans, 1979). Although this
undertaking shed some new light on many problems, I feel it was
only partially successful. My own approach is rather related to
the question of whether integrating some of Kohut's ideas in
analytic practice might not be helpful in refining our therapeutic
tools for the benefit of our patients.

Summary
This chapter deals with some of the astonishing similarities
between Heinz Kohut's theories on narcissism and many basic
views of C. G. Jung. As in his last book Kohut places the self as
the 'centre of the psychological universe', those similarities have
become even closer and call for a differentiated comparison.
Kohut seems to have arrived at his conclusions independently, by
his own observations, without reference to Jung. There are many
of his subtle insights which can also be used fruitfully in the
practice of an analytical psychologist—as a case example tries to
156 MARIO JACOBY

show. The chapter, furthermore, contains some reflections on the

taboos of many narcissistic needs in our society. It finally deals
with some difficulties that can be inflicted by the 'grandiose self
also upon the analyst.

REFERENCES
Berne, E . (1964). Games People Play. New York: Grove Press.
F o r d h a m , M. (1973). The empirical foundation and theories of the self in
J u n g ' s works. I n Analytical Psychology: a Modern Science. L i b r a r y of
A n a l y t i c a l Psychology, V o l . 1. London: K a r n a c Books.
(1974). Notes on the transference. I n Technique in Jungian
Analysis. L i b r a r y of Analytical Psychology, V o l . 2. [Reprinted 1989,
with corrections and new introduction by J. Hubback.]
London: K a m a c Books.
(1976). The Self and Autism. Library of Analytical Psychology,
V o l . 3. London: Karnac Books.
Freud, S. (1912). Recommendations to physicians practising
psychoanalysis, Standard Edition 12. London: Hogarth.
Gordon, R. (1974). Transference as the fulcrum of analysis. I n Technique
in Jungian Analysis. L i b r a r y of Analytical Psychology, V o l . 2.
[Reprinted 1989, with corrections and new introduction by J .
Hubback.] London: K a m a c Books.
H a r t m a n n , H . (1964). Comments on the psychoanalytic theory of the ego.
I n Essays on Ego-Psychology. New York: International Universities
Press.
Homans, P. (1979). Jung in Context. Chicago: University of Chicago
Press.
J u n g , C . G . (1963). Memories, Dreams, Reflections. London: Collins and
Routledge & K e g a n Paul.
K o h u t , H . (1966). Forms and transformations of narcissism. Journal of
the American Psychoanalytical Association 14, 243-272.
(1971). The Analysis of the Self. N e w York: International
Universities Press.
(1972). Thoughts on narcissism and narcissistic rage. I n The
Psychoanalytic Study of the Child, 27 (pp. 360-400). N e w York:
Quadrangle.
(1977). The Restoration of the Self New York: International
Universities Press.
N e u m a n n , E . (1973). The Child. New York: G . P. Putnam's Sons.
[Reprinted 1988, London: Maresfield Press.]
CHAPTER EIGHT

The borderline personality:

vision and healing
Nathan Schwartz-Salant

Herein, with a wealth of clinical material, Schwartz-Salant

demonstrates the use of the concept of the 'unconscious dyad' in
analysis. This leads to a sophisticated reframing of the coniunctio
to suggest the multi-leveled dynamics of an interactive field.
Such dynamics are specifically stated by Schwartz-Salant to go
beyond the personal realm.
A further technical innovation is the idea of 'imaginal sight'.
This way of relating to the patient and the clinical material
makes explicit what many analysts probably do—but they do so
implicitly, hence at a lower level of conscious awareness.
Schwartz-Salant's twinning of the 'logic' of the borderline
patient with a particular mystical tradition serves to prevent any
simplistic pathologizing. The borderline patient is presented, to a
degree, as Everyman or Everywoman.

F i r s t published i n Chiron, 1988; also forms part of a book, The

Borderline Personality: Vision and Healing (Wilmette, I L : Chiron
Publications, 1989). Published here by k i n d permission of the author and
Chiron Publications.

P-F» 157
158 NATHAN SCHWARTZ-SALANT

The many references to the Rosarium or the Rosarium

Philosophorum refer to Jung's commentary on an illustrated
alchemical tract of the sixteenth century. The pictures of the
Rosarium are numbered, and the whole work, entitled The
Psychology of the Transference, is found in Volume 16 ofJung's
Collected Works. Jung thought that alchemy, looked at with a
symbolic and not a scientific eye, could be regarded as one of the
precursors of modern study of the unconscious and, in particular,
of analytical interest in the transformation of personality.
A.S.

The field of battle is the hearts of people.

[Dostoevsky, The Brothers Karamazov]

Introduction

A
lthough experiences with borderline patients can be
understood i n terms of transference or countertransfer­
ence projections that repeat early continual traumas
( K h a n , 1974) a n d developmental failures, this is nevertheless
a faltering perspective. I n this chapter I also envision my
experiences i n terms of field dynamics that engage atemporal
forms. These field experiences are larger i n scale than purely
personal dynamics comprised of our mutual projections. For in1

some mysterious way our interaction constellates, creates or

discovers—no one word will do—some 'third thing*. Jung's
description of the alchemical god Mercurius is apt: 'The elusive,
deceptive, ever-changing content that possesses the patient like a
demon now flits about from patient to doctor and, as the third
party i n the alliance, continues its game. . . .' (CW 16, para. 384).
We can say that the archetypal transference is constellated by
the reactivation of early introjects i n the transference and
countertransference, and that this new material projects outward
to yield the wondrous imagery of hermaphrodites, the combined
THE BORDERLINE PERSONALITY 159

or double-sided objects that Jung's alchemical research illumin­

ated. But are we simply dealing with a replay of earliest
infant-mother interactions where 'archetypal' and 'personal'
designations are of little value (Eigen, 1986a; 1986b, pp. 59fJ), or
are these new processes and energy fields that are not reducible
to infant or even prenatal life? This is a crucial theoretical
crossroad, for therapists who believe that experiences in
psychotherapy replicate early failed or aborted developmental
experiences would do well to consider whether theoretical pursuit
alone is adequate to the nature of the psyche and its archetypal or
objective dimension. Often psychotherapy reveals bewildering
and bizarre introjects stemming from the patient's early child­
hood experiences. The therapist then identifies these through
reflecting upon fusion states and participation in projective
identification. But this approach is too limiting. An imaginal
focus is required i f one is to engage the borderline person
effectively. The therapist must begin to think differently—that
is, he or she must imaginally focus upon interactive fields that
are structured by atemporal forms (Levi-Strauss, 1967, p. 198).
The interactive field can be comprehended only as 'third
presence', which often takes the form of an unconscious dyad; it
should not be viewed through a structural model of projections
that must be integrated. The object relations model is not
unimportant; its value is unquestionable. But though it is
indispensable, by itself it is insufficient. Both models are
required: the projection model that is concerned with early
developmental issues and the imaginal model that incorporates
the alchemical imagery of the coniunctio and its attending
stages. We need to adopt a model that is two-sided, one aspect
2

pointing toward a space-time world and the other toward a

unitary world structured by archetypal processes. These two
aspects intertwine. They cannot and should not be split into
separate and opposing categories of 'personal' and 'archetypal'.
The unconscious dyad may be seen as stemming from both the
patient and the therapist while also being part of a larger,
interactive field. Once it is sufficiently seen and experienced, the
unconscious couple can eventually lead the patient and therapist
to an experience of union. This union experience is precisely what
the borderline person lacks.
160 NATHAN SCHWARTZ-SALANT

Discovering the borderline patient's unconscious dyad:

projections and field dynamics
'Ed' was an exceptionally intelligent and multi-talented 38-year­
old man. He entered treatment for several reasons. He employed
his intellectual and creative gifts only marginally in his career;
in general, he was plagued by a lack of purpose and commitment
to any goal. Other people were getting along in life, and he was
not. A major theme in his life was an obsession with actions that
others had taken toward him which he often found to be immoral;
he was also absorbed with his own behaviour, of which he was a
keen critic. He would spend hours alone engrossed in wondering
why someone treated him as they had, or why he was so
emotionally paralysed and unable to be forthright during some
interaction with another person whose malevolence would later
become quite evident to him.
At the outset of our work Ed seemed to be suffering from a
narcissistic character disorder. An idealized transference com­
bined with the controlling dynamics of his grandiose-exhibi­
tionistic self was present, so that I felt compelled to have answers
to his questions (Schwartz-Salant, 1982, pp. 50 ff.). My responses
were usually well received, but I had an uncomfortable sense that
he was trying very hard to be open to me and was merely being
polite. It was soon clear that his narcissistic character formation
was a defense against a deep and chaotic part of his personality.
His transference did not differentiate into idealized and gran­
diose-exhibitionistic strands as it might have if he had had a
narcissistic character.
My work with Ed demonstrates a complex interactive field
(which to one degree or another is always present in the
treatment of the borderline patient), that is exceptionally
difficult to apprehend. In fact, my compulsion to act out a pattern
of unrelatedness—by talking without much reflection—could at
times nearly nullify my observing ego, and his as well. During
these periods all my attempts to bring coherence or consciousness
to the session only led to role reversals and often resulted in pain
for both of us. I then felt my own pressure to 'get it right'; often I
could not remain quiet. Instead, I would attempt to make
interpretations, though even scant reflection would have shown
me that I had only shallow comments to make. During these
THE BORDERLINE PERSONALITY 161

times, however, I was not disposed to self-reflection, but would

proceed with my commentary, all the while feeling dull-witted
and hoping that what I had to say would be accepted. As Ed was
intent upon being truthful, he did not accept this behaviour from
me. He had suffered too many years of being tortured by
frustrated mental and creative gifts and previous unsuccessful
therapeutic experiences to allow our work to fail, too.
Often, I felt that Ed was the truth-seeker, whereas I was the
liar, just barely able to survive. Survive what? That is not easy to
describe, but I can say that soon after our work began and the
strength of his narcissistic transferences diminished, our uncon­
scious psyches became meshed together in such a way that a
searing and tormenting energy field was established that nearly
destroyed my capacity to think and reflect. Each time Ed arrived,
I would have a brief period of optimism and feel that we might
establish a good connection and proceed with our work. I would
then become emotionally and physically limp, and it would be
difficult for me simply to remain embodied and be with him.
Instead, I usually felt obliged to talk, and thus to act rather than
be. Often I could not tolerate the absence of meaningful content
between us, and sometimes I was frightened of this man. At
times, I felt that he might strike me, but my more usual afflicted
state was one in which I believed that he was the one dedicated to
the truth and that I was a fraud. This stance was unchallenged by
Ed's torment about being the subject of his own lies, especially
the denial and distrust of his perceptions.
For over a year we could barely relate to one another, though
there were many desperate attempts to create a sense of
connection. During this period, my work with Ed primarily
consisted of my showing him that I could survive amidst his
attacks. Every word I used, each tone of expression I chose, came
under his scrutiny. During this process, Ed began to form a
growing alliance with me. One day, he spoke of some reading he
had been doing and, to my surprise, asked about the nature of our
unconscious couple. This represented a crucial shift in his psyche
toward an attitude of more cooperation in the therapy; I was then
able to reflect imaginatively upon what might be structuring our
interactive field. I arrived at a hypothesis that made sense to both
of us: that a couple who did not want union was our major
obstacle. The state of non-union (depicted, for example, in picture
162 NATHAN SCHWARTZ-SALANT

seven of the Rosarium, The Extraction of the Soul', CW 16, para.

476) is described by Jung as a loss of the soul, and has a similar
impact to that of a schizophrenic dissociation. Our soul-less
interaction manifested in ways that seemed to catapult us into
completely different universes. A t such times, I would believe
that we were actually relating well to each other, yet we were
actually not communicating at all. Upon reflection it became
clear that my interpretations were strained; I wasn't connected to
him and had been speaking to avoid the pain of emptiness,
despair and a feeling of impotence. In fact, the level of
dissociative intent was so profound that we each might as well
have been talking to ourselves.
The Rosarium, commenting upon picture seven, offers the
following recipe for healing this disconnected state:
Take the brain ... and grind it in most sharp vinegar, or in
children's urine until it is obscured, and this being begun again
as I have written it, may again be mortifed as before. . . . He
therefore that maketh the earth black shall come to his purpose
and it shall go well with him. [McLean, 1980, p. 45]
Notably, the Rosarium also adds that in searching for this black
earth 'many men have perished' (ibid.).
'Grinding the brain in sharp vinegar' is by no means a poor
metaphor for the way I functioned with this man, and he with me.
Many of his nights were spent trying to recover from sessions that
destroyed his ability to think and left him totally confused and
enraged. The Rosarium implies that there is a purpose to the
tormented states of mind that afflicted both of us. This purpose is
suggested by the creation of the hermaphrodite (picture ten, The
Rebis', CW 16, para. 525). The alchemical Rebis is a combined
male-female object and represents the creation of a fertile and
stable interactive field. But illustration seven, 'The Ascent of the
Soul' (CW 16, para. 475), warns of a great danger—perhaps the
death of the therapy, and perhaps activation of the patient's
tendencies towards self-destruction, a possibility that always
exists with the borderline patient when levels of extreme
dissociation and despair are engaged. In Ed's and my work
together, there was some ground for believing that the states to
which we were subject had some purpose; it was equally clear
that our nigredo would not become fruitful if our therapy process
were to be dominated by acting-out and unconsciousness.
THE BORDERLINE PERSONALITY 163

Over the course of many trying sessions that took place within
a period of approximately two years, the nature of our problem
began to emerge. Our interaction was structured by an uncon­
scious couple dominated by a drive for non-union; each half of the
couple desired to destroy the other through lies and malicious
envy. At the same time, the parts that comprised this couple were
stubbornly and inextricably bound to each other. Thus our
interaction was dominated by the characteristic borderline
quality of simultaneous drives toward fusion and separation,
which together produced great confusion.
As a very young child Ed had experienced his parents in ways
that resembled the dynamics of this dyad. He recalled feeling
persecuted by his parents' false implications that they actually
saw him and had his best interests at heart. Over and over again,
he would be perplexed by their antagonistic behaviour towards
one another and their destructive fraud and deception towards
him. Apparently, they had functioned as a double-sided object,
each half contributing to this persecuting dyad. The young,
extremely intelligent and sensitive child would earnestly lecture
them on their behaviour and would be repeatedly upset and
unhinged by the accumulating knowledge that he had had no
effect at all, except as it rebounded onto him in the form of his
father's rage or his mother's martyrdom.
This unconscious parental dyad had been split off from his
otherwise normally functioning personality in order that Ed
could survive. Consequently, he developed the typical borderline
split between a normal-neurotic and a psychotic personality—a
split that was also a fusion state. James Grotstein writes:
In approaching a psychoanalytic conception of the borderline I
should like to offer the following understanding: What seems to
give the borderline personality (and borderline state) its
uniqueness in differentiating itself from psychoses on one hand
and neuroses on the other is not so much its midplace on the
spectrum but is instead a qualitative difference. This qualita­
tive difference is characterized, in my opinion, by the presence
of a psychotic personality organization and a normal or
neurotic personality organization which have undergone a
unique interpenetration with each other so that a new
amalgam emerges which can well be stated as 'psychotically
neurotic' or 'neurotically psychotic'. It is as if a collusive
symbiosis exists between these two twin personalities which
164 NATHAN SCHWARTZ-SALANT

allows for an unusual tenacity, stability, and cohesion com­

pared to psychotic states generally. [1979, p. 150]

When Ed's defensive-idealized transference waned, his psychotic

parts (largely conveyed by the unconscious dyad) entered the
therapy process and nearly usurped it. This led to what could be
called a transference and countertransference psychosis; its
intensity was extreme. Yet unless therapy contains a transfer­
ence psychosis (and a countertransference psychosis as well,
though hopefully to a lesser degree), there is little chance of
healing the borderline person. By countertransference psychosis I
do not imply the therapist's blatant loss of reality or decompensa­
tion, but rather the emergence of parts of his or her personality
that are unintegrated, thus having an autonomy beyond the
organizing domain of the self. These 'mad parts' of the therapist
can take over the therapy in subtle and diverse ways—the patient
may introject them and begin to act quite mad, even to the point
of engaging dangerous situations in the outer world. For
example, after a therapist had seductively shared his personal
material with a borderline patient, the patient dreamt that he
was being driven in a vehicle by a madman. The patient's
outer-life situation reflected this psychic state: as a result of his
irrational behaviour he was nearly fired from his job. This
sequence was a consequence of the therapist's denial of his own
psychotic parts—unintegrated and compulsive qualities of his
personality—which he was 'sharing' in the hope of creating a
'holding environment'.
To convey the extent to which Ed and I were dominated by an
unconscious dyad, I will relate material taken from sessions that
took place two years after our work had begun. At this time, Ed
dreamed that he was gently embracing two women, one black, the
other white. I understood this to be the image of a combining
state, which I , too, could now carry in projection because there
had been sufficient reparation on my part for previous analytical
errors (for example, talking too much and acting rather than
being embodied). I felt that he thought me more reliable than
heretofore; it seemed to me he was no longer obliged to split me
up into 'good' and 'bad' parts, which he had to scan from both a
conscious and an unconscious perspective.
THE BORDERLINE PERSONALITY 165

The dream of the two women was soon followed by another in

which he and another man, whom he associated with me, were
flying in an aeroplane very close to the ground in order to gain a
view of the earth below. At first, the other man was guiding the
vehicle, but then the patient was taught by the man to guide it
himself. This dream seemed to indicate that the therapy was now
based on mutual cooperation. Indicative of the potential of our
interactive' field was the emergent image of a fruitful coital
couple. The dream image of the aeroplane symbolizes a vessel; as
this vessel hovers near the earth, we can say that the image
indicates both spirit and a capacity for a solid therapeutic
alliance. Such understanding had been sorely lacking during the
prior two years; Ed had suffered as a consequence and had taken
great pains to make me understand that I was the cause of his
great distress.
Soon after this dream, I was surprised to find Ed once again in
a state of extreme agitation and doubt about my role as therapist
and about the therapy itself. Yet this was no cause for surprise.
My desire to see our process progressing and free of Ed's searing
criticism was a tendency that, he said, 'drives me crazy'. His
comment led me to examine why I was driving him crazy, and
whether or not I wanted to do such a thing to him. To use his
phrase, which I found unpleasantly apt: why was I (again)
'operating in bad faith?' But, before the examination could
proceed, a row occurred that left both of us in a state of doubt over
whether or not it would be possible to continue therapy.
I will be specific about the session in question. Ed arrived on
time, and even before sitting down asked me a question about a
previous remark I had made. His question felt like an attack,
although it was not expressed angrily; I became very defensive.
But my response was far stronger than usual; I lost sight of my
defensiveness as I felt my body fill with an agitation that was
disintegrating in its affect. It seemed that my insides were under
an attack of global nature. I was anxious, inwardly shaking; at
the same time I found myself trying to act as if everything were
okay. In effect, I was denying the state of non-union that existed
both between us and within myself. Clearly, I was behaving in a
borderline way. I had previously experienced this state with him,
though not so intensely as in this experience. The accusation of
166 NATHAN SCHWARTZ-SALANT

operating in 'bad faith' always appeared as a reaction to this kind

of behaviour. The seriousness and prominence of this accusation
gradually increased during the course of the therapy.
The session I am describing cannot be understood without a
clear comprehension of the evolution of this theme. In this
instance, the illusion that a viable and helpful connection now
existed between Ed and myself was part of the underlying deceit;
the fact was that in significant ways I did not want an emotional
contact with him. The awareness of my desire not to have any
form of union with Ed was slow in arriving; in retrospect, I am
both chagrined and astonished at the ingenuity of the tactics I
employed to avoid this discovery. Certainly, a subjective counter­
transference was present, but much more was operative in this
interaction. There was a field-quality inherent in our process in
which non-union was the main ingredient.
One of my unconscious strategies to avoid contact with Ed was
to remain anxious. My fear of the malignant energy field, evoked
by our mutual presence, would thereby allow him to take the lead
in understanding any material the therapy process was engaging.
When I was at my worst, I would present Ed with an extremely
toxic double bind by denying the madness between us and
electing to see him (and, by implication myself) as possessing
strength and adeptness, qualities carried by the normal-neurotic
self. I often found myself dull and unable to think clearly. Worse,
I would find myself immersed in an imaginative and creative
void, a leaden state that combined heavy Saturnian authority
and the compulsion 'to know'. In contrast, Ed would seem bright,
sharp and intelligent. It was as if his ownership of these qualities
meant that they were unavailable to others—specifically, to me. I
would submit to the sense of having lost all acuity, all creative
energy. In any other case I had at the time I would have capably
employed these countertransferential reactions syntonically and
unearthed an 'other side' of chaos, despair and helplessness; in
this case, I did not. Nor did I recognize that Ed needed me to be
able to think with him, if not for him. I later came to realize that
there was a choice involved in this profound countertransference,
though this choice was not evident to me at the time. Leon
Grinberg has described the course of this countertransference as
follows:
THE BORDERLINE PERSONALITY 167

From a structural point of view, one may say that what is

projected by means of the psychotic mechanism of projective
identification operates within the object as a parasitic super­
ego, which omnipotently induces the analyst's ego to act or feel
what the patient in his fantasy wants him to feel or act. I think
that this, to some degree, bears comparison with the dynamics
of hypnosis as described by Freud. According to Freud, the
hypnotizer places himself in the position of the ego ideal, and
hypnotic submissiveness is of a masochistic nature. Freud
further holds that in the hypnotic relation a sort of paralysis
appears as. a result of the influence of the omnipotent
individual upon an importent and helpless being. I believe the
same applies to the processes I am discussing in that the
analyst, being unaware of what happened, may later rational­
ize his action, as the hypnotized person does after executing the
hypnotic command. By means of the mechanisms of obsessive
control, the inducing subject continues to control what he
projected onto the induced object. The subject's omnipotent
fantasies thus acquire some consistency, as they seem con­
firmed by the object's response. [1977, pp. 128-129]
In time, I began to shake myself out of this hypnotic involvement
with the patient and was able to recognize this state of non-union.
This emerging awareness, combined with Ed's concerted efforts to
contain me, resulted in redeeming the therapy.
I have emphasized that I 'chose' non-union because I have no
doubt that a choice was involved, although I was unaware of it at
the time. But the fact that a choice existed meant that a moral
issue was involved: I had lied to Ed about understanding him, and
about being i n the same psychological universe with him. I must
emphasize the aptness of his complaint that I was acting in bad
faith; the recognition of its truth was shocking. My self-image
had been that I was a person who deeply wanted union—indeed,
who held it i n the highest esteem.
It was against this background that I was finally able to
recover my bearings in the therapy. It was abundantly clear that
transferential elements were involved and that my behaviour
was a representation of Ed's interaction with his mother and
father, and particularly with the parental couple that their
psyches evoked: a couple in intense, antagonistic disunion, each
out to destroy the other through envy and hatred. My bad faith
168 NATHAN SCHWARTZ-SALANT

and lies reflect his parental experience. The state of being

overwhelmed and barely able to retain my thoughts replicates his
feelings when his parents continually denied his perceptions. His
parents also represented deceitful behaviour, of which he was
certainly capable—indeed, he could treat his friends and
acquaintances with the very lack of truthfulness that he found so
distressing in others. But I , too, was driven to behave in immoral
ways; and while I can attribute this compulsion to countertrans­
ferential acting out, which it certainly was—especially the
resistance of experiencing despair—something else was involved.
We were both participants in a process that was not merely a
repetition of past history but was also a creation in its own right.
In my therapeutic work with Ed I was often thrust into a
masochistic position. In part, this was a matter of choice, based
3

upon my belief that the borderline person sees what the therapist
does not wish to be seen. By acknowledging Ed's perceptions (for
example, that I had chosen to act in ways injurious to him), I was
obliged to recognize unconscious shadow aspects of my personal­
ity that I had allowed to guide my behaviour. This helped him to
begin to gain faith in the correctness of his perceptions. I could
easily have dismissed his complaint as a paranoid distortion
which was picking up a shred of truth. This perception would
have been comforting to me, but very undermining of Ed.
I also wish to note that there were times, though perhaps too
few of them, when I reacted to Ed in ways that were not
masochistic. For instance, at times I expressed how much I hated
the way he was treating me, especially his criticism of my words
and behaviour, which he mercilessly scrutinized as being careless
and incompetent. This expression of hatred was possible—and
was not assaultive—when I could feel how much his attacks (even
though they may have been premised upon truth), were painful
and frightening to the small child within me. I was standing up
for this child when I could talk about my hatred without
attacking Ed. Indeed, this direct response was a relief to Ed, for it
showed that I was real and perhaps even trustworthy, despite the
fact that a good deal of what occurred between us was dominated
by an intense drive to disrupt contact.
The clinical material that relates to this patient depicts some
of the more difficult aspects I have encountered when treating the
borderline person. It is impossible to separate clearly the personal
THE BORDERLINE PERSONALITY 169

transference and countertransference from the archetypal field

dynamics that are so richly constellated within these levels of
treatment. The therapist treating the borderline patient must
acknowledge the experience of non-union. He or she must also be
capable of accepting its existence and of respecting it as a
state that holds meaning beyond what can be gleaned from
the immediate experience. Hence, therapy will depend to large
measure upon faith and a capacity to repair the errors incurred
while defending against the pain of non-union.
Ed and I seemed to engage a transference couple that desired
non-union and was so split from awareness that neither of us had
any idea at all what the other was saying. Some other active force
placed us in what felt like separate universes. Was he responsi­
ble? Was I? Was he out to defeat me, or to see whether I could be
tricked by his duplicity? For example, would I obligingly act as if
things were going well just as he often did as a child when he had
to split from his real perceptions and try to believe instead that
his parents were doing the best they could? And was our
interaction doomed because of its destructive nature, or, as the
Rosarium suggests, was it somehow a process through which a
new self was being formed? Often our therapeutic endeavour
seemed possessed by a demonic, trickster-like force that toyed
with me as i f I were its infant.
How can one understand this demonic force? Can it be reduced
merely to the component of envy—that is, my envy attacking our
connection by 'misunderstanding' him? Or, was I acting out his
introject of parental envy? Such interpretations have value; other
equally Valid' interpretations could also be made. But if we do not
also possess an archetypal viewpoint, we are likely to overlook
the essential fact that something of a significantly different
nature has been operating—an archetypal process much larger
than the two of us.
A subsequent session revealed other aspects of our unconscious
process. Ed began with a question: 'What is your relationship to
my inner couple?' It seemed as if his plight was encapsulated in
this question, and I acted as i f there were no time to lose, feeling
pressed and harried to 'get it right'. I began to lecture him: The
inner couple is also an image of the relationship of your
consciousness to the unconscious. If the couple is in disharmony,
you will be in disharmony as well.' To this assertion he bristled,
170 NATHAN SCHWARTZ-SALANT

as usual, with the insistence that I was being as impersonal as a

textbook. And he was right, of course. There were other instances
of my intellectualized attempts to answer his question during this
session; all were spun from my haste and a refusal to take the
time to sort out what he was saying—to understand truly instead
of pretending to understand. My behaviour had perpetuated my
erroneous belief that I was connected to him. We also exchanged
roles: at times I would feel the need to slow down and be utterly
precise, whereas he would gallop along, moving too quickly for
me to be able to understand him in a full, grounded way.
Suddenly, Ed returned to the question: 'What is your relationship
to my inner couple?'
The fact that I was feeling somewhat depleted helped me to
orient myself in a way that I knew might be helpful—back
towards what had been happening between us in the here-and­
now. I allowed myself to become more centred, more fully
embodied, and I surrendered much of my control. Only when I
finally succeeded in returning to my own feelings was I able to
recognize that I had been afraid of being physically harmed. My
fantasy had been that I had better get the right answers or he
would hit me.
Then I began to realize that I had been experiencing and
re-enacting Ed's early life with his parents, for when he failed to
create harmony between his parents, he would be in great danger
of being hit. He experienced his parents' disharmony and
antagonism as dangerous both to the family unit and to himself,
and he had to set it right, lest he be attacked. His solution was, in
effect, to attempt to force his mother and father to behave
differently—both towards one another and also towards him. It
appears that I had been acting out an introject of his child-self as
it compulsively attempted to create union. In this particular case,
the urgent demand was that I create harmony between us by
answering the question about his inner couple. And the
compulsion to do so overrode the underlying awareness that a
basic lack of connection—a prevailing non-union—was the
dominant factor in our relationship.
I expressed these thoughts to Ed, and this interpretation
proved somewhat effective in leading us to a deeper understand­
ing. He suggested the possibility that he was attacking me for
acting in disunion with myself, adding that I could be seen as
THE BORDERLINE PERSONALITY 171

representing both his own couple in disunion and his child-self

frantically attempting to change the situation. Alternatively, I
could be seen as a person who incorporated the potential to evoke
the disharmony that he found so devastating. Whenever I would
evoke disharmony by being out of harmony with myself, Ed
would become very nasty and have the urge to hit me. The
verbally abusive negative inner couple (his parental images in
their state of disunion), which were constellated in me, severely
affected him.
There was a definite improvement when we became able to
objectify the interactive field in terms of a couple engaged in
battle while paradoxically desiring no contact at all. We were also
able to observe this same couple as persecutory of the small child
within each of us. Containment for these persecutory affects grew
as we became able to identify the couple imaginally. Perhaps this
containment is the element that enabled the therapy to continue
and even reach the point at which our interactive field was able to
transform into a unified field and a working alliance. At that
point, the significance of transference and countertransference
dynamics diminished, and Ed could begin to make substantial
changes i n his life. In the Rosarium (CW 16), picture seven is
followed by a regenerative state depicted by falling dew. The
soulless couple, washed and revitalized by the dew, is eventually
renewed i n the form of the Rebis, the hermaphrodite (picture ten).
The hermaphrodite represents the creation of a linking structure,
akin to what Jung calls the 'transcendent function' and what
Winnicott calls 'transitional space'. As a result of our linkage, the
therapy gained a playful and explorative quality that had
previously been absent. I n an important sense, Ed's individuation
process began anew at this juncture, and the significant
life-changes that he was able to make further contributed to his
growth.
The following example illustrates how an unconscious dyad
structures not only the interactive field, but also one's mind-body
experiences. It also reveals how the therapeutic apprehension of
the unconscious dyad in its form of non-union can lead to a field of
union.
'Mallory', a 35-year-old woman, began a session by telling the
following dream: 'In an ancient stone atrium I was doing an erotic
dance with an eighteen-year-old boy. He knew more than I ever
172 NATHAN SCHWARTZ-SALANT

will.' I sensed that she wanted me to be excited about the dream

and felt awkward about having absolutely no response at all. I
reflected upon the previous day's session, which had dealt with
Mallory's fears that I would be angry with her because she was
emotionally distant. I felt disconnected from the dream; i t also
felt dismissive to sidestep my thoughts about yesterday's session.
I attempted to link these feelings by saying, 'Since the dance with
the boy and the stone atrium seem to be such positive symbols,
perhaps you had the dream to affirm how vital it is to stay on the
track of what happened yesterday, and to encourage you to not
withdraw out of fear of my anger.' To this Mallory replied,
4

'You'll have to help me, I don't know where to go from here.'

Suddenly I felt dull and flaccid, as if all sense of structure, all
alertness, had vanished from my body. I was mentally engaged
and expectant, waiting for something to arise either from her or
from me. But I could not readily contain the dull and flaccid
feelings, and almost immediately began to recount yesterday's
experience, recalling how frightened Mallory had been. With
this, her countenance changed abruptly, and she bitterly
reproached herself: T never do it right. You're cold, angry with
me. I can feel it.' I had difficulty at that moment distinguishing
'me' from what felt like a 'them'—that is, her parents.
It was clear that something important was going on, and I
realized that Mallory might be using the session to repeat a
family pattern. I asked, 'Where are you with your parents now?'
'I'm at the dinner table, she is to my left, he to my right. I'm
terrified, constantly alert, scanning for danger. I have to be, I
have to make sure everything is okay. She's a bit drunk and
stuffing herself with food; he is passive, simply waiting. But I
know he will explode at any moment. I have to, prevent this
somehow, but I don't know how. I try to humour them; i t barely
works. I know his anger will eventually come out, he'll explode.
Then she'll withdraw and be a martyr, terrifying everyone with
her martyrdom. He'll then be frightened, and her martyrdom will
turn to anger against me.'
With this information, I could play with the following
possibility: when I had initially heard Mallory's dream, my
silence had stemmed from the fact that my mental processes had
replicated her silent father's dullness; and my awkward and
flaccid body feelings probably resembled those of her drunk
THE BORDERLINE PERSONALITY 173

mother. I was somewhat intimidated by this patient's capacity to

put me into such uncomfortable states. I did not feel any
recognizable anger, but it was difficult to allow myself even
minor feelings of irritation in working with this patient, because
I feared they might trigger a paranoid reaction that could lead to
a delusional transference certain to doom the therapeutic work.
This aspect of our interaction was a mixture of mutual neurotic
and psychotic parts. I had split off from the rage I was feeling and
as a consequence did not adequately embrace the nature of the
couple I had introjected; instead, I avoided the anger embedded in
my dull state by absorbing it, behaving like her martyred mother.
I recognize that I could have interpreted this state as a response
Mallory might naturally have anticipated. But Mallory's para­
noid, scanning field was too intense to have hazarded such an
interpretation.
My mind and body seemed in general to represent Mallory's
inner parental couple. The parts of the couple were split from
each other and also at war; my mental and somatic selves
reflected this state. When I was well-connected, Mallory would
feel at ease. She would keep me centred by telling me stories
about her life. At such times, Mallory was able to create in me a
unified inner couple that did not terrorize her. But this endeavour
was always strained by her foreboding that the future would
bring further persecutory states. By 'fixing me' Mallory could
only temporarily avoid the battle that would certainly come. Just
as her parents would fight with each other in spite of her best
efforts to entertain them, so my two natures would eventually fall
out of harmony. On one level they already had, for the unity
Mallory had been able to achieve was only accomplished through
our mutual splitting—she from her fear, and I from the tension
and anxiety that was always nearby.
The feeling-tone of the session would immediately change
when these moments of disunity occurred. If I did not know what
to say or do, or if I felt muddled, Mallory would think I was angry
with her. She would experience me as if I were her father at the
dinner table. 'What's wrong?' she would ask; she would then feel
that she could not 'fix' me, and would become very frightened and
would complain that she 'never does it right'.
When I was able to become aware of how my own unconscious
was being influenced and structured by Mallory's internal
174 NATHAN SCHWARTZ-SALANT

parental couple, several advantages accrued. First, she partici­

pated in a corrective emotional experience, in the sense that she
could experience me as embodying her parental couple but could
see that I did not retaliate. I also required less 'fixing* than they
did, especially as I grew more conscious and did not act out the
splitting process, thereby losing sight of the opposites. Mallory
now had the possibility of freeing psychic energy that had
hitherto been in the service of an incessant scanning process that
had remorselessly energized her negative parental couple.
Secondly, by Mallory experiencing how I could maintain my own
mind-body union while she was in disunion, she gained the
possibility of introjecting a more harmonious dyad.
In the sessions that followed, we had a sense of connection, of
working well together. Mallory said that it 'felt good, but what
about the other stuff?' She meant, of course, the disunion we had
previously experienced and was also referring to her fear of my
rage. I noticed that she was scanning me, for I felt its pressure, as
if her vision had a substantial quality that exerted a force. I
encouraged her to express what she saw, and she reported that I
was defensive. I t was a struggle to accept her finding, and I asked
how she recognized my defensiveness. Mallory responded by
saying, 'Maybe you're worried about something.' I was aware of
an inner tightness and had a sense that I was withholding my
feelings. Mallory wondered aloud i f these feelings were sexual,
saying, 'that's usually the root of things'. Here was something
new and important, for Mallory had dared to imaginally see me
and express her feelings about me.
The borderline person concretizes imaginal perceptions
inwardly. For example, at the beginning of a session, he or she
might perceive the therapist as being tired and withdrawn but
will say nothing about it. After some contact has been made in
the session, the patient, provoked by an inner attack, might
comment on how he or she is being 'too much of a burden for you,
or for anyone'. The patient's vision, which may be regarded as a
psychic organ or structure that the person refuses to acknowl­
edge, will become demonic i f he or she cannot dare to
communicate through it.
Mallory had dared to share what she had seen; I could then
respond to her vision by indicating where her perceptions were
accurate and also by indicating areas that were beyond her
THE BORDERLINE PERSONALITY 1 7 5

perceptual lens. Thus, her imaginal perception was tested, and

she was able to depart from a feeling of omnipotence—namely,
that what she saw was the truth. On other occasions, Mallory
split from what she could see by relegating her accurate
perceptions to her own madness. What one sees is often very
disturbing. In fact, a person's imaginal perception is usually
denied early in life because what is perceived by the child (for
example, a parent's hatred) is too searing to absorb. Many
borderline persons begin to integrate split-off psychotic parts
when they become able to dare to see that they had been hated by
their parents. Being able to share one's imaginal perceptions is
extremely important, though this ability is rarely available to the
borderline person. Instead, as dreams often reveal, the imagina­
tion usually becomes mired in matter. The dreamer may attempt
to jump across a stream and will be able to get only halfway
across, or try to enter a room, only to encounter a lead-sealed
door. There are endless variants of such themes, in which the
linkage of two different states is severely hindered.
In Mallory's case we continued to explore her scanning process,
noting everything she saw. She began to experience the virtues of
her sight and came to enjoy the fact that it could be a relational
tool rather than merely a defensive one, one that operated like a
kind of psychic warning radar. She could also experience how my
seeing her, as well as she seeing me, had the effect of enlivening
our interaction. This, i n turn, produced the experience that
something autonomous was coming to life between us: a sense of
union with a characteristic rhythm that both joined and
separated us. In following sessions, Mallory and I began to grasp
aspects of her negative inner couple and also began to experience
the release of a positive couple that began to structure our
interactive space.
The coniunctio is not only an event but a pattern; disharmo­
nious aspects of that pattern soon began to emerge with Mallory
and myself. In the session following the union experience
something was askew; the positive couple was absent, we were
not working well together, and it felt terrible. In an effort to
resume our good connection, I actually said: 'What about us?'
No longer passively scanning with paranoid defenses, Mallory
immediately sensed what was 'off in my remark. The us feels
slimy,' she said. That's how my father was, but he would always
176 NATHAN SCHWARTZ-SALANT

deny it. It was never in the open. I f you had said, "How about
you and me?" it would have been different—clear, honest. The us
feels terrible!' This remark led to our awareness of the existence
of an incestuous couple. This couple also appears in the Rosarium
following the coniunctio (CW 16, para. 468). Our coniunctio had
served to attract more unconscious material and to perpetrate the
kinship quality between us. It also led to another stage in
Mallory's integration of her vision.
Integrating one's imaginal sight—that quality which is
usually split off and has taken up domain in the patient's
psychotic part—is often accomplished only after the therapist sees
this sight operating in the patient; in effect, it is as i f the
therapist is being spied upon. For example, after I had worked
with a male patient, 'John', for six months, I recognized that
while he constantly scanned me, he also idealized me and
sacrificed his vision, or attempts at vision, to that idealization.
Usually, the scanning was a very subtle background phe­
nomenon, which was barely perceptible unless I made an extra
effort to be embodied and emotionally present. But his idealiza­
tion induced me to bask in the self-approving light of what a good
therapist I am, rather than reach out to contact him sufficiently
to perceive that he saw.
Once I was able to focus upon his background scanning process,
John began to speak about his fears of women. The world, he
claimed, is 'a batch of piranhas'. I was not included in this
assessment, however. I was different, safe. Indeed, how else
except by idealizing me could he face his fear? John asked if the
piranhas were real, then quickly affirmed their reality and their
power to fracture his sense of identity. It became clear that his
idealization separated me from destructive energies and allowed
him to split from his negative inner images. Any attempts John
made to confront these negative images had an 'as-if quality that
conveyed the falseness of his effort.
John volunteered that each time I saw him scanning me he felt
a physical tension in his chest, stomach and throat and would feel
the reality of inner persecutory attackers. When I did not employ
my imaginal sight, his splitting defenses of idealization would
remain intact. When I would communicate this idealization
strategy to him, its defensive function would temporarily abate,
only to be replaced by a masochistic defense. John would agree
THE BORDERLINE PERSONALITY 177

with everything I said and even add further examples to help me

prove my point. He would explain that my reflections made him
very anxious. It was clear that in these strenuous efforts to keep
me 'ideal' he was splitting from what he really saw—namely, the
knowledge that I often did not see him or the intensity of his fear.
Over and over he would complain that his smooth exterior hid his
true feelings from everyone except from me; only I knew that he
was really very young and afraid. He would simultaneously
attack and soothe me: he would tell me that I did not see him, but
would continue to split from his own perception by insisting that I
was different from other people.
Imaginal sight is like active imagination, but when using
imaginal sight in the here-and-now of therapy it is essential that
the unconscious of the therapist be constellated through his or her
countertransference. For example, only after I had become
conscious of my splitting tendencies and of a somewhat flattened
affect that did not engage John's psychotic parts could I begin to
make use of this countertransference reaction. By consciously
submitting to this induced countertransferential state and
becoming embodied, I could allow imagination to lead me to
perceive his background scanning.
The imaginal realm does not necessarily manifest through
visual images; feeling and the kinesthetic sense are also natural
conduits. Possibly the nature of the imaginal act is coloured by
the therapist's inferior function, so that one therapist will see
'visibly', whereas another will see 'feelingly'. In any event, the
process requires that the therapist allow himself or herself to be
affected by the patient's material without having to resort to
interpretation, which would at best prove to be a defensive
manoeuvre.
Imagination is an act born of the body. It arises out of a matrix
of confusion and disorder. Faith, rather than the mastery of
understanding, is its midwife.

Madness, religion, and the self

in borderline states of mind
The borderline patient has a core of madness that must be
uncovered if successful treatment is to be achieved. The patient's
self, or soul, is enmeshed in psychotic mechanisms of splitting
178 NATHAN SCHWARTZ-SALANT

and denial. This true self might be represented as a child living in

filth, or locked up, or petrified, or frozen in ice. There are
countless images that depict this state. The following clinical
material is drawn from my work with 'Amanda', a 48-year-old
borderline woman. Amanda's psychotic parts could only enter the
therapy after I was able to end her obsessional control, which
manifested by her reading to me from a notebook. Her
explanation for this controlling behaviour was that she might
'otherwise lose her thoughts'. In daily life Amanda functioned
quite well; to a large measure her madness intruded into an
otherwise competent, functioning personality only during ther­
apy sessions. A relatively condensed psychotic transference, in
which delusional processes are contained by a sense of alliance, is
highly desirable in treatment (Grotstein, 1979, p. 173).
Amanda's confusion was dominant in our therapy process; this
confusion was disorienting for both of us. As a three-year-old
child Amanda had suffered an overwhelming trauma: her father
had left the family. He had never said goodbye to Amanda,
5

ostensibly because the family felt that she would be better off
without so explicit a closure. Yet her father had been her only
source of love and comfort, as well as the only barrier between her
and her mother and grandparents, whom Amanda experienced as
cold, aloof and harsh. She recalled an early memory of her mother
sending her to play outside on a rainy day. Her mother had
dressed her in new white shoes but had then scolded her for
getting them dirty. This memory is a paradigm for her early
individuation experiences: separation from her mother was
undermined by the implicit demand that she remain fused with
her mother's narcissism. This included the demand that she
appear to be perfect. With such a maternal background Amanda
had only minimal positive internal resources. She thus had little
support to help her contain the intense anxieties that erupted
when her father abandoned her. She had lost her only love object.
This incident had been so traumatic for Amanda that no
therapeutic work on her relationship with her father could occur
for several years. Up to that time, Amanda had never mentioned
him. Eventually, she began to refer to him as a *nice person'. She
would also say that 'he preferred my mother'. Even though he
returned to the family fold after a nine-month absence and was
present in her life for the next 40 years, there was almost nothing
she could find to say about him; her mind would become blank.
THE BORDERLINE PERSONALITY 179

Gradually, Amanda's abandonment fears entered the transfer­

ence, and session endings became very painful for her. Between
sessions Amanda's image of me was often effaced, but occa­
sionally she was able to suffer my absence consciously, rather
than by splitting and becoming manic. It became possible to begin
the reconstruction of what had happened in her inner world when
her father had left. One memory she was able to salvage was that
she 'became hysterical and hid under the bed' after she discovered
that he had left. Her conscious memories of this event began and
ended here, however; even this recollection felt uncertain. In fact,
all of Amanda's recollections had a strange uncertainty to them.
Our reconstruction of what may have happened upon her father's
return nine months later includes the hypothesis that Amanda
believed that the returning father was an impostor. Moreover,
she had, in effect, created an inner, idealized father who would
someday return and truly loved her. In the transference, Amanda
split me into several 'fathers', including both the impostor and
the idealized father. The latter existed only outside the therapy
sessions in her imaginary conversations with me.
A severe reality distortion occurred when Amanda's father
deserted her: she denied her love for him and his very existence.
Since Amanda's positive inner world was of such little worth, she
could not mourn his loss. A delusional inner world came into play,
one that was structured by both the idealized father and its
negative split-off polarity, the impostor father. She did not
experience either of these images consciously; life with real
father continued as if he had never abandoned her. Amanda
would say that he was 'nice'. Inwardly, however, her perceptions
were dominated by severe distortions: her father was/was not the
man who had returned to her—that is, this was neither her real
father, nor an impostor.
In the transference I was initially regarded as the impostor to
whom Amanda had to learn to relate. This took the form of her
insistence that I list the rules of patient behaviour. 'What should
patients say or do with the therapist?', Amanda would ask. I was
depersonalized by her, but not completely. She was always able to
maintain a sense of humour, which represented her observing
ego; at the same time, she was extremely serious.
When I succeeded in interpreting her splitting, she suffered
the loss, outside the therapy sessions, of my image; a painful
deadness eclipsed her imagination. 'Out there you don't love me
180 NATHAN SCHWARTZ-SALANT

any more', she would say. A long period of depression and acute
suffering of abandonment feelings ensued. At these times,
Amanda's psychotic parts would become enlivened, for she could
not be sure the real 'me' would return.
After working with Amanda's abandonment feelings, it
became clear that yet another 'father' existed—one who carried
the depth of her abandonment experience. This 'father' was
identified with money, although the very mention of this theme
released an almost immediate hysterical flooding. She recalled
that her father had left the family home because he hadn't been
able to earn a living that matched family standards. Amanda's
understanding was that her mother and grandparents had kicked
him out because of his financial dereliction. In her unconscious,
money was the root of all her loss. In daily life Amanda would do
everything she could to 'forget' how much money she had. An
inheritance she received was traumatic because it forced her to
think about money; her only recourse was to hide the money in a
bank account and forget about it completely. To invest it, or even
to draw interest from the principal, was beyond her capacities.
Money had little reality for her other than its connection to
abandonment.
For many months the mere mention of money invoked such
overwhelming abandonment feelings that the continuity of
memories and insights was disrupted. After my persistently
confronting this issue during many therapy sessions, Amanda's
capacities to deal with money issues gradually began to improve.
With her growing capacity in this area a fog seemed to clear; the
fact that money was unconsciously identified with the father who
had deserted her became a more stable psychic reality. We could
then recognize 'three fathers': the impostor father, the idealized
father, and the abandoning father, represented in Amanda's
psyche by money.
Amanda's splitting in therapy sessions lessened, but it still
served to dull her pain; she remained extremely confused. A
'blanking out' of her mental processes often occurred. As she put
it, The head doesn't work.' Each thought or memory would
immediately produce others, so that a multiplicity of centres was
created; each would compete for her attention and thoroughly
confuse both of us. Amanda would then reject all my attempts to
explain what was happening. These experiences truly reflect
Harold Searles's statement:
THE BORDERLINE PERSONALITY 1 8 1

I often have the sense that one or another patient is functioning

unconsciously in a multiple-identity fashion when I feel not
simply intimidated or overwhelmed ... but, curiously and more
specifically, outnumbered by him. [1979, p. 448]
These qualities of confusion, splitting and reality distortion all
form parts of the borderline person. Rarely is there a total
distortion of reality, although the behavioural stance often
possesses an autonomy that is like a state of demonic possession.
The quality of near-psychotic behaviour is often stressed in the
literature on the borderline personality. But there is also a
strange kind of order in this 'possessed' behaviour. We can begin
to glimpse it in this clinical material as we consider the way in
which Amanda often rejected interpretations.
Amanda would say something like, 'that's not quite it', or
'maybe'. Her response was always frustrating because I had
usually put a great deal of effort into trying to create some
coherence for her as well as for myself. As a result of her denial I
would often become irritated. At times, this reaction would be
quite strong; it was often clear that projective identification was
involved. This led me to attempt to examine her anger with me
for 'disappearing outside of the sessions'. Such interpretations
were somewhat effective. But this enterprise did not reach
Amanda's psychotic parts.
It should be noted that when Amanda gave me such
conditional answers, though I was irritated, I did not feel that my
interpretations had been totally negated. In fact, Amanda was
often at her best at these moments, and her mode of rejection
rarely displayed a strong intention to defeat me. I f my
interpretations were grossly inaccurate, she would become
confused. Then 'other thoughts' would fragment her attention,
leaving both of us in a muddle that also obscured her anger
towards me. But when my interpretations were relatively sound,
they elicited a reaction in her that revealed a level of depth that
was not usually apparent. If, regarding an interpretation, I asked
the question, 'Does that seem right?' Amanda would reply, 'Not
exactly.' If I asked, 'Is it wrong, off the mark?' she would answer,
'No, not completely.' At these moments, it seemed that she was
using my interpretation to get close to something. But what?
Apparently, Amanda was able to find value in the same
interpretation that she was negating. What I said was considered
P—G
182 NATHAN SCHWARTZ-SALANT

by her to be neither true nor false. She would suspend choice, but
not for defensive purposes. A process was at work inside her that
could only express itself by her suspending choice. I discovered
that if I 'hovered' in the suspension without trying to amplify the
interpretation, she would often remember a detail from the past
or have a new insight. She would have to balance each statement
she made with a second statement that revealed the confusion or
incompleteness of the first. There was no possibility of saying,
This is right,' but only, I t is neither right nor wrong.'
The French psychoanalyst Andre Green, whose thinking has
influenced my approach to this clinical material, has described
the borderline person's 'logic' as follows:

According to the reality principle, the psychic apparatus has to

decide whether the object is or is not there: Yes' or No'.
According to the pleasure principle, and as negation does not
exist in the primary process of the unconscious, there is only
'Yes.' Winnicott has described the status of the transitional
object, which combines the 'Yes* and the No\ as the tran­
f

sitional is- and is-not-the-breast. One can find precursors of

Winnicott's observations in Freud's description of the cotton
reel game and in his description of the fetish. But I think that
there is one more way of dealing with this crucial issue of
deciding whether the object is or is not, and that is illustrated
by the judgment of the borderline patient. There is a fourth
possible answer: Neither Yes' nor No'. This is an alternate
r

choice to the refusal of choice. The transitional object is a

positive refusal; it is either a 'Yes' or a 'No'. The symptoms of
the borderline, standing for transitional objects, offer a negative
refusal of choice: Neither 'Yes' nor 'No'. One could express the
same relation in experiential terms by asking the question: Is
the object dead (lost) or alive (found)?' or 'Am I dead or
alive?'^-to which he may answer: Neither Yes nor No'. [1977, p.
41]

When in acute distress, the borderline patient can never be

certain whether the therapist is truly present in a flesh-and-blood
sense. One could also say that the patient is uncertain i f the
therapist is alive or dead. This state of uncertainty always exists
in the patient's unconscious and manifests itself in bewildering
ways when splitting defenses fail to dispel abandonment anxiety.
THE BORDERLINE PERSONALITY 183

Hence, the patient can never answer the question: Is the therapist
alive or dead? as it would appear meaningless and confusing to do
so. Moreover, if he or she were to be asked: Is the therapist both
alive and dead? the patient would continue to be confused, for it
would mean that the therapist was a transitional object, that is,
something both created and found.
The patient cannot experience the creativity of transitional
space while in a state of confusion. Indeed, the possibility of'play*
is usually absent for the borderline patient. The therapist, who
tends to become so embroiled in countertransference reactions
that his or her foremost desire is simply to survive each
encounter, often feels either depressed and dull, or manic; like the
borderline patient, the therapist will then act by using commen­
tary to fill space rather than undergo an experience of absence
(Green, 1977, p. 41). This state is a difficult one to bear; to be able
to sustain it requires the supporting faith that if one delays action
and simply waits, the patient will not become destructive, and the
psyche will become enlivened. At crucial moments in the
therapeutic process, the therapist's supreme act of faith in
relation to the borderline patient is to trust that this patient will
not 'kill' him or her. To render the therapist ineffectual and
mindless would be one way in which the patient would effect such
a 'killing'.
In Amanda's material it was not a matter of my interpreta­
tions becoming more cogent, or of my needing to augment and
deepen them. Instead, what was needed was that I be able to
register and accept Amanda's sense of paradox. This sense of
paradox was only able to manifest itself when I could remain in
an embodied and receptive state amidst the experience of
absence. Her dialogue would now be sharply in contrast with her
more usual confused and fragmented state of mind. For fleeting
moments I would be privy to a depth in her that was normally
hidden by her splitting defenses and an infantile ego that 'just
wanted to feel good'. Thus, Amanda's remarks carried with them
an awareness that my interpretations were only partially
satisfactory. Her response to my interpretations was that they
were 'not correct' and 'not wrong'. However, on a deep and subtle
level it was not a question of whether or not a statement was
right or wrong but rather that it was neither completely right nor
completely wrong.
184 NATHAN SCHWARTZ-SALANT

The subtleties of madness are often only perceived through

feeling and observing our own states of confusion. In the case
under discussion, more overt forms of madness also began to be
uncovered. Some of these forms were not very subtle, and their
perception merely required an empathic observer who would be
sensitive to the patient's shame at carrying such fears of
madness. For example, Amanda revealed a considerable paranoia
when she expressed fears that her money would be stolen by the
bank, or that her checks were only the bank's way of cheating
her. She was also persecuted by fears that her grandchildren
would be stolen from her while she accompanied them to school.
But Amanda's more subtle forms of madness, in which confusion
and reality-distortion coexisted as part of a 'neither-yes-nor-no'
logic, were more difficult for me to decipher; this was so because
of my tendency to deny the existence of these states.
There are a number of reasons for the therapist's having
countertransferential reactions of confusion and irritation.
Firstly, the therapist is not being asked to add or subtract content
from what he or she had said, although that wish may be implicit
in the patient's communication. More important is the frustrat­
ing sense of coexisting opposites: one has the feeling that he or
she is both approaching and at the same time failing to
apprehend the patient's process. This process is not a sum of
distinct parts; i t can be known only in its wholeness. Generally,
the borderline person hates partial interpretations; the therapist
often feels persecuted for not being perfect and may even
complain (sometimes aloud to the patient!) that he or she is
always being criticized. Often, the therapist's best efforts are
diminished by the patient's outright anger and rejection.
Amanda's splitting began to diminish further when she
became able to experience her abandonment anxieties; our
confusion lessened, and her imagination slowly began to function.
Gradually, she began to be able to 'find me' outside our sessions. I
was becoming more of a Veal' object and less an 'idealized father'.
The therapy became lively, though the outside world (in which
she functioned well but took little interest) remained a place of
psychic deadness. All of Amanda's interest was concentrated on
returning to the therapy.
Amanda's external object relations were becoming more
realistic. Her husband, who for years had carried an idealized
THE BORDERLINE PERSONALITY 185

projection and had betrayed her through affairs with other

women, came gradually to be seen more realistically. Previously,
his inner deadness had persecuted her, but once she came to know
and respect her own angry feelings, she was able to rail at his
lack of relatedness. Gradually, and without necessarily liking it,
Amanda could begin to accept him as he was. There was also a
substantial improvement in Amanda's relationship with her
mother. This change accrued as a result of her learning to
recognize when she was angry with her mother. At first she could
feel this anger only with therapeutic help, and it would often take
many days to do so. Gradually, the interval between incident and
anger decreased until finally her inner response coincided exactly
with the outer provocation. Amanda began to confront her
mother more assertively and was actually able to forge a better
relationship with her. The gradual emergence of a functioning
self was epitomized by her greatly diminished tendency to split;
her imaginative capacities grew, and she became more willing to
find value and meaning in the pain of her abandonment
anxieties.
This new split between the affectively dead external world and
the lively therapeutic world represented not only a good/bad
dichotomy but also an entrance into the Kleinian depressive
position that she now experienced in relation to her father. Our
process prior to this development had largely taken place within
a paranoid-schizoid realm where splitting and persecutory
affects dominated. As the process moved to a level of the
depressive position, Amanda's hatred of me as the transference
father was displaced into the full outer world, and her love of me,
as the transference image of the once-loved father, was more fully
experienced in our work together. This splitting was, however,
more manageable than it had been formerly, and interpretation
could now be more effective. What she was facing was the split
between love and hatred, and with great trepidation she began to
express her hatred to me. Its first appearance took the form of a
jocular remark: 'Out there I hate you.' Over time she could begin
to join with the affect while in my presence.
This new-found courage had a continuing positive effect. Her
capacity for the play of imagination had previously been severely
limited, and she had been especially prone to split her emotional
life between feelings of love and hate. This splitting now
186 NATHAN SCHWARTZ-SALANT

diminished, and Amanda gained an imaginative capacity that

could be communicated to me and was more complex than her
previous flow of fantasy that had circulated around the idealized
father-projection. This distinction is important and registers the
difference between what alchemists called true and fantastic
imagination (CW 12, para. 360). The borderline person often
experiences either an imaginative lacuna or else a torrential flow
of imagery and affect in countless passive fantasies that void
experiencing feelings. The false imagination functions to split a
person from his or her feeling; it also furthers mind-body
splitting and often manifests in somatic complaints. But true
imagination, according to the alchemical metaphor, is far more
realistic; it engages feelings and nurtures the growth of
consciousness and the awareness of the suffering of one's soul.
There is one other important issue that should be mentioned in
relation to this case. About a year before Amanda's abandonment
anxieties and imagination became the focus of treatment, she
dreamed of a small girl who was frozen in ice. The ice began to
thaw, and the child began to come to life. This dream was itself a
critical juncture in our work, and i t was preceded by a strange
occurrence. At the close of a particular session, Amanda suddenly
turned around and spoke to me in French, which she had never
done before. In the next session Amanda asked me about
'sub-personalities', since she had realized that 'another person'
had spoken French to me. We discovered that this 'personality'
carried her sexuality for her. For the first time, an erotic feeling
existed between us. I believe that the 'sub-personality' in her
dream material was the first appearance of a self structure,
especially because its appearance had a synthesizing effect that
overcame dissociation. This 'personality' had previously been
split off and had existed in a frozen, schizoid state.
The loving and erotic quality between us remained for several
months, then vanished with the emergence of her abandonment
anxieties and depression. It appears that in order for the self in
this patient to embody and become part of space-and-time life, she
first had to be able to experience and suffer acute feelings of
abandonment. Schizoid self-parts are always present in the
borderline person, and their integration is essential if a sense of
self is to emerge.
THE BORDERLINE PERSONALITY 187

The borderline person's emerging self will make use of the

therapist's interpretation in a bewildering way. When an
interpretation is accepted, he or she will often return to the next
session with material that seems to deny it. The therapist may
feel confused or angry and will often tend to act through
intervention or withdrawal. 'Acting', as Andre Green says, is 'the
true model of the mind. ... Acting is not limited to actions;
fantasies, dreams, words take the function of action. Acting fills
space and does not tolerate the suspension of experience' (1977, p.
41). The therapist may feel as though the patient has denied what
has previously been communicated, but this 'perception' actually
serves to block perception in his or her own emerging state of
confusion and incapacity to tolerate absence. That is, we feel
attacked by the patient because of our limited capacity for
self-experience, and our incapacity to experience the absence of
the patient; wefleeto the safety of feeling hurt, rejected or angry.
At this point it would be worthwhile for us to examine the
discrete parts of this process. If the therapist is unable to contain
the pain of the patient's absence and says something like, 'But
last time we came to an understanding that you now seem to be
totally denying,' the patient might say, 'What have I said to
indicate that?' The therapist may then feel angry because his or
her sense of reality has been attacked. Yet the therapist had
misunderstood the patient's communication and had seen it to be
a negation of his or her interpretations, whereas in fact the
therapist has made an assumption that an agreement has been
reached. This assumption has been made in order to dispel his or
her own confusion and to avoid undergoing the suspension of
experience. At the point where the patient might say, 'What have
I said to deny what we did last time?' the feeling of confusion will
often dissipate, leaving the therapist with the sense that he or she
has acted badly by assuming that the patient had denied previous
insights.
At this point it will seem to the patient that he has been
merely reflecting, and in so doing setting aside what had
transpired. Yet the therapist has taken this 'setting aside' to be
an attack on the work of the last session; he or she may view it as
a 'negative therapeutic reaction'. In fact, the patient has been
trying to make use of the interpretation by temporarily denying it.
188 NATHAN SCHWARTZ-SALANT

This act can appear to be a complete denial. The therapist's

narcissism is attacked, since he or she wants a given interpreta­
tion to be definitive, not merely a stepping-stone to a deeper level.
What must be understood is that the patient is attempting to
disengage from the therapist's narcissism by employing this
'neither/nor' logic. To do this is terribly risky, for it means that
the patient is beginning to show more of the true self and is thus
daring to ignore the therapist's narcissistic needs.
The negative logic of the borderline patient so aptly described
by Green can also be understood conceptually through the system
of the via negativa of the fifteenth-century cleric and mystic,
Nicholas of Cusa. The via negativa is a metaphysical system that
provides a mode of perceiving both the nature and the goal of the
borderline person's use of negation as a path to self-emergence. In
this system, every positive statement stands in opposition to
another that demonstrates its finitude or incompleteness; thus,
each statement yields another that can be added to the previous
one. God, the unknowable object of this dialectic, remains unified;
He is a coincidentia oppositorum. Hence, the state in which
opposites are united, and painful and deceitful splitting may at
last be overcome, represents the unconscious goal of the
borderline person. To reach the goal, however, a journey through
a territory of madness is demanded. This domain of madness is
one in which the inner life suffers fragmentation and confusion;
in other words, i t is the complete antithesis to unity and the
harmony of opposites. Moreover, madness itself seems to guard
against the psychic intrusion of others. Madness is a process
belonging to a self that has survived persecution, and which,
however weakly, manifests in paradox—the fulcrum of the
borderline person's peculiar logic.
Moreover, the therapist can err by failing to embrace the
'neither/nor' logic of the borderline patient. He or she may
attempt to understand the meaning of a patient's communication
by interpreting feelings encountered in the countertransference.
For example, The anxious feelings I am having with this person
inform me that he may be dominated by abandonment anxieties.'
This is what Frederick Copleston describes as the level of the
senses, which simply affirm (Copleston, 1985, p. 237). Or, the
therapist may try to gain knowledge of the patient by determin­
THE BORDERLINE PERSONALITY 1 8 9

ing what is or is not; for example: 'She is in a manic state, but this
may not be the core issue; instead, the mania may be a defense
against her abandonment depression.' Copleston refers to this
form of reasoning as one in which 'there is both affirmation and
denial' (ibid,). What is required is that one face the madness; the
therapist must learn to continue to be, without necessarily
knowing. In this way, one respects the unknowable.
In Nicholas's thought, sense-perception corresponds to what
Green has called primary process thinking, and discursive
reasoning (ratio) corresponds to the reality principle. The
borderline person's logic, which follows the model of neither Yes'
r

nor No\ corresponds in Nicholas' system to the intellectus.

r

Whereas sense-perception affirms and reason affirms and

denies, intellect denies the oppositions of reason. Reason
affirms X and denies Y, but intellect denies X and Y both
disjunctively and together; it apprehends God as the coin­
cidentia oppositorum. This apprehension or intuition cannot,
however, be properly stated in language, which is the
instrument of reason rather than intellect. In its activity as
intellect the mind uses language to suggest meaning rather than
to state it. ... [Copleston, 1985, p. 237—italics mine]
One can never understand a person's mad parts, but one can know
that one does not know. Any understanding that translates the
state of madness into a discursive process (such as causal
sequences of failed developmental stages) fails to grasp the
nature of madness and also fails to provide a symbolic sense of
containment for the borderline person. Such reductive thinking
turns the borderline person's madness into a thing to be ordered,
instead of admitting it to be as vital and alive and characteristic
of self as the person's other more readily acceptable qualities. The
reductive method cannot circumscribe the phenomenon of mad­
ness, which is beyond the province of rational knowing.
The only knowing that is useful in the treatment of borderline
disorders is the knowing that is reached through a negative logic.
The patient's madness has the capacity to distort and destroy his
or her own and the therapist's perceptions in such a way that
seemingly benign interactions, or interpretations that were
formerly accepted by the patient and have been introjected, turn

P —G*
190 NATHAN SCHWARTZ-SALANT

into persecutory objects. But it should be clear that this change

from the benign into the persecutory is not the result of the
patient splitting from abandonment anxieties, since abandon­
ment experiences are neither the cause nor not the cause of the
person's madness. We need to be able to tolerate the suspended
state of not knowing, and at the same time not negate the attempt
to know. This form of waiting can provide a deep experience of a
person's psychotic parts, as well as a mode of gaining familiarity
with them, even if it is not possible to become truly comfortable
with the feelings of oddness and terror, absence and mindlessness
that they are apt to provoke.

Madness:
personal or impersonal?
Is the madness one experiences in another person personal or
impersonal? Certainly, it can feel like a soulless thing that
terrifies subject and object by its very absence of form and clear
affect and by the void of experience that is part of it. For madness
is imbued with absence or blankness rather than the affirmative
presence of any thing. In therapy, the madness one begins to see
seems like an alien Other that has nothing to do with the patient
with whom one wishes to be. Certainly, it is difficult to accept the
mad parts a patient brings into the room. To avoid these parts, we
tend to cling to explanations of projective identification dynamics
and to manufacture interpretations that may even include the
therapist's fear of being abandoned. But these choices all are
defensive strategies to fill a void, an absence of experience, a core
where thought and experience do not exist.
It is easy to think of madness as matter to be organized. A
therapist may communicate the following: 'You are fleeing from
an abandonment anxiety and fear that I , too, will abandon you in
the process.' This rationale may be true, but i t is also defensive, a
way of avoiding the absence and blankness that can characterize
madness. Yet the patient, assaulted by 'well-intentioned' inter­
pretations, quickly flees into extreme states of mind-body
splitting, and the therapist's intrusion goes unnoticed. Indeed,
the patient is as happy as the therapist to have something to cling
to—in this instance, the interpretation of an anxiety state. The
patient's anxiety becomes a thing to be ordered and understood. It
THE BORDERLINE PERSONALITY 191

becomes a substitute for madness and reduces it to an impersonal

energy.
How can madness be considered to be personal? Can I , or need
I , love my patient's madness? The image of St. Teresa drinking
the pus of her sick patients seems relevant in its excess. How can
this madness, which often succeeds in turning both people into
automatons, be part of one's humanity? To bear a saintly attitude
towards it, to be the 'wounded healer' or the doctor who wears the
mantle of the suffering patient, will not be experienced by the
patient as embracing and containing the patient's process. Indeed
if the therapist identifies with this saintly image of the wounded
healer, a disjunction between patient and therapist will be
certain to occur.
A quite different situation emerges if the therapist is able to
succeed in encompassing the phenomenon of a patient who now
reveals his or her madness. The patient has been terrified of
exhibiting this madness. The realm of madness is a no-man's
land, a place where meaning, imagery, and all relational
potential is destroyed. When the therapist is able to comprehend
6

madness as an aspect of the patient and becomes able to

experience the patient and the patient's madness in a personal,
human way, a change can occur: as one enters into the alien
territory of the patient's madness, one's personal orientation
fails. A solely personal relationship to this phenomenon cannot
fully contain it. One has the feeling that madness must be
apprehended through a more comprehensive perspective. As a
larger container for madness is allowed to develop, a sense of an
impersonal dimension becomes prominent. The patient's madness
begins to seem autonomous; it can appear like a machine or a
deity, a separate force that not only rules the patient, but can also
rule the encounter between patient and therapist. The imper­
sonal/archetypal perspective can become too extreme and stray
too far from human levels. One must then return to the smaller
personal framework, though this soon feels too confining and
again requires expansion.
Thus one's perception of madness oscillates between personal/
impersonal, or personal/archetypal polarities. I cannot say that I
relate to the patient's madness in a personal way, but neither can
I say that I relate to it in an impersonal way. Yet if I say that the
relationship is both personal and impersonal, I have abstracted
192 NATHAN SCHWARTZ-SALANT

my experience in an intellectual way that destroys the experience

of madness. I resist destroying the strange and even awesome
way in which personal and impersonal qualities are coupled—a
coupling that seems to become manifest only when the phe­
nomenology of madness as part of the patient is deeply engaged.
What I can say with certainty, however, is that the patient's
madness is neither personal nor impersonal.
This distinction between the personal level and an impersonal
transcendent level is also revealed when the mystic is asked the
question: Is the God you experience personal or impersonal? The
mystic will answer that the god-experience is intensely personal.
Once this observation has been voiced, it will seem incorrect; the
mystic will then speak of God as sublimely Other, and say that
his or her experience belongs to a realm that is intensely
impersonal. It will not do to say that the god-experience is both
personal and impersonal. To do so would bind and falsify the
experience. One can only say that the god-experience towards
which the mystic's soul reaches is neither personal nor imper­
sonal.
The mystic's paradoxical expression embraces his or her
experience. The borderline person's neither Yes nor No rarely has
the fluidity of paradox but instead caricatures it. The mystic's
paradox communicates a sense of wholeness, whereas the
borderline patient's paradoxical logic—when its elusive and
underlying truth is not apprehended—can trigger feelings of
emptiness and confusion in the therapist.
The borderline person's neither Yes nor No seems to cancel
whatever has been achieved. For example, a session may
approach clarity, and confusion will wane. The following session
may begin with an attack. The patient's attack is his or her way
of guarding against the therapist's tendency not to see in a
paradoxical way. What the patient would wish to say to the
therapist—if the therapist has not eliminated all possibility of
communication by precipitous talk or action—is that the insights
gained in the previous session are neither correct nor incorrect.
By attacking the therapist, the patient is simply expressing an
inability to grasp the paradoxical nature of the therapeutic
experience. If the therapist can suspend action and create a space
for confusion and an absence of knowing, then the patient may be
THE BORDERLINE PERSONALITY 193

able to say that a previous interpretation was neither complete

nor incomplete.
The soul of the borderline person and Nicholas of Cusa seem to
have a common approach to the numinosum. It is as if the person
were saying, 'You cannot fully know me. I am beyond any
rational comprehension. You can only know that you do not
know. I f the knowing you possess is authentic and hard-won, I
will allow you to approach my soul, but only if you always know
you do not know. Your need to know and your arrogance are the
greatest threat to me, as is your being anything less than your
best as you try to understand me/ As one approaches the soul of
the borderline person, one crosses into the territory of madness.
Jacques Lacan has written: 'Not only can man's being not be
understood without madness, it would not be man's being if it did
not bear madness within itself as the limit of his freedom' (1977,
p. 215). Unless one can delve into the borderline person's
madness, one will never be able to understand him or her.
The borderline person's madness accrues from experiences of
extreme pain, confusion and bewilderment. To a degree, madness
is created—though it is also an a priori state, like the chaos of
myth and alchemy—by denial, splitting, projective identification
and identification of the ego with archetypal images. Madness
defends against the pain of being hated, scapegoated and
attacked by parental guilt and envy for any individuation effort.
Madness also serves to dull the experience of pain. The soul, in its
exit from the territory of madness (when, for example, it is being
seen and daring to be seen), is always attended by the pain that
accompanies the process of overcoming splitting.
The borderline person often acts in ways that appear mad
because the pain is so deep and the risk of having it touched so
great that all avenues to his or her soul are full of roadblocks,
detours and warning signs of danger. The borderline person is
always testing, for example, by asking an 'attacking' question.
When the borderline sector in any individual is approached, the
danger light goes on. The coniunctio, with its capacity to heal
splitting, always touches upon the insufferable pain endemic to
it. This pain and its attendant madness is at the core of the
borderline person. The patient will "go on alert" in order to
ascertain whether or not the therapist realizes and is capable of
194 NATHAN SCHWARTZ-SALANT

handling the depth of his or her pain and sensitivity. I f the

therapist asserts his or her understanding, while the patient sees
this assertion to be incomplete if not false, then a detour must be
made until the risk is diminished. These detours engage madness
and lead to 'nothingness —a state of suspension and waiting; the
5

patient watches to see i f this time his or her pain will be

apprehended and understood.

Borderline and religious experiences

Is there a relationship between the thought processes of the
borderline person and genuine experiences of the numinosum as
in mystical experiences or in Nicholas of Cusa's via negativa? In
genuine mystical experience a union with the divinity is known
as a complexio oppositorum. The soul's immersion and then
separation from God is a reality, and that union then lives on in
the soul of the mystic. But for the borderline person loss of union is
the critical issue. Whatever union experiences with the numino­
sum may have existed, especially during the first months of life,
and whatever union experiences in later developmental stages
may partially have taken place, the borderline person has not
been able to own or incarnate them sufficiently.
Often, the borderline person may serve as a link to the
numinosum for other people—for example, he or she may be
psychic, or be a therapist who is a borderline person. The
numinosum may be alive and remarkably healing for others
when the borderline person serves as its conduit. But it has not
incarnated for the person. When he or she is alone, the
numinosum disappears; it is no longer experienced as a healing
Other, but constitutes instead a reminder of painful absence and
abandonment that can barely be tolerated. Somatizations and
mind-body splits eliminate the capacity to differentiate feelings
and to experience conflicting opposites; a bewildering simul­
taneity of contradictory feeling-states occurs.
There is a link between borderline states of mind and a
genuine experience of the numinosum. The manifestation of
borderline states of mind within religious experiences is well
known. For instance, St. John of the Cross suffered from a terrible
sense of emptiness and depression. In his experience of The Dark
THE BORDERLINE PERSONALITY 195

Night* his mind was often blank and his thoughts fractured; he
lived in despair, feeling abandoned by God and by people. He had
profoundly difficult experiences that caused him severe suffering.
He was ostracized by his community and imprisoned. Yet, he was
also able to remain calm, even serene, in the belief that all of his
suffering was for the purpose of purification through which he
might receive God (Williams, 1980, pp. 159-179).
The story of St. John's life evokes diagnostic reflections over
borderline phenomena. The workings of John's 'psychotic twin'
are evident in his mental blankness. The persecutory anxieties he
suffered are manifest in the responses of the world elicited by his
behaviour. Borderline persons generally thrust their madness
into the environment. John's severe states of abandonment are
characteristic of the borderline person, as are his feelings of
emptiness and his proclivity for seeking pain. Moreover, John's
vision of suffering as a way to God might be seen as a symptom of
good/bad splitting and manic and omnipotent defenses; these
states would then be viewed as defenses against his feelings of
worthlessness. John may have been a borderline personality, but
his influence upon spirituality and his understanding of complex
meditative states of mind has made him an invaluable source of
wisdom.
But one does not need to examine borderline logic and its
relationship to various mystical systems to recognize the link
between borderline phenomenology and religious pursuit. Con­
sider The Diagnotic and Statistical Manual of the American
Psychiatric Association, Third Edition (DSM I I I ) , which offers
7

the following eight diagnostic criteria for the borderline personal­

ity disorder:
1. impulsivity or unpredictability in at least two areas that are
potentially self damaging, e.g., spending, sex, gambling,
substance use, shoplifting, overeating, physically self­
damaging acts;
2. a marked pattern of unstable and intense interpersonal
relationships, e.g., marked shifts of attitude, idealization,
devaluation, manipulation (constantly using others for one's
own ends);
3. inappropriate, intense anger or lack of control of anger, e.g.,
frequent displays of temper, constant anger;
4. identity disturbance manifested by uncertainty about
196 NATHAN SCHWARTZ-SALANT

several issues relating to identity, such as self-image,

gender identity, long-term goals or career choice, friendship
patterns, values, and loyalties, e.g., 'Who am I?*, ' I feel like I
am my sister when I am good';
5. affective instability: marked shifts from normal mood to
depression, irritability or anxiety, usually lasting a few
hours and only rarely more than a few days, with a return to
normal mood;
6. intolerance of being alone, e.g., frantic efforts to avoid being
alone, depressed when alone;
7. physically self-damaging acts, e.g., suicidal gestures, self­
mutilation, recurrent accidents or physical fights;
8. chronic feelings of emptiness or boredom.
But these criteria are also a profile of the Old Testament
creator Yahweh, who certainly possessed at least five of the
stated criteria! He was impulsive and unpredictable in ways that
were self-damaging. His relations with his people, with Israel,
were unstable and marked by idealization and devaluation. His
anger was intense and often uncontrolled, and he could behave
ruthlessly and with complete disregard for his chosen people. He
destroyed his own creation with a flood. His identity was diffuse,
for he needed constant mirroring. His moods often changed
capriciously,
Diagnostically speaking, Yahweh is a borderline personality.
This fact is instructive: Yahweh may indeed be a borderline
personality, but he is also the supreme light, the source of the
numinosum. In the Old Testament, Yahweh has a personality
that includes not only numinosity, creativity and wisdom beyond
that of any mortal, but his personality also includes borderline
characteristics. Perhaps it is not possible for a human being to
bear a creativity that touches a divine level without his or her
also suffering borderline states of mind. In the figure of Yahweh,
light and the dark are united, albeit in a bewildering fashion. But
the combination of the positive numinosum with borderline
characteristics is a mark of the creative genious of the Old
Testament. This should not be forgotten amidst our efforts to
separate light and dark qualities of the numinosum from each
other, an essential task that must be performed in order that the
light may incarnate.
THE BORDERLINE PERSONALITY 197

The therapist learns to see the dead or blank self of the

borderine person and to survive persecutory attacks upon any
form of linking and the suspension of mental processes that its
'neither/nor' logic induces. Although it is important to uncover
chronic states of abandonment i n working with the borderline
person, this task is only a first step along the path of
encountering states of mind characterized by blankness and
mind-destroying fury. The torment of abandonment may thus be
seen as a rite ofpassage for an incarnating Self But abandonment
issues do not sufficiently explain the borderline condition. To
focus upon them at the expense of engaging deeper levels of the
numinosum results in creating the capacity for repression but
does not facilitate the embodiment of the self as a centre that is in
contact with the numinosum.

Treatment
The following reflections on the borderline psyche and treatment
considerations derive from various sources. These are Bion's
concept that there are both normal and psychotic parts to every
personality, Jung's researches on alchemical symbolism, my own
clinical experience of the numinosum manifesting in positive and
negative forms, and my emphasis on the importance of the
unconscious dyad. The psychotic part of a person may be thought
to contain the image of the child, who represents the true self or
soul. This child image often appears in a depleted or helpless
state; it is a dead self not unlike the dead Osiris, who languished
in the Underworld and was attacked when he dared arise.
Another image representing the psychotic part is of a couple who
are fused, yet in a state of radical disunion. This couple violently
rejects separation, yet the parts of the couple are at the same time
without any genuine contact. I have found, in my clinical work
with patients, that the unconscious couple often assumes a
violent form, with each member striving to attack the other; the
female part often has a powerful phallus, and the male part is
engulfing and mutilating. This unconscious couple often man­
ifests in interpersonal relations and causes confusion or a
sado-masochistic interaction between therapist and patient. But
198 NATHAN SCHWARTZ-SALANT

this interaction is a defensive operation engaged in by both

patient and therapist to prevent them from experiencing the
actual nature of the unconscious couple, which is especially
hateful towards the soul. The couple, locked in a deadly and cruel
combat, is actually a single, double-sided object (Green, 1977, p.
40), which is deeply antagonistic to the child held captive within
its territory.
Thus the psychotic part of a person contains the soul as well as
an extremely persecutory dyad, a couple existing 'before the
creation' and prior to the separation of opposites. The dynamics
operating within this dyad are complex, but Jung's researches
into alchemical symbolism provide some guidance for an under­
standing of them. Should we regard the extremely destructive
affects that accompany the psychotic part of the individual as a
result of developmental traumas? Or might these destructive
affects instead be a consequence of union experiences that include
but are not simply reducible to historical antecedents? Jung
amplifies alchemical texts that illustrate how union experiences
at first create very destructive contents; in alchemical language
these contents are called thief or devil, and often they assume
such animal forms as the rabid dog, snake, basilisk, toad or raven
(CW 14, para. 172). The borderline person's shadow, which houses
these destructive contents, will commonly appear in the form of
the renegade that seeks to destroy anything positive or life­
giving. Another prominent shadow configuration is the seductive
death demon (which Neumann calls uroboric incest), who lures
the soul into a regressive fusion and plays upon the soul's
memories of its original experience of the numinosum.
It is important to have a dual understanding of these shadow
elements. On the one hand, they can be perceived as part of an
introjective structure, born from the patient's ongoing need to
deny the horror of his or her early perceptions. A kind of inner
fifth column is thereby created—what Bion represents as the
fiend that lies (Meltzer, 1978, pp. 106ff.). This image of the fiend
is clearly identical to the devil, who carries the destructive
function in many religions. On the other hand, extremely
destructive states of mind can be created through the experienc
union; these dark creations attempt to destroy the memory of the
union experience, and they shred the patient's recall of the
god-experience. The so-called negative therapeutic reaction is
THE BORDERLINE PERSONALITY 199

susceptible to containment when both patient and therapist

become conscious of the fact that a union experience, though
barely perceptible, has previously occurred. Such union experi­
ences are registered in dreams and may also be experienced as
processes between two people.
The union experience is of special significance when one is
working with the borderline person. Through it, the therapist
introjects the person's previously split-off, helpless self, which, as
I have noted, commonly takes the form of an injured or tormented
young child. Such union experiences, including their resulting
demonic products, can bring to light the patient's constant inner
struggle—a battle between life and death in which the opposing
forces are God and the Devil. When this conflict is unconscious, it
is manifested in sado-masochistic dyads that structure the
patient's inner life and relationships. This sado-masochistic style
creates a relatively safe territory for the patient, even though he
or she must pay dearly for it. The toll is taken in terms of
relational failures and an undermining of creativity and all forms
of self-assertion.
When the truly demonic parts of a person become conscious, a
new stage is set, one in which death through suicide, illness or
accident becomes a serious concern. At this stage, the therapist
will often wonder whether the patient's previous unconscious use
of splitting devices were not a better state of affairs! But i f the
patient can be helped to confront the death-drive within the
context of union—that is, by seeing its relationship to positive
experiences—he or she may discover new self-images and thus a
reason for living. In alchemy, forms that are dangerous at the
outset (such as the 'rabid dog' and the 'thief) later become
protective of the 'child', which represents the new self. In some
mysterious way, demonic aspects may be necessary for the
destruction of structures in the old personality that have outlived
their usefulness.
Throughout this process, a grave danger lies in the therapist's
need to be in control, for if this need is not surrendered, he or she
becomes aligned with the 'old king', who rules the normal,
competent personality. This neurotic need may severely under­
mine the healing process by creating more splitting in the patient
and between patient and therapist. One needs the patient's help,
otherwise the healing process cannot stand against the powerful
200 NATHAN SCHWARTZ-SALANT

forces of death and destruction that emerge from the psychotic

parts of both patient and therapist.
To be able to see that the psychotic part is also the link to the
numinosum in the borderline person is crucial for the initiation of
the healing process. But once the person's madness begins to be
more fully uncovered and mutually acknowledged, then the
numinosum may be directly encountered as the transcendent
Self. I believe this experience is what Grotstein calls the
'background object'. One would hardly expect to discover the
8

numinosum amidst the confusion, splitting and denial that can

dominate treatment. But the numinosum is nevertheless present.
This transcendent Self is not created through interpersonal
relations, but rather an increatum (an a priori), and the patient's
birthright. When the numinosum incarnates, healing is nearby.
But the forces of death or destruction must never be
underestimated. The devil works at this stage of potential
healing as a trickster, luring the therapist into thinking that all
is well and often seducing him or her away from an encounter
with the patient's madness. Once the numinosum becomes part of
the patient's (normal-neurotic) functioning personality, we enter
a phase in which the patient aligns with life and against death.
The linking of the normal-neurotic to the psychotic part of the
patient is a crucial treatment issue. I have underscored the
importance of imaginal sight in this process. Also, the therapist
must remain vigilant; he or she must be careful not to split the
person into separate functioning and psychotic parts. The
patient's splitting and denial can be so strong that the 'normal'
part may be favoured by the therapist. Both parts must, instead,
be seen as fragments of a whole.
Discovering the existence of the unconscious dyad and
entering the imaginal process it engenders can lead to the
transformation of the interactive field, so that an ability to play
and an experience of the transcendent function (CW 7, para. 121)
can emerge. This transformed space is crucial because it allows a
possibility of linkage between the normal and psychotic personal­
ity that cannot be achieved through acts of interpretation
(Grotstein, 1979, p. 175).
The borderline person lacks a transcendent function. This is
not to say that a link between conscious and unconscious does not
THE BORDERLINE PERSONALITY 201

exist—in fact, the person may have a channel through which the
unconscious may be freely brought to consciousness. According to
Andre Green and others (see Meissner, 1984, pp. 55ff.), borderline
persons do not manifest functional transitional phenomena:
Borderline patients are characterized by a failure to create
functional byproducts of potential space; instead of manifesting
transitional phenomena, they create symptoms to fulfill the
function of transitional phenomena. By this I do not mean to
say that borderline patients are unable to create transitional
objects or phenomena. To say such a thing would be to ignore
the fact that many artists are borderline personalities. In fact it
can only be said that from the point of view of the psychic
apparatus of such individuals, transitional objects or phe­
nomena have no functional value, as they do for others. [Green,
1977, p. 38]
The borderline person has little capacity to play with the
unconscious, to affect it by consciousness or to allow the conscious
personality to be affected by the unconscious. Instead, the
unconscious will pronounce itself by presenting the patient with
extremely concrete associations to dreams which rarely lead to
other associations; or with a random flood of ideas, or, conversely,
with a total incapacity for free association or imagination. The
borderline person may be a psychic or a creative person of great
gifts, yet he or she is usually only a 'receiver' for this information
and can rarely interact with it in a meaningful way. Borderline
persons can often use their psychic gifts to help others but can do
little to aid themselves. Subject to the unconscious, they feel
completely helpless when confronted with its contents. Therefore,
creation of a transcendent function is especially crucial for the
therapy of the borderline individual.
I suggest a model of a psychotic part that contains a parental
couple that is a single object (a negative state of the hermaphro­
dite) and wherein the soul is terribly afflicted by the death-force
that incarnates as the renegade. Yet, by imaginally working with
the unconscious dyad manifesting between patient and therapist,
a transcendent function can emerge that will link the normal­
neurotic and the psychotic parts of the patient. Throughout
the process, vision will be severely curtailed unless there
is a profound recognition of the numinosum. That uncreated
202 NATHAN SCHWARTZ-SALANT

element—often perceived in the background, or fusing with the

normal personality to create a polluted state—must be seen as
the patient's birthright and an essential source of healing.

NOTES
1. The following statement by Claude L6vi-Strauss describes an
approach to psychic material that precisely mirrors Jung's model,
and, indeed, my own: 'Many psychoanalysts would refuse to admit
that the psychic constellations which reappear in the patient's
conscious could constitute a myth. These represent, they say, real
events which it is sometimes possible to date.... We do not question
these facts. But we should ask ourselves whether the therapeutic
value of the cure depends on the actual characterization of
remembered situations, or whether the traumatizing power of these
situations stems from the fact that at the moment they appear, the
subject experiences them immediately as living myth. . . . The
traumatizing power of any situation cannot result from its intrinsic
features but must, rather, result from the capacity of certain events
. . . to induce an emotional crystallization which is molded by
pre-existing structure . . . these structural laws are truly a-temporal'
(1967, p. 197ff.).
2. Andre Green's discussion of what he calls tertiary processes' is
pertinent here. He defines these processes as *not materialized but
made of conjunctive and disjunctive mechanisms in order to act as a
go-between of primary and secondary process. It is the most efficient
mode of establishing a flexible mental equilibrium and the richest
tool for creativity, safeguarding against the nuisance of splitting, an
excess of which leads to psychic death. Yet splitting is essential in
providing a way out of confusion. Such is the fate of human bondage,
that it has to serve two contrary masters—separation and reunion—
one or the other, or both' (1977, pp. 41-42). Green's 'tertiary
processes' occur, I believe, in the interactive fields I am describing.
This process, as he says, links 'conjunctive and disjunctive mechan­
isms', or, in our terms, the separating and conjoining aspects of the
coniunctio. We also recognize the need for interpretation which
always involves some degree of splitting.
3. For an important discussion of masochism by Gordon see chapter
twelve in this volume.
4. This interpretive attempt was clumsy and useless to the patient; it
was stated to relieve my own discomfort.
THE BORDERLINE PERSONALITY 203

5. I n this discussion I have not focused upon the patient's maternal

experiences, which certainly contributed to her splitting defences.
My impression is that they may have had lesser developmental
significance than abandonment issues with her father.
6. See M. Eigen's The Psychotic Core (1986b) for a masterful discussion
of psychosis,
7. The criteria for borderline personality listed in the updated version,
D S M I I I - R , do not change the argument that follows.
8. He writes that this 'corresponds to the most archaic organizing
internal object which offers background support for the infant's
development. . . . it is one which is awesome, majestic, unseen, and
behind one. I t " r e a r s " us and sends us off into the world. I n moments
of quiet repose we sit on its lap metaphorically. I n psychotic illness
and in borderline states it is severely damaged or compromised'
(1979, p. 154n).

REFERENCES
American Psychiatric Association (1980). Diagnostic and Statistical
Manual of Mental Disorders (Third Edition). Washington, D C : A P A .
Copleston, F . (1985). A History of Philosophy, Vol. 3. N e w Y o r k :
Doubleday/Image.
Eigen, M. (1985). Toward Bion's starting point: between catastrophy and
faith. International Journal of Psycho-Analysis 66:2.
(1986a). T h e personal and anonymous T . Voices. Vol. 21, Nos. 3
& 4.
(1986b). The Psychotic Core. New York: Jason Aronson.
Green, Andre. (1977). T h e borderline concept. I n P. Hartocoliis (ed.),
Borderline Personality Disorders. New York: International U n i v e r s i ­
ties Press.
Grinberg, L . (1977). A n approach to understanding borderline disorders.
I n P. Hartocoliis (ed.), Borderline Personality Disorders. N e w Y o r k :
International Universities Press.
Grotstein, J . (1979). The psychoanalytic concept of the borderline
organization. I n J . L e Boit & A. Capponi (eds.), Advances in
Psychotherapy of the Borderline Patient. New York: Jason Aronson.
Jung, C. G. (1975). Letters, vol. 2. Princeton, N J : Princeton U n i v e r s i t y
Press.
K h a n , M. (1974). The Privacy of the Self London: Hogarth.
L a c a n , J . (1977). Ecrits (translated by A. Sheridan). New Y o r k : Norton.
Levi-Strauss, C . (1967). Structural Anthropology. New York: Doubleday.
204 NATHAN SCHWARTZ-SALANT

McLean, A . (ed). (1980). The Rosary of the Philosophers. Edinburgh:

Magnum Opus Hermetic Sourceworks No. 6.
Meissner, W . (1984). The Borderline Spectrum. New York: Jason
Aronson.
Meltzer, D . (1978). The clinical significance of the work of Bion. I n The
Kleinian Development, P a r t I I I . S t r a t h T a y , Perthshire: Clunie Press.
Schwartz-Salant, N . (1982). Narcissism and Character Transformation:
The Psychology of Narcissistic Character Disorders. Toronto, Ontario:
Inner C i t y .
(1986), O n the subtle body concept in analytical practice.
Chiron. Wilmette, I L : Chiron Publications.
(1988a). Archetypal foundations of projective identification.
Journal of Analytical Psychology 33:1.
(1988b). The Borderline Personality: Vision and Healing.
Wilmette, I L : C h i r o n Publications.
Searles, H . (1979). D u a l - and multiple-identity processes in borderline
ego-functioning. I n P. Hartocollis (ed.), Borderline Personality Dis­
orders. New Y o r k : International Universities Press.
Christian Spirituality: A Theological History From
Williams, R. (1980),
the New Testament to Luther and St. John of the Cross. Atlanta, G A :
John K n o x Press ( B r i t i s h title: The Wound of Knowledge.)
CHAPTER NINE

The treatment of chronic psychoses

C. T. Frey-Wehrlin, R. Bosnak,
F. Langegger, Ch. Robinson

Though said to be a report, this short paper by Dr Frey and his

colleagues from the Ziirichberg Clinic in Zurich is in fact a
thought-provoking disquisition on the subject of chronicity in
psychological illness. As such, it contains a wealth ofideas for the
workaday clinician, some of them tending to the optimistic, some
to the pessimistic. The authors propose that our concern for the
chronic patient is truly a concern for something chronic in
ourselves—'the shadow of our individuality'.
A.S.

A
s it is now more than thirteen years since the Zurichberg
Clinic opened, we welcome the opportunity to report on
our experiences with psychotic patients and to follow it up
with some reflections based on these experiences.

F i r s t published in The Journal of Analytical Psychology 23:3, in 1978.

Published here by kind permission of the senior author and the Society of
A n a l y t i c a l Psychology.

205
206 FREY-WEHRLIN, BOSNAK, LANGEGGER, ROBINSON

To begin with, a brief description of the setting: the Ziirichberg

Clinic is a State-accredited, closed psychiatric clinic. It houses 35
patients in two buildings. Although in the annexe boarders are
free to come and go, the main building is run as a closed nursing
home, the centre of which is a closely supervised eleven-bedded
ward.
The team looking after the patients consists of the following:
five analytically trained physicians and seven analytical psy­
chologists provide individual psychotherapy, usually three times
a week. (All twelve work with out-patients as well.) Two art
therapists introduce the patients to drawing, painting, and
modelling in clay. There is also a weekly general discussion group
as well as a Gestalt group, psychodrama, a group for physical
education and another on music; a therapist for breathing
technique is available when required. The nursing team consists
of a dozen nurses (male and female). A further six people do the
housework and kitchen work. The director, and the administrator
who also works as a therapist, are assisted by two secretaries.
Contact among the personnel is assured by regular conferences
several times a week as well as by frequent personal conversa­
tions.
Patients with all kinds of psychiatric diagnoses, except severe
organic illness, are represented; one-third suffer from schizophre­
nia, one-sixth from manic-depressive psychosis and the rest
mainly from severe neuroses and addictions. More than half the
patients are under 30 years old. About half are Swiss. In addition,
about 20 nationalities have been represented, mainly from
Europe and the United States, and psychotherapy has been
conducted in ten languages. This mixture is fortuitous; admis­
sions are in no way selected.
It would be tempting to try to convey an impression of the
variety of our lives to you—the routine day, interrupted by feast
days and holiday camps, the empty boredom which repeatedly
afflicts the whole community, the silent or noisy despair of
individuals, natural death by old age, or suicide, and the
successes, sometimes after long and arduous labour, sometimes
sudden and unexpected. Surely almost all modern psychiatric
private nursing homes are familiar with such events, which offer
nothing new. How often, for example, are spectacular successes,
on closer investigation, reducible to average expectations?
THE TREATMENT OF CHRONIC PSYCHOSES 207

In this paper we should like to focus on one aspect of our

clinical work which, however peripheral, nevertheless makes
constant and insistent demands on our attention. We should like
to discuss the dark side of the healing process, that of the chronic
and incurable. As early as 1861 Griesinger (1871) had noted in
his text-book that while one-third of the inmates of psychiatric
hospitals in Germany get well and one-third improve, the other
third are incurable. Do these figures differ essentially from those
of today?
Pschyrembel's medical dictionary defines 'chronic' as 'slow to
develop, slow in its course'. But this is not the meaning the term
has for us. 'A case has become chronic' means that our
therapeutic efforts have been of no avail, have become ineffec­
tual. 'Experience teaches that active treatment is of no further
use/ The patient is then removed from a 'therapeutic' institution
in order to make room for another who may be helped; he is
transferred to a 'caretaking' institution where less effort is made
because it is no longer worth it. 'Chronic' means no further
development, final standstill. It means unchangeable—hopeless.
How do these patients come to us? Maybe one of our colleagues
has been working with a patient for a longish time as an
out-patient when the condition worsens, thus necessitating
admission. Or, again, a case is admitted because treatment at
another clinic has failed to bring about the desired result. The
experienced clinician sometimes knows that it is a hopeless case.
Nevertheless, we respond as if we did not know this and proceed
to treat such cases, in our usual way, in tacit expectation that
'progress' will be made. Nor are we strangers to ambition in
therapy; we like the challenge of a difficult case.
New surroundings and the therapist's enthusiasm have a
stimulating effect on the patient: his condition improves.
Nonetheless we know the improvement will not last, and
deterioration, when it comes, is therefore not unexpected. But
renewed improvement brings new hope: relapses can be
'explained', e.g. by the unfavourable effect of a visit by a relative.
But there comes a time when all this changes. The therapist
leafs through the patient's records kept by the physician in
charge i n which the condition and behaviour of the patient are
recorded. This is how the therapist experienced the patient in the
last session—but, alas, the entry was made four years ago. It is
208 FREY-WEHRLIN, BOSNAK, LANGEGGER, ROBINSON

now that the therapist comes to realize that, from the clinical
point of view, four years of intensive work have been wasted.
Furthermore, he must reckon that possibly, or even probably,
nothing is going to change in the future. He is treating a chronic
case.
This realization changes the situation in a fundamental way.
The joint efforts of therapist and patient hitherto were based on
the expectation that, sooner or later, the patient would get well.
This fundamental assumption has now been demolished. The
disquieting question arises whether the attitude which aimed at
an ultimate recovery was ever really appropriate. This can hardly
have been the case since it left out a reality—the chronic nature
of the case. On the contrary, the expectation of a cure had
prevented the therapist from completely accepting his patient; he
had put him under pressure of becoming a success, and the
patient could not live up to this expectation.
Paradoxically, it is at this point that, sometimes, a ray of hope
appears which, every now and then, may be fulfilled. Now
liberated from the pressure to succeed, the patient finds he can
breathe freely in the new atmosphere, and thus may still find his
own way to recovery (Rupp, 1974).
If we remind ourselves of the original meaning of the word
therapeia—'tending'—psychotherapy continues even when there
is no success in sight. Thus 'to accompany' takes the place of the
'urge to heal'—a more modest approach. The great departs; the
small approaches' is the essence of the sign P'i, Standstill
(Stagnation) in the / Ching. This finds expression in the method
of the analysis. It remains analysis in the strict sense, inasmuch
as the unconscious continues to lead; the patient reports
phantasies, dreams, hallucinations. But the interpretations
become more modest. They are limited to integrating the
unconscious products into the framework of the patient's by now
restricted existence (and thus, perhaps, opening it up a little).
Often the interpretations are limited to what Fierz, with
reference to Klaesi, once called 'valuing'—that is, the value of the
unconscious products is recognized (personal communication).
An example may serve to illustrate that this, too, may be
meaningful. A patient had been in the Clinic for ten years. He
was completely absorbed in observing his stomach and in the
scrupulous observance of a self-prescribed diet. At times he was
THE TREATMENT OF CHRONIC PSYCHOSES 209

bedridden; then again there were times when he felt more free
and could even do regular errands for the Clinic. One day he
decided to exchange our Clinic for a dietetic nursing home. Once
there, he telephoned occasionally, complaining of loneliness and
asking for visits. Then one day, completely without warning, he
committed suicide. Would it not be reasonable to assume that the
familiar surroundings of our Clinic and regular talks with his
therapist could have prevented this?
We should like to raise the question of how the therapist can
stand having spent years doing 'futile* work.
To begin with it should be noted that 'futile' has been put in
quotation marks. Certainly the work of the analyst does not serve
to re-establish the patient's 'capacity to work and play'. But
caring for the sick and for invalids is practised everywhere, be it
as Christian charity or as some form of social ethos or other. Such
an ethos may motivate us for part of the way, but in itself it is not
adequate. It is possible to sustain a great effort for any length of
time only if one does it for oneself This observation is not as
pessimistic as it may sound, since it refers not so much to the ego
as to the self For even though the ego may enjoy the patient's
transference—that is, the feeling of being loved and of power—
this, too, becomes tedious in time, all due respect to our
narcissistic needs notwithstanding.
We believe that our response to the chronic patient has deeper
roots. Let us remember the therapist's astonishment when he
noticed that the clinical picture of his patient had not changed
during four years. Apparently he did not have the impression of
doing meaningless work, he did not feel that his work had been
wasted although, objectively, this was the real state of affairs.
What then gave him the feeling of doing something worthwhile?
What is our concern for the chronic patient if it is not the concern
for our own chronic illness? It is that which is most distinctly our
own, that from which we suffer; although it may have been
touched upon during our own analysis, yet it has remained
untransformed. I t is sick, unproductive, evil and infantile—it is
the shadow of our individuality.
This shadow can be realized very little, if at all. Nevertheless,
it continues to live and wants to be accepted. Therapy in the spirit
of Jung's analytical psychology does not mean, even with chronic
patients, 'objective treatment'; rather, it means engagement and
210 FREY-WEHRLIN, BOSNAK, LANGEGGER, ROBINSON

encounter which corresponds symbolically to the alchemical

process in as much as both partners are involved. Indeed, the
chronic defies transformation but not recognition, and such
recognition may become both profound and differentiated. In this
way reflection and awareness are brought about.
But why does chronic illness defy transformation? We know
that Chronos, the father of Zeus, knew how to prevent all further
development by devouring his children. Only Zeus could be
rescued by his mother and taken to a safe place until he could
outwit his father and defeat him 'with guile and strength*
(Kerenyi, 1951, p. 29). Ever since, Chronos, whose reign
corresponds to the Golden Age, has lived on the outermost edge of
the earth, on the Isles of the Blessed.
The myth reveals that aspect of the resistance which prevents
any change in the chronic. He remains where the 'honey flows', in
paradise where life knows no hardship. Expulsion from paradise
is resisted with any and every means; thus a violent attempt to
eject him from paradise, to push him into life, may provoke an
attempt at suicide. If, however, a genuine rebellion on the part of
Zeus takes place—or, to put it analytically, if the arousing affect
of the therapist is derived from a syntonic countertransference
(Fordham, 1957, p. 142f.), then an unblocking of the chronic
condition may yet occur, effecting a transformation to a greater or
lesser extent. Even an experienced therapist needs more than just
'guile and strength' for the timing and doing of such actions—he
also needs luck. In the final analysis the therapy of chronic
patients consists of waiting for this moment—even i f it never
comes.
Working with chronic patients suggests, inevitably, the
comparison with Sisyphus. Again and again Sisyphus rolls his
boulder to the summit of the mountain where it slips out of his
hands and disappears into the abyss. Sisyphus follows it into the
depths. According to Albert Camus,
It is just during his descent, in the interval that Sisyphus
interests me. ... I see this man descending with measured
tread, approaching the agony of which he cannot see the end.
This hour is like a sigh of relief: it will return as surely as his
torment. It is the hour of his consciousness. Each time when he
leaves the heights and gradually descends into the caverns of
THE TREATMENT OF CHRONIC PSYCHOSES 211

the gods he transcends his fate. He is stronger than his boulder.

[Camus, 1942, p. 155]
The awareness which emerges from our efforts on behalf of the
chronic patient includes, in addition to subjective, also objective
knowledge. The increasing differentiation of the analysis reveals
psychic micro-structures which do not necessarily become accessi­
ble during routine, especially ambulatory, analysis. What we see
here is psychology in the broadest sense which extends far beyond
the individual patient. It seems to have been this aspect that
interested Jung above all else during his clinical years. His
patient Babette was for him 'a pleasant old creature because she
had such lovely delusions and said such interesting things' (Jung,
1963, p. 128). But he added that he had *seen other cases in which
this kind of attentive entering into the personality of the patient
produced a lasting therapeutic effect/ Meier describes a similar
case (Meier, 1975, pp. 130ff.), and Fierz reports the same of
Binswanger, who carefully explored cases described in his studies
of schizophrenia for months but without any therapeutic inten­
tion or hope (Binswanger, 1957). While these investigations were
being conducted, a significant improvement was registered in
each case.
There is something else which must not be overlooked. It is
well known that a chronic schizophrenic can experience, albeit
seldom, a spontaneous remission even after many years. Should
this happen, it will make a difference to the patient, who has to
re-enter life, whether the duration of his illness—possibly many
years of his life—figures as a great void or whether it was filled in
by a stable human relationship and regular meaningful discus­
sions. This, we believe, must be the aim on which to concentrate
in our work with chronic patients. For it is by no means certain
that severe schizophrenia can be cured by psychotherapy. Jung
was also sceptical in this regard (CW 3). Therefore we do not see
our job as technical manipulation but as an empathetic accom­
panying of the patient. This is far removed from resignation: it is
confidence in the regulatory powers of the unconscious, which far
surpass our conscious potentialities.
It appears that we have arrived once again at hope. It is always
there as long as life goes on. But we are not concerned only with
hope; we are also concerned with the knowledge that it may not
212 FREY-WEHRLIN, BOSNAK, LANGEGGER, ROBINSON

be fulfilled. Hope lives for the future. We believe that work with
chronics is to be done i n the present, for the sake of the
here-and-now person who faces us as well as for ourselves.

REFERENCES

Binswanger, L . (1957). Schizophrenic Pfullingen: Neske.

C a m u s , A . (1942). Le Mythe de Sisyphe. Paris: G a l l i m a r d .
F o r d h a m , M. (1957). Notes on the transference. I n Technique in Jungian
Analysis. L i b r a r y of Analytical Psychology, V o l . 2. [Reprinted 1989
w i t h corrections and new introduction by J . Hubback.] London:
K a m a c Books.
Griesinger, W . (1871). Die Pathologie und Therapie der psychischen
Krankheiten. Braunschweig: Wreden.
J u n g , C . G. (1963). Memories, Dreams, Reflections. London: Collins and
Routledge & K e g a n Paul.
K e r e n y i , K . (1951). Die Mythologie der Griechen. Zurich: Rheinverlag
(Harmondsworth, Middlesex: Pelican Books, 1958).
Meier, C . A . (1975). Einige Konsequenzen der neueren Psychologie. I n
Experiment und Symbol. Olten: Walter.
Rupp, P. H . (1974). La disperazione dell'analista. Venice-Padova:
Marsilio.
CHAPTER TEN

The energy of warring

and combining opposites:
problems for the psychotic patient
and the therapist
in achieving the symbolic situation
Joseph Redfearn

As Editor, I should like to pick out the ideas in Redfearn's paper

that have strongly influenced me since I first heard it in 1977.
1. Psychosis involves a distortion in the relation to the Other
who tends to get used as a dumping ground.
2. The self always contains a body-self But in psychosis,
particularly, the physical pole of the psyche-soma spectrum is
activated (or suppressed). This needs to be taken into account
in therapy.
3. When considering who or what might function as a transform­
ing container for psychotic process, one should not be too
idealistic; many improvised solutions can do this.
4. At the level of the primal relationship, simple and straight­
forward affect is translated into something far more primitive
and explosive.

F i r s t published i n The Journal of Analytical Psychology 23:3, in 1978.

Published here by k i n d permission of the author and the Society of
Analytical Psychology.

P—H 213
214 JOSEPH REDFEARN

5. 'Affective psychoses represent premature attempts to attain

whole-person feelings. This preserves a prospective or teleolo­
9

gical function for psychosis.

6. There is something that can be called 'pseudo-health'. This is
based on an unrelated projection of bad stuff rather than
achieved via 'suffering and transformation'. Though notice­
able in psychotics, this can also be seen in non-psychotic
persons.
It is worth adding that there is still no residential centre in
Britain of the kind wished for by Redfearn.
A.S.

I
want to discuss some of the problems the therapist may have
in coping with conflicting opposites in his 'psychotic' patients
and in the psychotic parts of his 'normal' patients and of
himself. Of course, the psychotic patient may often impute evil
motives or intentions to the therapist when an impasse or
frustration arises, but it is not always as simple as that. The
patient may actually need to unload pain or evil into, or onto, the
therapist. For the patient this may be a matter of survival or at
least of bodily health.
The level at which psychic and psycho-physical interactions of
this type take place I am calling the level of the primal
relationship. It is in many ways similar to that which exists
between the mother and her baby. At this level we are sensitive
to emotional atmosphere, even to a quite detailed and specific
degree. So-called narcissistic needs are bodily needs. The need to
unload badness and later to project badness is a physical as well
as a psychic necessity.
Using the terminology of Erich Neumann (1954), we are
dealing with the uroboric stage of psychic development and the
early part of the great mother stage when we have a life-giving
all-powerful world or great mother, and a world-destroying and
annihilating great mother.
Many of us are familiar with the untreated psychotic patient
who apparently has to act out violently, even murderously, in
order to obtain relief for himself. By the same token we as
THE ENERGY OF WARRING AND COMBINING OPPOSITES 2 1 5

therapists may need to distance ourselves or at least share with

other helpers the bad or destructive projections and the physical
effects of these bad feelings 'put into us* by our psychotic patients.
And so the problem becomes a wider social one.
At the level of the uroboros we are probably dealing with
undifferentiated psychic energy and an undifferentiated cosmos.
Later, we are dealing with the differentiation of opposing drives
and with the corresponding opposing emotions and images, and
still we are up against forces of the most powerful and-elemental
kind, in both creative and destructive relationships with each
other. We must not forget that there is a disintegrative process in
nature and in the human psyche which is itself the opposite of the
creative synthesis of opposites which we associate with the
symbolic process. Ignoring the death-dealing, implacable, maim­
ing aspects of nature and of ourselves is a perilous and suicidal
attitude. In dealing with psychotics we need to explore these
levels in ourselves, in our patients, and in society.
This primal psychic level has much to do with the archetypal
aspects of union and separation, and with the immense creative
and potentially destructive energies involved. Union has to do
with love, merging, linking, feeding, the coniunctio oppositorum,
and creation. In a less positive form it has to do with
hallucinations, delusions and ideas of reference.
Separation in its positive aspects has to do with differentiation,
with the avoidance of distress, pain, and over-excitation. We
avoid the pain of conflicting feelings by separating. We discon­
tinue unions which are unbearable—too depressing, too much of a
strain, bad for the health, poisoning or debilitating or depleting
or injuring us, or which are simply too confusing and chaotic. We
avoid being painfully penetrated, or invaded, or swallowed up, or
taken over, or annihilated—treated as a non-person. But the
psychotic person in his need to survive does all these things to us,
and he has to, or else suffer these things himself. For brevity we
use some such term as splitting defences in the patient. They are
experienced as extremely offensive i f they are at all effective.
The healing of splitting defences is always painful to patient
and analyst. It requires, in order of priority, survival, recognition,
concern, and even love on the part of the therapist. Fortunately
the patient often teaches the therapist how to provide these
things in time.
216 JOSEPH REDFEARN

The containing and holding aspects

of the mother-therapist and later of the ego
If we take the alchemical image of opposing psychic forces or
substances coming into contact inside a container, with the
absorption or creation of energy, we can use this image as a model
with which to understand the phenomena of psychosis.
First of all, let us consider the symbolic process, the process
involved in therapy and in individuation. A personal conflict or
life crisis will result in the activation of conflicting unconscious
tendencies—opposing archetypal activities. In the working-out of
such conflicts, the healthy person will be able to use some
containing element in order that the energy produced will be
harnessed and used creatively rather than being wasted, or
producing destruction, explosion, or disintegration. In other
words he will, in the course of maturation, have learned how to
sustain and resolve conflicts within himself. The capacity to
sustain and resolve conflicts is usually regarded as an important
aspect of the ego. In the early months of life the mother and the
environment subserve this holding function, and the maturing
ego introjects the mother's particular ways of holding and
containing, of restraining, delaying, and delimiting conflicting
instinctual patterns. The symbolic attitude is normally depen­
dent upon the introjection of the mother's holding capacity. I t
may have to be learned from the therapist, of course, by example.
If the holding capacity of the ego is not adequate to enable the
conflict to be sustained and result in the emergence of a
life-enhancing symbol or in creative activity, various makeshift
vessel-like functions may be used. A parent or parent-substitute,
a friend or analyst, the analytical situation, conventions, rules,
moral principles, rituals, a persona function, dramatization,
turning the conflict into a play activity, or the framework or
structure of aesthetic activity, all these are in universal use for
providing the structure, the limits and the inhibitions within
which the ethical conflict can be resolved. All these are therefore
versions of the alchemical vessel, or are parts or fragments or
miniature versions of it. They could be called ego-aids or
ego-substitutes in this context.
This 'alchemical vessel' in the mature person corresponds with
a sense of personal identity based on the body image. In other
THE ENERGY OF WARRING AND COMBINING OPPOSITES 217

words, the vessel has basically a human form. At this basic level
the vessel, the body of the great mother, and the body-self of the
individual are not differentiable (cf. Neumann, 1955).
As I have said, this containing function, although innate, is
normally experienced and differentiated through the experience
of the baby of its mother's affirmative, recognizing attitude
towards himself as a person (Newton & Redfearn, 1977).
The mother-vessel-self archetype is at first coterminous with
the cosmos and is at first relatively unbounded and undifferenti­
ated. The containing and limiting of excitation is done by the
actual mother. Later the mother—her insides, so to speak—are
experienced archetypally as paradise, a treasure house, or as hell,
depending essentially on whether she is experienced as giving
herself or taking herself away from the baby.
Later still, the mother acquires more human dimensions, and
the containing function is located in the individual's own
personal bodily self. In the joys and sorrows of the personal
relationship between mother and infant there still goes on the
sharing of treasures and the pangs of hurt in the give-and-take of
feeding, playing, and communication.
Going back to the idea of the alchemical vessel's being an
analogue of the body-ego, we must understand that the Vessel' of
the strong mature individual can contain and transform large
amounts of energy produced by the meeting of opposites. On the
other hand, for example, the Vessel' of the weak, schizoid
individual can contain and harness little energy. He is easily
over-excited. Energy easily reaches the level where it is
experienced destructively. I t soon assumes omnipotent dimen­
sions, and it tends readily to be experienced either as an attribute
of the 'ego', or to be projected and thus be alienated from the ego.
The situation in either case involves an absence of real
responsibility in relation to the energy or forces concerned.
Thus for the borderline person the approaching 'Other' has
often to be pushed away or else experienced as part of oneself or
completely under one's control. I f incorporated, the 'Other* may
become bad and have to be extruded. All these phenomena are
consciously experienced in the body-ego of the stronger person.
The body-ego of the strong person can 'contain' large amounts of
love and energy, whereas the body-ego of the weak person can
'contain' little before spilling over in premature ejaculation,
218 JOSEPH REDFEARN

metaphorical or literal, or in acting-out or in anger (see Lowen,

1966). On the other hand, we hear of holy men capable of actually
taking into themselves not only the problems but even the bodily
diseases of friends or others, of suffering them and of getting over
them. Whether these stories are strictly factual or not, they
illustrate my concept of strong vessels.
Now, as the heirs of Wilhelm Reich assert, the amount of
containable energy depends on the absence of neurotic 'armour­
ing' and the aliveness of the body. I myself am not equating
aliveness with absence of suffering or even of disease.
For example, the bodily pseudo-health of many eccentrics,
ascetics, schizophrenic and hypomanic persons may be achieved
at the expense of relatedness rather than through suffering and
transformation. And this can apply to the 'narcissistic' person
who is well within the range of the normal.
This hypothesis, namely that there is apparent health based on
projection of the bad, and another kind based on acceptance and
transformation, is at present just a suggestion for medical and
bio-energetic research, rather than a statement of undoubted
fact.
According to my hypothesis, it is not the ego that is doing the
unloading or projecting but an archetypal function of the
body-self. Later it has to do with the narcissistic self-image, or
egotism, not, I suggest, with the ego.
In the case of patients functioning at this level, an affirmative
primal feeling in therapist or attendant is very sensitively picked
up and reacted to. However, this affirmative primal attitude may
have to be patiently worked towards during many months of
therapy and is not necessarily the 'instinctive' response of the
born therapist. One's 'instinctive' response tends to be similar to
or the opposite of that which the real mother originally had, or
developed, towards the patient. One may have to learn from the
patient over the course of time how to be able to take an
affirmative or recognizing attitude towards his 'evil' or 'destruc­
tive' impulses, particularly when these involve actual loss and
sacrifice from the therapist.
At this schizoid level of mental life, both approaching, getting
closer to the patient, and separating or distancing, have to be
handled with great sensitivity. For the schizoid person, the
excitement which we all feel on increasing closeness tends to be
THE ENERGY OF WARRING AND COMBINING OPPOSITES 219

experienced as invasive, destructive, or deleterious. Conversely,

the withdrawal of the wanted person brings about extremely
negative and destructive images or impulses, which are often
projected. Thus the withdrawing loved mother or beloved person
becomes a loathsome witch, a murderess, someone who ought to
be got rid of. The other person has to be omnipotently controlled
or becomes the object of intense energetic feelings or impulses.
Thus ' I want to be closer to you' becomes 'you have sexual designs
on me', or 'we are going to be married.' ' I hate you for refusing to
be close to me' becomes 'you are going to murder me'; and ' I hate
you for leaving me after such a short visit' can become 'you are
Satan', at the level of the primal relationship. Not only is natural
and correct distancing important, but so is unforced timing. At
the primal level of caring, the mother is able to take her timing
from the baby and his natural functions. Forcing her own time on
her baby constitutes a gross disturbance, particularly at the
autonomic level, and may result in a precocious ego-self
relationship, a false, compliant ego-like structure rather than one
truly related to the self and the unconscious, autonomically based
bodily functions.
At this level the symbol does not exist, the metaphor is the
experiential reality, because the excitement of the conflicting
opposites cannot be contained and transformed. There is no 'as if,
no sense of humour, no tolerance of ambivalence, and so all these
functions have to be carried by the therapist.
'Primal scene excitement' in its most basic archetypal form
belongs to this sphere of experience. In its most archaic form the
engulfing interacting parent-creatures are represented in
imaginal monsters or in very primitive muscular and autonomic
patterns. These experiences are prehuman and prepersonal and
antedate the emergence of the human self-image. This is why as
the persona and the shadow are analysed, the primal scene or the
coniunctio oppositorum, and the link between the T and one's
body, may assume bizarre and monstrous forms on the one hand,
or sublime or god-like forms on the other.
Both the persona and the shadow are partial body-selves, at
least to the extent that they remain as unadaptive and
stereotyped patterns relatively alienated from the ego. I prefer to
use the terms 'persona-function' and 'shadow-function' to describe
the healthy, ego-available forms of these bits of the self.
220 JOSEPH REDFEARN

The uncontainable opposites may of course originate in the

environment, in the form of a psychotic or seriously disturbed
parent, incessantly warring parents, or insupportable double­
bind situations. I am reminded of a patient who in her psychotic
state complained of not existing in her body and of a feeling of
being situated outside her body. When I met her mother with her
lying self-deceptions, I felt precisely the same feelings as my
patient complained of, and I knew exactly why the patient felt as
she did. R. D. Laing (1961) in England and Harold Searles (1965)
in the United States have convincingly described massive
introjections of psychotic parents and psychotogenic situations,
and so there is no need for me to elaborate on these. Jung was
possibly the first to emphasize how parents in a sense force
themselves, their world, and particularly their unconscious
complexes on their children.
At the schizoid level, bodily impulses and affective discharges
are experienced as cosmic events. Later in life, unintegrated
patterns of affective discharge, when they are alien to the ego, are
experienced in the same way, i.e. as alien forces. Patients
describe their unintegrated discharges as mighty winds or as
elemental forces, and so on. Jung gives an excellent example in
his dream of his own struggle against a strong wind with his
shadow going before him (Jung, 1963). He observes that the
shadow is thrown by the tiny light of consciousness. Newton and I
described how in a borderline patient her pregenital bodily
impulses and her infantile rage were at first experienced in this
way, i.e. as uncontrollable elemental forces, and how through the
affirmative primal relationship with the analyst these parts of
the self were gradually contained by and functionally related to
the now more friendly ego (Newton & Redfearn, 1977).
'Containment by the ego' should not be confused with the
concept of mastery and control, which is a manic or obsessional
defence, as illusory as mastering the wind or controlling the
lightning. Premature and stereotyped posturing in relation to
these archetypal forces are rife in collective psychology and
certainly should not be added to by the analytical psychologist.
All 'techniques' constitute illusions of this sort. Premature
reductive interpretations as well as naive introjections and
idealizations on the part of the therapist may both be damaging,
because both increase splitting defences. I f there is a split
THE ENERGY OF WARRING AND COMBINING OPPOSITES 221

between the bodily and the spiritual, we should not make matters
worse with one-sided interpretations.
So much for the pre-personal level of psychic functioning. An
analyst who is not aware of this level of functioning in himself
could not be expected to cope with patients in whom things were
wrong at this level. A mother who was not functioning well at
this level, not being a person, could not help her child become a
person with a personal sense of identity.

Manic and depressive parts of the self

Whereas the schizoid or paranoid person splits and projects the
bad in order to survive, we might say that the depressive person
takes in the bad in order to preserve the loved Other, and the
manic person denies his feelings of badness and dependence upon
the loved Other. The depressive person tends to take the Other
into himself whole, denying the bad parts and denying his anger
for fear of loss and fear of damaging the Other. So one can say
that affective psychoses represent premature attempts to attain
whole-person feelings. They are premature because the goodness
or badness is not fully accepted before being transformed. Manic
denial is short-cut transformation, depressive introjection is
defensive incorporation of the bad. Using an oral metaphor, there
is as yet no chewing and taking in only the good while spitting
out the bad.
By about the age of eight months, as all parents know from
experience, the baby is able to relate to his mother as a person, to
distinguish between her and others, to differentiate her from
himself, and even to care for her in a loving way. We think that
his love for her causes him to feel sad or ill, rather than to hate
her, when she seems to be cross with him. Paranoid and splitting
mechanisms are replaced by depressive ones in which aggression
is contained by the child because of the value to him of the loving
primal experiences he has had with her. The normal infant can
begin to delay or inhibit his impulses. He remembers his mother
in her differing aspects, coming and going, giving and withhold­
ing, loving him and being angry with him, and so on.
The good and bad great mother now has a much more human
form, the infant is more outside the mother, more of an individual

P-H<
222 JOSEPH REDFEARN

person, provided that his mother has affirmed him as such and
continues to do so. We are now entering Neumann's patriarchal
stage, the beginning of Margaret Mahler's stage of individuation
and separation from the mother and from the symbiotic capsule
containing mother and child in the dual unity of the primal
relationship (Mahler, 1969).
Both depression and mania, it seems to me, involve premature
and unsuccessful attempts to swallow the loved Other whole,
with opposite but equally ineffective ways of dealing with bad or
unacceptable feelings.
As far as treatment is concerned, I suppose one's main
pre-occupation in treating depressive patients is to protect them
from their own self-destructiveness and help them dare feel angry
with the loved Other. One's main pre-occupation with manic
patients, on the other hand, is often to assert and maintain one's
own identity and point of view, because one feels constantly in
danger of being swallowed up and taken over by them. The
depressive patient feels devoured by the self, the manic patient
feels he has devoured the self, as Jung so well understood (CW 7).
The self includes the archetypes in projection, including the
mother and often the combined parents. I well remember the
excited and omnipotent state I was in when I first felt I had
devoured my analyst, and he coped by relying non-analytically on
my good feelings and on the established relationship between us.
Where this does not exist, therapy of manic conditions is not
possible in my experience. The patient usually terminates the
relationship as he feels perfectly well.
It would be hardly conceivable to me to deal analytically with
depressed patients without using notions about anger, bad
feelings, swallowing and incorporation, feelings of being over­
whelmed, and so on. It would be hardly possible for me to relate to
the manic parts of my patients or myself without using similar, I
hope well-digested, concepts of denial of dependence, control,
triumph, and contempt.
I hope I have managed to give some indication of how I am
always trying to relate the so-called symptomatology of the
patient with his behaviour, his body-self, at the level where we
can understand these so-called defence mechanisms in terms of
unconscious phantasies and, fundamentally, to archetypal pro­
cesses and the self, which includes the actual functioning of the
THE ENERGY OF WARRING AND COMBINING OPPOSITES 223

digestive system, let us remember. To become caught up in the

patient's fantasies without relating them to his actual behaviour
or to things happening to him is to become swallowed up i n him
and in his psychosis, which is abandoning him in a very real
sense.

Countertransference towards psychotic patients

The infectiousness of manic patients is of course well known; one
tends to be swallowed up by them in the sense of being taken over
by their mood and viewpoint, until the snapping point is reached
where one can no longer go along with them and one has to take
over, to contain them, in other words. For example, they may be
spending all the family's money or refusing to pay one's fees. This
snapping point in several patients in my case was a real 'gut'
reaction. I found that to go along with them in their world was an
increasingly gut-twisting, gut-tightening exercise until I rescued
my guts by asserting myself and my own viewpoint. I am quite
sure my intestines were actually involved in the way these words
indicate. Incidentally, one of my manic patients expressed herself
very pertinently one day just before she had to be hospitalized by
telling me that her fondest wish at that moment was to rip out my
guts, and it felt as i f she were doing just that at the time.
Of course the therapist who cannot lose himself in—i.e. allow
himself to be swallowed up by—his patient is no good either,
although he may be good for certain moods and conditions.
Although one must be prepared to struggle to maintain one's
identity and values rather than be overwhelmed by the patient,
one must also be prepared at all times to have one's values and
identity shattered in some sense by new evidence, new circum­
stances, new aspects of the patient.
Countertransference feelings, or the awareness for the arche­
typal atmosphere at any moment, are the best guide to the
psychopathological level and nature of the situation between
patient and therapist being constellated. Although relatedness at
a primitive level is a sine qua non of therapy, I myself find that
when a patient has got into me to such an extent that he or she is
having striking telephathies or clairvoyant dreams about me, or
seems to be exerting a disturbing influence over me of this kind,
224 JOSEPH REDFEARN

it is time to summon consciously suitable resources to counteract

this state of affairs. I have always found that a simple effort of
awareness and will has been sufficient to effect the necessary
distance or separation. Feelings of being 'got into* or 'got at' or
'swallowed' are for the experienced therapist an infallible guide
to the patient's unconscious wishes and phantasies, and can give
valuable information about where the patient wishes to enter you
and about the amount of sadism involved in the entry or
penetration. It is not the words of the personal question or remark
that is the guide in this matter, but the way in which it is asked
and the amount of discomfort caused in the therapist.
The countertransference feelings which I have experienced
most frequently with psychotic patients are perhaps worth
listing. I have often felt dismay and sadness when a patient seems
to be slipping away from where one can be with him; indignation
when a patient is everything good and I am all bad, and often a
feeling of being robbed in such cases; I experience cold horror at
schizoid callousness, for example at a description of so-called
love-making when schizoid defences are prominent; I have often
felt completely overwhelmed by the flood of unconscious material
from patients in danger of psychosis and have found that it is
often wise to say so; I have sometimes been frightened when a
patient is splitting off his fear and making me feel his fear for
him; tightening and twisting of the guts is a commonplace,
particularly in potentially violent group situations, or when i t is
becoming imperative to 'cut off from the patient for his sake or
one's own; I sometimes experience numbness or weakness in the
arms when a strong impulse to strike the patient is being
inhibited; murderous feelings when a witch anima is being
constellated. I have listed negative feelings, but the primally
deprived patient often elicits impulses of primal love in the
therapist—impulses to hold, stroke, caress, feed, and so on, which
are more embarrassing to enumerate than the negative ones.
Now the energy with which the psychotic defence, e.g. splitting
or projection, is invested is the amount of energy which has to be
held and harnessed if therapy is to take place. This is the energy
of the warring and combining opposites to which I have referred.
It is a moving experience when a patient's holding and balancing
ego replaces the patient endeavours of the therapist, and when
the alienated, dreadful forces of unintegrated instinct become
THE ENERGY OF WARRING AND COMBINING OPPOSITES 225

accepted as part of the inner world of a responsible human being.

Sometimes, for example in children, this can happen quite
quickly in therapy. In other cases it is a matter of months or years
of patient work against the gradient of one's own instinctive
nature.
The symbolic attitude requires giving full value to the
unconscious and to the psyche, including visionary and numinous
experience and so-called phantasy. Expressions such as 'acting­
out' seem to be expressions with a bias in danger of under­
valuation of the psyche. What the patient with the symbolic
attitude achieves is a synthesis of acting-out and not-acting-out—
a new attitude towards the impulse and the emerging symbol. We
as therapists try to achieve a similar attitude towards the patient
and his visions. Just as a mother who is too realistic or too
autistic can kill or distort the vital magical omnipotence in her
baby and can destroy all the joy of living, so the therapist who is
too realistic or too autistic can prevent the therapeutic process
from taking off at all. Yet he must always be true to himself and
sincere in his transactions, particularly with the psychotic
patient, so that if the therapist has not coped with the primal
forces in himself he cannot have the necessary empathy and
integrity to cope with them in his patient. This applies to the
persona of course, but with psychotic patients it applies to the
shadow and the anima and splitting and differentiation between
good and evil at the deepest levels of the psyche, where psyche
and body image and bodily activity are no longer distinguishable.

The organization of therapeutic environments

Psychotic patients demand that the relationship with the
therapist be right, or got right at the primal level. Neurotic
patients have it right anyway, more or less.
The frustrating thing about treating psychotic patients is the
difficulty of providing enough treatment at this level. It is
obviously not enough merely to see patients, even daily, i f the
rest of the time they are in a psychotogenic environment. This is
why the Agnew project, places like Chestnut Lodge, and the
Philadelphia Association in England are so valuable and
226 JOSEPH REDFEARN

important. We need an analogous institution for London Jungian

analysts.
We in London have no residential centre in which we can look
after our patients i n analysis at times when they need such an
environment. We have a few friendly hospitals, particularly
where our members work, which go some way to providing this
facility, but none where the whole staff are involved in this kind
of approach to psychosis. The classical medical training and
approach and the classical psychoanalytical approach are both
highly schizoid, and the emphasis on the nineteenth-century
scientific approach and the selection of doctors in key posts for
academic brilliance exaggerate splitting between feelings and
behaviour, feeling and thinking, patient and therapist, rather
than healing these splits and humanizing the therapist and
through him the patient. However, the younger generation of
doctors do not seem as badly affected in this way as our own, and
we can probably look forward to a greater understanding by the
medical profession of the matters I have discussed in this paper.

Summary
The psychotic patient may not merely project his shadow onto the
therapist. He may sometimes need to act out or in some way
unload bad parts of the self onto the therapist or onto the
environment in order to maintain his experience of integrity or
his bodily health. These phenomena belong to the primal level of
relationship analogous to that between mother and baby, when
the mother is the vessel containing and meeting the interplay of
opposing forces i n the child. This holding and containing function
of the therapist, as with that of the mother, is, hopefully,
introjected by the successfully treated patient. It constitutes an
important aspect of ego functioning and is necessary for the
symbolic process. I t is closely related to a personal sense of
identity based on the body image.
The necessary affirmative holding attitude on the part of the
therapist is not usually the natural or instinctive reaction to the
patient. It may have to be worked towards by both patient and
therapist over a long period. At this level, getting closer to the
THE ENERGY OF WARRING AND COMBINING OPPOSITES 227

patient and withdrawing from him require great sensitivity. The

timing of events may have to be taken from the patient and not
imposed upon him. The withdrawing loved person so easily
becomes the evil one; the treasures of her insides so easily become
poisonous, persecuting, or loathsome creatures or objects. The
insides of the archetypal mother, the insides of the therapist and
the phenomena of the world are experienced in some sense as one.
Archetypal activity is unintegrated and is experienced as
ego-alien cosmic forces.
In the affective psychoses the opposites are partially but not
fully assimilated and transformed in the symbolic process. The
depressive person identifies with the bad in order to preserve the
good aspects of the Other, whereas the manic person denies and
projects feelings of badness or dependence onto the Other (often,
of course, the therapist).
As therapy proceeds, the good/evil Great Mother projections
assume more human form, and the energy of the conflicting
opposites is held and harnessed by the patient in the symbolic
process.

REFERENCES
J u n g , C . G . (1963). Memories, Dreams, Reflections. London: Collins and
Routledge & K e g a n Paul.
L a i n g , R. D. (1961). The Self and Others. London: Tavistock.
L o w e n , A . (1966). Love and Orgasm. London: Staples Press.
M a h l e r , M . S. (1969). On Human Symbiosis and the Vicissitudes of
Individuation. London: Hogarth.
N e u m a n n , E . (1954). The Origins and History of Consciousness. London:
Routledge & Kegan Paul. [Reprinted 1989, London: Maresfield
Library.]
(1955). The Great Mother. London: Routledge & Kegan Paul.
Newton, K . , & Redfearn, J . W. T . (1977). T h e real mother, ego-self
relations and personal identity. Journal of Analytical Psychology 22:4.
Searles, H . (1965). Collected Papers on Schizophrenia. London: Hogarth.
[Reprinted 1986, London: Maresfield Library.]
CHAPTER ELEVEN

Schreber's delusional transference:

a disorder of the self
Alan Edwards

Edwards puts forward what can be described as a 'post-Jungian'

viewpoint concerning the case of Schreber. To Jung's idea of an
anima inflation, he adds the possibility that there may have been
a disorder of the deintegrative-reintegrative processes'ofthe self
(without ruling out some inborn defect). Professor Fleschig,
Schreber's doctor, functioned as a paternal self object, felt to be
hostile and dangerous. Schreber identified himself with a
maternal self-object, hence his gradual 'unmanning'.
From the prospective or teleological point of view, Schreber
could be seen as trying, via the agency of the self, to heal the
pathological splits ... between the maternal and paternal
self-objects'.
A.S.

F i r s t published i n The Journal of Analytical Psychology 23:3, in 1978.

Published here by k i n d permission of the author and the Society of
Analytical Psychology.

229
230 ALAN EDWARDS

Introduction

I
t was in 1907 that Jung published 'The psychology of
dementia praecox' (CW 3), and for him, and also for analytical
psychology, the study of disorders of the self has always been
of major interest. Now, with the presentation by Fordham of his
clinical work and theoretical views on autism (1976), it seems
possible to begin to extend his approach and insight into other
clinical areas, and to look again at the schizophrenias, borderline
states, narcissistic personality disorders, and homosexuality.
Just as in molecular biology, research focuses on the complex­
ities of the nucleus of the cell, the D.N.A., and the R.N.A.
messenger processes, so in our field i t is the pathology of the
original self, and of the deintegrative-reintegrative archetypal
processes, the fixations of, and regression to, the early internal­
ized self-object relationships and the interference with the
development of identity, which are of concern. With these ideas in
mind, I thought it might be of interest to look again at some
features of the paranoid psychosis and psychotic transference
towards his physician described by Daniel Paul Schreber (1955)
in his Memoirs of My Nervous Illness. Originally published in
German in 1903, it was translated into English by Macalpine and
Hunter in 1955.

Clinical account
Schreber was an eminent judge who, before his illness, had been
given positions of increasing responsibility. Though married, he
was childless, and this had been for him a matter of some concern.
His young wife was diabetic and had had a series of six
still-births. His first psychotic breakdown was at the age of 42,
from which he recovered after six months. When he was 51 there
was a recurrence, and, as before, he was treated by Professor
Fleschig of the Psychiatric Clinic of the University of Leipzig.
After seven months he was moved to a mental hospital, the
Sonnenstein, where he remained for a further nine years. During
this time Professor Fleschig continued to remain at the centre of
SCHREBER'S DELUSIONAL TRANSFERENCE 231

his persecutory delusions and hallucinations, using, Schreber

thought, supernatural and hypnotic powers over him in a
ruthless way. In his account, however, he insisted that he was not
just airing grievances, and that religious truths had been
revealed to him which he wished to make common knowledge;
that he had been transformed into a woman and made pregnant
by divine rays in order that 'a new race of men might be created*.
It was Jung who introduced Schreber's book to Freud, who
then later published his classical paper, 'Psychoanalytical notes
upon an autobiographical account of a case of paranoia (dementia
paranoides) (1911c). The argument presented by Freud was that
7

the main aetiological factor in this paranoid illness was the

negative oedipal conflict, with the defences against the acknowl­
edgement of the unconscious homosexual love for the father. He
also postulated fixation at the narcissistic stage of libidinal
development. Jung felt dissatisfied by Freud's analysis and in
Symbols of Transformation (CW 5) gave his own views on
Schreber's condition.
At the outset, while in bed one morning, Schreber had a
feeling, 'which thinking about it later when fully awake, struck
me as highly peculiar. It was the idea that it really must be
rather pleasant to be a woman succumbing to intercourse.' This
idea developed further during the psychosis, and he became
convinced that he was being 'unmanned' by divine rays in order
to be impregnated by God, and the world thus renewed. 'The male
genitals retracted into the body, and the internal sexual organs
were transformed into the corresponding female sexual organs.'
He asked for a scientific approach to be made towards the facts
that he was presenting and thought that his body should be
dissected after his death.
In his exalted and persecutory state he felt that his experiences
were akin to those of an immaculate conception, and in his
delusions he was both the virgin mother and suffering child hero,
a world saviour and redeemer. In the divine 'miracle' which
furthered these processes he felt he was not only emasculated, but
also suffered splitting and smashing of bones in his head, ribs and
spine, pathological changes in his internal organs, and had his
body distorted in many strange ways, being given several heads
at one time.
232 ALAN EDWARDS

God for Schreber could be divided into two Zoroastrian gods,

Ormuzd, a higher god of love and wisdom, and Ahriman, a lower
god of evil, death and destruction, and also into anterior and
posterior realms. The anterior realms had maternal qualities and
could be healing and give states of bliss and sleep, while the
posterior realms were severe and paternal, and could be
persecutory. God, he thought, wished him to develop Voluptuous­
ness* in order that he might imagine himself as 'man and woman
in one person, having intercourse with myself. Schreber com­
plained of God's lack of continuous contact, when he felt that God
was withdrawing from him, which was the reason that when he
was alone with an empty mind, he felt compelled to make loud
bellowing noises.
Fleschig was believed to have contact with God and, at other
times, to be God, 'Godfleschig', and to be in conspiracy with the
anterior realm of God to the harm of the whole Schreber family.
He could seem like a woman, on occasion a charwoman, or he was
able to be swallowed. He had visions once that Fleschig had shot
himself; he saw his funeral, and also the destruction of the whole
world. 'About that time I had Professor Fleschig's soul and most
probably his whole soul temporarily in my body. It was a fairly
bulky ball or bundle which I can perhaps best compare with a
corresponding volume of wadding or cobweb which had been
thrown into my belly by way of a miracle, presumably to perish
there. In view of its size it would in my case probably have been
impossible to retain this soul in my belly, to digest it, so to speak;
indeed when it attempted to free itself I let i t go voluntarily,
being moved by a mind of sympathy, and so it escaped through
my mouth into the open again.'

Discussion
Jung said that 'a successful life makes a man forget his
dependence on the unconscious' (CW 3). If the separation from the
mother has not been made, 'the mother imago represents the
unconscious, and turns into a Lamia'. The demands of the
unconscious act like 'the bite of a poisonous snake'. According to
SCHREBER'S DELUSIONAL TRANSFERENCE 233

the myths it is the woman who secretly enslaves a man, so that he

can no longer free himself from her, and becomes a child again/
This demon-woman of mythology is in truth the sister—wife­
mother, the woman in the man who unexpectedly turns up during
the second half of life and tries to effect a forcible change of
personality. I t consists in a partial feminization of the man, and a
corresponding masculination of the woman/ In the second half of
life 'the assimilation of contra-sexual tendencies then becomes a
task that must be fulfilled in order to keep the libido in a state of
progression'.
Since the original contributions by Freud and Jung, numerous
papers have been written by psychoanalysts about various
aspects of Schreber's psychosis. Additional historical information
has been gathered about his family, his sister, and his wife, and
additional hospital case records were found, and the publications
of his physician father have been further assessed. Schreber's
father was an acknowledged expert, in his day, on methods of
child-rearing, believing that from the beginning the strictest
discipline was necessary. Within the first year, 'the art of
renouncing' had to be taught, with the child being allowed to
watch his mother or nurse eat food, and then when he reached for
it, the morsel was taken away. In later years he believed it was
important for children to sit upright, with shoulders back, and to
this end he had designed various pieces of apparatus and straps.
Over the years analytical interest has shifted from the
conflicts of the oedipal phase, the unconscious homosexual love
for the father, as the basis for the paranoid projections, to those of
the pre-oedipal phase, the intense ambivalent feelings towards
the mother, and the fears of being devoured and disintegrated. R.
B. White, in an excellent paper (1961), demonstrated most clearly
the pre-oedipal conflicts and defences in relation to the infantile
destructive impulses towards the mother, the failure to integrate
them and their projection into Fleschig and God. Looking at the
links now between homosexuality and paranoid illness, most
analysts would see them as presenting differing defensive
systems in relation to similar nuclear pre-oedipal conflicts.
For analytical psychology Schreber's psychosis is primarily
approached as a disorder of the self. Here it is of value to refer to
Fordham's (1976) concepts of the primal self, contributing to
234 ALAN EDWARDS

developing psychic structures by the process of deintegration,

which he sees as a psychic as well as a physiological process.
'Deintegrates carry within them the attributes of wholeness and
treat the external object as part of that wholeness', and, further,
'all the structures developed, including the perception of real
objects and so of the "external" world, conform at first to the
absolute criteria of the self, i.e. it is made up of self objects' (pp.
88-93). Fordham also observes the need to make a differentiation
between the self and the self-object, and their representations.
In schizophrenia we are presented with a defect in the self and
a failure in the deintegrative-reintegrative processes, with a
fixation and regression to an early oral primitive level of
self-object relationships, with splitting, merging and a lack of
differentiation and clear boundaries. Psychotic identifications are
based on these self-objects, which play compensatory and
defensive roles. This schizophrenic defect, with the associated
lack of clear definition from the human and non-human
environment, means a considerable degree of psychobiological
vulnerability and difficulty in adaptation.
Schreber's delusional and hallucinatory experience was vast,
complex and disconnected, but one is able to begin a clarification
when one understands it in terms of primitive self-object
relations. Schreber's predominant identification was with an
idealized maternal self-object, a merger of divine and mytholo­
gical great mother figure, and that of the divine child, with the
helpless infant in himself, compelled to 'bellow' when the parent
withdraws.
As Fordham said, the deintegrates carry within themselves
the attributes of wholeness, and that certainly applies to the
paternal self-object projected on to Fleschig. He is both divine and
human, male and yet female, noble and yet also containing
powerful, - ruthless, omnipotent, sadistic impulses, parts of
Schreber's infantile shadow. The representations of the self-object
seem to fuse both part object and whole object images and reveal
deep splits and persisting 'enmity' between these primitive
organizers of the psyche.
All the important self-object representations show the evi­
dence of archetypal situations, and from the material preserved
one gets, in addition, the feeling of the constant unconscious
SCHREBER'S DELUSIONAL TRANSFERENCE 235

activity of the self behind the psychotic transference attempting

to heal the pathological splits, particularly between the maternal
and paternal self-objects. God was trying to transform him not
only into a woman, but also into a man and woman in one person,
'having an intercourse with myself.
The attempts of the self to bring about a creative renewal
within the psyche of Schreber, a new synthesis of the self-object,
and a firmer and more differentiated structure, are unsuccessful,
and one is reminded of Jung's suggestion that in schizophrenia it
might be that 'the destructive process is a kind of mistaken
biological defence reaction'. The possibility of psychosomatic
processes analogous to those seen in auto-immune disease, when
the body suddenly may not recognize a tissue as homologous,
treats it as foreign antigen, and forms immune antibodies, which
seek to destroy it, has been further taken up both by Stein in
discussing psychosomatic illness (1967), and Fordham in relation
to autism (1976, p. 90). I f such a process were happening here,
and parts of the self were being treated as non-self, it would seem
to be in relation to the paternal self-object projected on to Fleschig
in the regressive reconstruction of the early stressful relationship
to the father who had intruded into the nursing situation so
forcefully, and had done so much to usurp the mother's role.
It was Jung also who supported the idea that biochemical
changes might play an aetiological part in schizophrenic dis­
orders of the self; 'up to a certain point psychology is indispens­
able in explaining the nature and causes of the initial emotions
which give rise to the metabolic alterations. These emotions seem
to be accompanied by chemical changes that cause specific
temporary, or chronic disturbances or lesions' (CW 3, p. 272).
Certainly there was a factor in this illness which was
irreversible. There may have been an inborn defect of the self, or
as a result of the infantile stresses there may have developed a
disorder of the deintegrative-reintegrative processes with patho­
logical splitting occurring between the archetypal self-objects.
Though well compensated for over many years, with increasing
masculine responsibility in the second half of life, and the
disappointments of having failed to become a father himself, the
acute regression took place in an attempt to reconstitute the early
situation and the self-object relationships. One can see only too
236 ALAN EDWARDS

clearly the complexities and difficulties that would exist for the
physician, or analyst, caught in a delusional transference of this
kind, and how the maintaining of a self-object relationship
merger of this intensity might well be an impossible task.

REFERENCES
Fordham, M. (1976). The Self and Autism. Library of Analytical
Psychology, Vol. 3. London: K a r n a c Books.
Freud, S. (1911c). Psycho-analytic notes on an autobiographical account
of a case of paranoia (dementia paranoides). Standard Edition 12.
London: Hogarth.
Schreber, D, P. (1955). Memoirs of My Nervous Illness (translated by
G, Macalpine & R. A. Hunter). London: Wm. Dawson.
Stein, L . (1967). Introducing not-self. Journal of Analytical Psychology
12:2.
White, R. B. (1961). T h e mother conflict in Schreber's psychosis.
International Journal of Psycho-Analysis 42.
CHAPTER TWELVE

Masochism:
the shadow side
of the archetypal need
to venerate and worship
Rosemary Gordon

Non-Jungian clinicians may well feel at home with Gordon's

description of her actual clinical work with patients, because it is
close to and exemplifies general psychoanalytic method and
practice.
However, her vision is rooted in analytical psychology, and
this has led her to explore the possible origin, meaning and
function of the psychopathological syndrome of masochism in
some of her patients. As with Freud, Klein and some other
analysts, this search has led Gordon back to the thesis that there
exists an original death drive—also interpreted by Erich
Neumann, for example, as a 'wish for a weak ego to dissolve in the
self, or by the Kleinian analyst Betty Joseph's suggestion that
masochism may be based on the infant's belief that the price to be
paid for the love of the parents is the surrender of personal
separateness and individuality. But, unlike most psychoanalysts,

F i r s t published i n The Journal ofAnalytical Psychology 32: 3, in 1987.

Published here by kind permission of the author and the Society of
Analytical Psychology.

237
238 ROSEMARY GORDON

her Jungian understanding leads her to link the death drive to

themes like 'death and rebirth' and the symbolic meanings of
death.
Guided by the material from her patients, by a review of the
rituals and body postures in the various religions, and by themes
discernible in literary works such as D. H. Lawrence's short story,
'The Woman Who Rode Away', she proposes that there is a
universal, archetypal drive in humans to surrender and to
worship something beyond personal being, and that masochism is
the negative, the shadow side of this archetypal drive. She argues
that such a pathological or perverted form can be said to exist if
the need for pain is self-chosen and is an end in itself, instead of
just an inescapable part of a larger goal or task.
Gordon also discusses the clinical implications and conse­
quences in analytic work, while pathological masochism predomi­
nates, in terms of transference, countertransference, the negative
therapeutic reaction, and the ineffectiveness of interpretation.
AS.

Introduction

his paper is essentially speculative. The reactions,

behaviour, and phantasies of several patients have led me
mMm to reflect whether there might be a connection between
masochism on the one hand and, on the other, the belief in,
worship of, and surrender to, a deity, albeit in its perverted, its
shadow form.

Five cases of masochism

A man whom I will call Richard had been in analysis with me for
18 months. He was in his early fifties, a lecturer in a theological
college, and married, with three grown-up children: two sons and
a daughter. He was of average height, sported some middle-age
spread, and always wore dark and very conventional suits. He
complained of finding it very difficult to be alone, to find
MASOCHISM 239

satisfaction in his profession, and to have the right sort of

relationship with both his junior and his senior colleagues.
The main theme in many sessions was his preoccupation with
death, his fear of death, his anger with death. And closely related
to this battle with death was his anxious concern about the
existence of God. Indeed, he felt angry and resentful that God did
not seem to deign to prove to him that He exists. He did not give
him the sign, the evidence for which he craved. For in spite of a
life ruled by his belief in God, he was a man of the age of scientific
and concrete proof, a man dependent on belief because unable to
give himself over to faith. As time went on, his belief became
more and more threadbare, and the existence of God seemed to
him more and more unlikely and unconvincing. And then
phantasies of being beaten, phantasies that excited him sexually,
began to possess him. As these phantasies grew in intensity, he
found himself driven to act them out with women he picked up
here and there and who were willing to do as bidden. He was
intensely disturbed and guilty and very angry with analysis, with
me, his analyst, and with God, i n the way that Sartre had
expressed it when he cried out, through one of his characters: //
n' existe pas, le Salaud [He doesn't exist, the bastard].
I then remembered a number of patients who had described to
me masturbation phantasies in which religious rituals had taken
on a markedly masochistic quality. One woman had described
lying on an altar and being solemnly whipped. Another woman
saw herself also on an altar in a convent being held fast, hands
and feet, by four nuns, while a fifth nun, the mother superior,
whipped her, and this had to happen i n full view of all the sisters.
A third woman patient dreamed of being beaten somewhere in a
dark church and woke up to find that she was having an orgasm.
And there was the male patient, Patrick, whom I described in
Dying and Creating (Gordon, 1978). He had told me soon after he
had started analysis with me that he was much involved with
Artemis, the Greek goddess. For the worship of Artemis involved
an annual event in which the most beautiful, most intelligent,
most courageous and most perfect youth was chosen to be her
sacrificial victim by being beaten to death. Patrick was a
schoolmaster. The masochistic experience of this rite governed
his masturbation phantasies—that is to say, he then experienced
himself as this perfect youth-victim, while the sadistic role of the
240 ROSEMARY GORDON

sacrificer tended to be enacted in his relationship to one of the

boys in his class to whom he was attracted, and whose qualities
he admired and idealized.

Thesis
These experiences and reflections led me to the hypothesis,
expressed in the title of this paper, that masochism is closely
related to man's need, probably an archetypal need, to venerate
and to worship some object, some existence that transcends one's
personal being; but that masochism, that impulse to want to
expose oneself to pain and to suffering, is the inferior, the
shadow-side, of the need to worship and to venerate. Masochism,
though not often seen in these very stark, extreme and perverse
forms in which they showed themselves in the patients I have just
described, is nevertheless a frequent and pervasive factor in
clinical work, affecting the process and the outcome of analysis. I
have, therefore, thought it worthwhile to explore it in this paper.

Literature on masochism
The phenomenon of masochism seems to figure very little in
Jungian literature. In fact, there is not a single reference to it in
the Index to Jung's Collected Works.
It is true Jung had thought and written a good deal about
sacrifice, pain and suffering and cruelty. For instance in his
paper, 'Transformation symbolism in the Mass', he makes the
point that \ . . for the neophyte it would be a real sin if he shrank
from the torture of initiation. The torture inflicted on him is not a
punishment but the indispensable means of leading him towards
his destiny' (CW 11, para. 410). But in the case of punishment,
initiation and sacrifice, pain is not self-chosen, nor is it the
primary objective, as it is in the case of masochism. Rather, it is
an imposed and inescapable part of the larger task or goal.
However, in the writings of one or two followers of Jung I have
found i t mentioned and discussed more directly. For instance
Erich Neumann, in his Origins and History of Consciousness
(1954), relates it to his concept o f uroboric incest' in which a weak
MASOCHISM 241

ego dissolves in the self, and this unconscious identity with the
stronger solvent, the uroboric mother, brings pleasure, which
must be called masochistic in the later perverted form. The other
valuable contribution has been made by Mary Williams in her
two-part article, The fear of death', published in the Journal of
Analytical Psychology (1958, 1962). She writes:
I will now make the assumption that there are two main ways
of avoiding the fear of death. In the sadistic method the
individual forms a counter-phobic identification with death as
the destroyer. The victim is then the mortal who must die in
fear and pain while the destroyer experiences the ecstasy of
immortality. ... The masochistic method derives from the
sadistic method and must be understood in terms of the latter,
for masochism is a counter-phobic reaction to unconscious
sadism. The sadist identifies with the invulnerable destroyer
and projects his mortality on to his victim. The masochist
identifies with the mortal victim and projects the invulnerable
destroyer; thus the destroyer is sought as the saviour who will
rescue him from his mortality. [1958, p. 160]
Thus, like Neumann, Mary Williams talks of the ultimate aim of
masochism as 'death in ecstasy', or 'the ecstasy of immortality'.
Searching out Freud's thinking about masochism, I found that
he distinguishes primary masochism from secondary masochism.
And while he regards secondary masochism as a reversal, a
turning upon oneself of the sadistic impulses and feelings
experienced towards another, primary masochism is the direct
expression of Thanatos, the death drive, when its object is still
one's own self; it is not yet the consequence of aggression, which
in defence of one's ego ideal has been directed outwards.
Freud was never at ease with his concept of a death drive,
which had in fact first been put forward and developed by Sabina
Spielrein as Jung acknowledged in Symbols of Transformation
(CW 5, para. 504), where he described the several forms taken in
mythology by 'the Terrible Mother who devours and destroys, and
thus symbolizes death itself.
However, in Melanie Klein's theories the death drive has
taken on a primary and crucial role, manifesting itself in and
through the ego's struggle to preserve itself. In Envy and
Gratitude (1957) she writes:
242 ROSEMARY GORDON

The threat of annihilation by the death instinct within is, in my

view—which differs from Freud's on this point—the primordial
anxiety and it is the ego which, in the service of the life instinct,
possibly even called into operation by the life instinct, deflects
to some extent that threat outwards.
Thus pioneers like Freud, Klein and some of the analytical
psychologists, in their search for the roots of masochism, are led
back to the thesis of Thanatos, that is, to the existence of an
original death drive or death wish. But Freud and Klein do not, or
so it seems, accept, or at least they pay no attention to, concepts
such as 'the transformation of impulses' or to the theme of'death
and rebirth' or to the 'symbolic meaning of death', or to man's
possible basic need to search for something or somebody that
transcends his personal being. And yet, in order to understand
the masochistic impulse and the masochistic experience, we must
consider and explore further these ideas. For masochism is, after
all, evinced not only in the pursuit of physical pain, but also in
such psychological states as longing for surrender, for dependence
on others, for helplessness, for self-abnegation or for immersion
and unity in and with an 'other'. It is also interesting that while
some regard masochism as a means of symbolic self-annihilation,
others understand i t as a way of resisting the experience of the
annihilation of self. Instead, pain is used as proof that there is
some sort of identity and some presence of ego-consciousness.
Masochism is then understood as a sort of pinching oneself to
know one is awake—which is how Betty Joseph has interpreted it
in her paper, 'Addiction to near-death' (1982).
However, to me one of the most meaningful contributions by a
psychoanalyst to an understanding of masochism has been made
by Masud Khan in his paper, 'From masochism to psychic pain'
(1979). He argues there that the human individual needs his—or
her—psychic pain to be witnessed silently and unobtrusively by
the 'other', and that i t is this need which has 'led to the creation of
the omnipresence of God in human lives'. It is the increasing
disappearance of God as the witnessing other, from man's privacy
with himself, so he believes, that 'the experience of psychic pain
has changed from tolerated and accepted suffering to its
pathological substitute, and thus the need has rapidly increased
for psychotherapeutic interventions to alleviate these patholo­
gical masochistic states'.
MASOCHISM 243

Masochism in religious experience

Khan's thesis meets quite naturally my reflections about

masochism in religious rites and rituals and in ascetic and
mystical practices. The presence in the religions of frustration
and denial of physical and emotional needs, and indeed the actual
infliction of pain on oneself—or on others—is almost ubiquitous
and universal. Circumcision, subincision, flagellation, fasting,
abstinence from sexual, social and other appetitive needs—be
they physical or emotional—and sacrifice of self, or else of what is
loved and valued, all these are well documented, well known and
in fact quite familiar. The various physical postures also express
and communicate humility, surrender and abandonment—pos­
tures such as the folding of arms, the clasping or joining of hands,
bowing, kneeling and prostration, all these convey non­
resistance, submission, yielding, obedience and renunciation.
The introspective reflections and experiences that Marion
Milner has recorded under her pseudonym, Joanna Field, in her
book An Experiment in Leisure, published in 1939, also lead in a
very similar direction. She writes:
All this would explain why certain symbols had so often forced
their way into my thinking; it suggested that they might in
essence be concerned with the creative spirit of man, with
man's capacity to find expression for and so lay hold upon the
truth of his experience; they might be a history of man's
struggle with the angel of God to force his name from him. ...
And although it had led me to discover that one wants among
other things pain, suffering, inferiority, it had also led me on to
the growing belief that this need to suffer was not in its essence
perverse. ...
Perhaps Groddeck was right in believing that the desire to
suffer is as innate as the desire to hurt and is in its origin an
essential part of the process of physical creation.
There is indeed a Very thin* line between the sincere desire to
surrender one's personal, egotistical and presumed mortal and
transitory needs, desires and wishes to something or somebody
beyond oneself and a perverted masochism, where the experience
of pain has become an end in itself. Such perversion, so i t seems to
me, parallels to some extent Arnold Hauser's (1965) description of
mannerism, or the mannered style in art which he has defined as
244 ROSEMARY GORDON

the perversion and almost caricaturing of a given style by

concentrating on some inessential details, and making them the
central feature of one's own work. Thus when pain, suffering and
self-abasement have become the primary objective rather than
only a preparation for an experience of surrender and union with
what is believed and felt to be the holy, the eternal, the
transcendent, then we are indeed dealing with a perversion, with
pathological masochism. It seems to me that it is the realization
of this distinction which led the Buddha in his search for
enlightenment to abandon the rigorous asceticism he had been
taught and had practised and to counsel instead what he
described as The Middle Way'—that is, the reining in, but not the
total rejection and destruction, of one's personal needs.
I must once more return to the theme of sacrifice which has
such a prominent place in the religions. Here I have found Elie
Humbert's paper, 'Le prix du symbole' [The price of the symbol]
(1980) to be quite seminal. He points out what is obvious, yet
rarely noted or remembered, that etymologically 'to sacrifice'
denotes 'to make sacred'. And he discusses and analyses in that
paper-the fact that in order to find or to create a symbolic order
and so give meaning to life, to one's personal life as well as to
one's natural and social life, so as to save oneself from chaos, man
is willing to forgo the satisfaction of his impulses and daily needs
such as hunger, cold, rivalry, sex, love and so on (p. 252).
A very powerful example of this impulse to escape frdm a sense
of comfortable meaninglessness through a quest for the unknown
is described in the short story entitled The woman who rode
away' by D. H. Lawrence. I read this story a lohg time ago but
re-read it recently. Married to an American self-made, now rich,
silver-mine owner living in Mexico, the woman—he never gives
her a name—uses a few days absence of her husband in order to
ride away from home, drawn by a 'vulgar excitement' to
encounter somewhere, somehow, signs of the Indian people she
has heard described as 'ancient, wild and mysterious savages'.
Indeed, she meets men who without Using force constrain her to
follow them up to their mountain village. She loses all self-will
and all self-direction. There is no struggle in her against this,
though she is also given strange potions that ensure further her
loss of sense of self. She is treated like a precious object. She is fed,
housed, massaged and clothed—in blue, 'the colour of the dead',
MASOCHISM 245

she is told; but she is kept in isolation, apart from the other
people, except for the daily visits of one of the priests and of the
only interpreter. They were gentle with her and very considerate
... they watched over her and cared for her like women.' She is
really left in no doubt about her fate. And indeed at the very
moment of the winter solstice, after a day of much ritual dance
and ceremony, when 'she felt little sensation, though she knew all
that was happening', the oldest man, the priest, 'struck home,
accomplished the sacrifice and achieved the power' (Lawrence,
1943).
In this short story Lawrence portrays the almost orgiastic
abnegation of consciousness and the willing, near-ecstatic
acceptance of sacrifice of self
How can we understand this drive to sacrifice our physical
needs and appetites, and indeed our actual body? I believe that
such denials and abnegations of self have as their aim the
suppression of what is felt to be but a temporary, a transitory part
of ourselves; it aims to liberate us from the domination of our
body over our mind or psyche. We all know that the body will
indeed return to dust quite shortly after death. And we all know,
we have all observed, the unreliability of this body when, for
instance, it begins to let us down in the course of the ageing
process. Is asceticism not perhaps a rehearsal of death, an
attempt to experience already in this life what we think death,
being dead, may be like, so as to rob it of its capacity to surprise
us or to find us unprepared? It was wisdom—or more likely it was
rational foresight—that made the king of Kapilavastu, Suddho­
dana, try to prevent Gautama, his son, from ever seeing illness,
old age and death. He knew that knowledge of this would draw
his son away from his palace and into the forest in search of
enlightenment.

Masochism in clinical work

To come now to the more daily, the more run-of-the-mill,
experience in our analytic work. Although masochism is fre­
quently the expression, albeit the perverted expression, of man's
need to worship, venerate and to search for the transcendental,
yet, as might be expected, its goal is usually more earth-bound

P-I
246 ROSEMARY GORDON

and less lofty. Nevertheless, it is most often unconsciously in the

service of securing love and admission to the admirable, the
idealized. As Betty Joseph has suggested in the paper (1982) I
mentioned earlier, the masochist, building on his childhood
experience or misunderstanding of how to gain or how to
maintain the parents' love, believes that the price to be paid for
this love is the surrender of his personal separateness and
individuality.
It is worthwhile to remember here that Freud himself wrote
that there are three forms of masochism: erotogenic masochism,
moral masochism and feminine masochism.
Clearly, the five patients I described at the beginning of this
paper showed primarily the erotogenic form of masochism. In the
case of the patients I want to describe next, we have a much more
complicated picture. They all show features that we quite often
encounter in our work, features that reveal the interaction of a
number of complex and different psychological mechanisms.
I shall first describe in some detail a patient I will name Bob.
He had been i n analysis for many years. He was a designer and
very anxious to become a good and inventive designer. He longed
to reach and to use his own creative resources. Longing to achieve
this had been one of his main reasons for coming into analysis.
He was the elder of two boys. His father, an engineer, a quiet
and somewhat withdrawn man, had been away fighting in the
Second World War when Bob was between eight and twelve years
old, the very years when he most needed the presence,
encouragement and inspired companionship of a man.
His mother had been a professional ballet dancer who, after
the birth of her two sons and then the absence of her husband,
became a teacher of dance and drama. She was—as she came to
appear from Bob's description of her—a very lively person,
somewhat-self-centred, devoted to her work and profession, with
easy access to her feelings and her creativity, but not really
interested in, or talented for, making a home, enriching such
home, or giving much time and attention to her children. She had
a close woman friend with whom she collaborated in her
professional work.
Bob was a tall, quiet, shy, timid, diffident, insecure and passive
person, who looked ten to fifteen years younger than his age.
MASOCHISM 247

He had great difficulty in asserting himself, either in his work,

in relationship to colleagues and bosses, or in his personal
relationship with friends, partners or acquaintances.
He seemed very cut off from his affects and impulses; and his
feelings in the transference were subdued. Only when he could
tell me of some new failure or of some new mishap, some new loss
of prestige, achievement or argument did a flash of triumph, of
masochistic triumph and satisfaction, enliven his facial and
verbal expression.
But the analysis jogged along quietly. Yet he had many
interesting dreams, and some of them were filled with strong
emotions. There were several about a birth-giving: either he
himself or some domestic animal, such as a cat, for example, was
bearing a baby. But even this potentially forward-looking theme
tended to be vitiated in some way or other: there was not enough
food for the new baby; or instead of milk the baby was offered shit;
or he, the mother, the birth-giver, was rejected and socially
excluded and shunned; or else the baby was damaged or disposed
of as rubbish. There was in these dreams so much hurt and pain,
but he would tell them in his quiet, gentle and bland manner, as
if they had been dreamed by someone else.
Strangely enough, my own feelings for him in my counter­
transference remained consistently patient, affectionate and
maternally caring. Why, I often wondered, did I not—at least
sometimes—react with impatience, anger and/or irritation, as
indeed his father had shown him and expressed to him when he
returned from war service and did not, as Bob remembered, seem
to be particularly pleased with the way his eldest son had
developed. It may well be that his father experienced Bob as part
of his own shadow, as a caricature of himself, representing his
own lack of a positive and secure confidence in his masculinity.
I did begin to suspect that perhaps there was no lively and
potentially creative centre to be found in Bob. When both of us
came close to a loss of hope—and yet there were the dreams!—he
decided that he would like to try his hand at some art therapy.
The results were truly surprising. Bob brought his painting to his
analytic sessions. They were a revelation! The paintings were
quite remarkably lively, colourful and full of imaginative
forms—of persons, of creatures like animals, of objects—express­
248 ROSEMARY GORDON

joy and fun as well as fear, anger, violence and even horror.
They showed a capacity to be playful—playful in Winnicott's
sense of'play'—that he had until now been unable to draw on and
use and enjoy consciously. But at first, as with his dreams, Bob
displayed and discussed them with me without much affect,
enthusiasm or even involvement.
But now my own reactions to him changed: I became more
fierce and challenging. I felt anger, as i f on behalf of these
pictures, his pictures, at what seemed to me to be his dismissal of
them and his churlish and almost sadistic refusal to acknowledge
as his own the paintings before us. And, as I began to express
some of these reactions, i t seemed as i f a father—a more potent
and potentially more enabling father than he had experienced in
his own personal history—had become activated, inside each one
of us and between us. A t first Bob reacted with sullen, sulky and
hurt withdrawal into more silence. But then, slowly, he rose to
my challenge: he became overtly more resentful, sometimes
abusive and finally openly and honestly hostile and aggressive.
This then seemed slowly to enable him to protect and to defend
what he had made and created and to relate to it as coming from
him and belonging to him. This then enabled him to stand by and
to protect that part of himself from where his pictures had drawn
their existence and their aliveness.
It seemed to me that he was now beginning to extricate himself
from the envy and from the sense of total and hopeless impotence
in relation to his lively and artistic mother; emerge also from the
delusion that all creativity is feminine and belongs to the woman,
the mother, who castrates males and leaves them with only one
way of associating with the forces of creation; that of being her
vassal, her slave, or, at best, of being her flirty and admiring
eunuch.
However, before Bob had achieved this extrication, and while
he was in the midst of this battle in and through the transference
to both the mother-analyst-me and the father-analyst>-me, he
had a rather bad car accident. It had not been altogether his fault,
but had he been more alert and attentive, he might have been
able to avoid it—at least that is how he himself explained it to
me.
It took many months to understand the many meanings of this
accident and to work through—in the relative safety of the
MASOCHISM 249

consulting room—the emotional upheaval and the emotional

experience of it. What emerged is that the accident was indeed a
murderous attack on the much admired and much envied mother.
It was also a murderous attack on the father, whom he thought of
either as absent and unavailable, or, i f present, as inadequate
and impotent because he had not succeeded in taming and
containing the mother. He had also been unable to guide Bob into
true and enjoyable manhood. But, in as much as Bob, when in a
somewhat less hopeless and less depressed state, was identifying
with the enviable mother, or when in a more depressed state with
the inadequate father, the accident was also a suicide, a killing of
him who had been swamped and taken over by one or by both
parents. This suicide was then an expression of the despair that
he would never be able to shed the incorporated and introjected
'others'; that he would never manage to overthrow their
domination inside him; despair that he could ever become his own
self.
But we worked and worked through the emotional experience
and the symbolic meaning of the accident; it then took on the
quality, not only of murder and suicide, but also of parturition, of
birth and sacrifice; and sacrifice is, of course, the essential and
always present constituent of all rites de passage.
Bob's case seemed to show up the temptation to idealize, then
to project and then to incorporate the person carrying the
idealized bit. But inevitably she (in Bob's case the mother)
remained experienced as a somewhat alien presence inside him,
and hence an obstruction, an obstacle in the way of discovering
his own true self and his own creative, powers. The fact that his
creative, idealized mother had remained like a foreign body
inside him provoked envy, a murderous envy. The sadistic attack
on the internalized mother, who was still a part of him, thus
ended in the masochistic attack on his own body. This was of
course a very dramatic example of a sado-masochistic acting out.
It also shows the pdwer of envy and how the search for one's true
self, in cases where there has been much internalization, can
produce the simultaneous enactment of both sadism and
masochism.
I want to give one other example of masochism, but in its less
dramatic and therefore more often encountered form.
250 ROSEMARY GORDON

Leslie, a man in his late thirties, had several nice things

happen to him, which had raised his hopes that he might
eventually have more time to do that by which he felt most
fulfilled: painting and writing poetry. However, two nights later
he dreamed what he described as an absolutely horrible dream*
which left him in a desperately bleak mood. He told me the dream
only in the next session:
I have to go somewhere, to my office I think. I am at a bus stop.
But I have to wait a terribly long time. I turn round for a
moment; and just then the bus I have been waiting for rushes
by—without me. And then I see that though I wear a shirt I
have no trousers on, which is most embarrassing. Then I am
back in my flat; I am now properly dressed. And now I realize
that where I want to go is actually nearby; I do not need to take
a bus at all to get there.
As we talked about the dream I became aware that the 'happy
ending* did not make him happy at all. The grim mood persisted;
he seemed to cling to the first, the negative, the unhappy part
which, I felt, was the masochistic part, a tendency in him which
he and I were aware of and had become quite familiar with. This
bleak mood continued into and through the next session. This
impelled me to end it by asking him: 'What do you need all this
pain for?' I kept to myself the possible answer: To attack you* (the
analyst) and 'to attack myself (the patient). When he came to the
following session he felt and looked much more cheerful. He had
suddenly remembered that his mother used to damp down any joy
at achievement. And he remembered the day when he had won
the first prize as the best actor in his school and indeed in the
county. But his mother, instead of congratulating him—at least
he did not remember that she did—warned him, 'You know such a
talent might suddenly disappear/ 'She always spoiled a good
experience/ he added. 'Am I now doing this to myself? After all,
only my father was allowed to be "great"/ Fortunately for this
patient the unconscious identifications were more accessible to
consciousness, were in fact actually more felt and experienced
than had been the case with Bob. In Leslie's case the self-attack
seems to have emanated from an internalized mother, and he
probably colluded with her in an attempt to placate her, to obey
MASOCHISM 251

her and to please her in guaranteeing that father alone was the
only great and powerful one. But he did also resent it and felt
anger and envy about it.

Discussion
I mentioned earlier that almost inevitably masochism has
clinical consequences. It is often one of the root causes of the
negative therapeutic reaction, for it tempts the patient to cling to
his hurt, suffering and unhappiness and to the memories of all
the saddest events and circumstances of his past. And when
interpretation touches on painful areas, this does not easily evoke
in him compensatory drives, memories and attitudes that could
then challenge him to do battle with the causes underlying the
pain. Rather, he will most likely grasp the pain, hold fast to it and
relax into its pleasurable effects. Also, unless it is painful, such
patients often maintain, they have not been given an interpreta­
tion at all.
Naturally the analyst's countertransference is very strong and
difficult. I find that either I am drawn into the masochistic mood,
in which case I may begin to share the patient's despair, see no
way out for him and commiserate and collude with his hardship
and his general bad luck; or I may get very bored and perhaps
even sleepy. Or else I begin to feel very irritated and feel arising
in me a certain sadistic reaction to the patient. Then I am likely
to experience anxiety and guilt, though on the whole I try to
protect the patient from my sadism. Yet sometimes such sadistic
reactions may have a function. I felt just such irritation with
Leslie, and I admit it was out of that irritable and sadistic
reaction that I had asked him why he needed his pain. In his case
it bore fruit, for he did then come to dredge up the memory of his
mother who 'always spoiled a good experience'.
It must be clear from what I have said so far and from the
patients I have described that masochism has usually multiple
causations; it is rarely a single event, or even a single trauma
that can explain or be held responsible for it.
252 ROSEMARY GORDON

However, in all these patients there was an element, a desire

to reach through love, surrender and submission something or
somebody beyond themselves, idealized maybe, but nevertheless
experienced as being beyond and superior to themselves. It is
true, in the cases of Patrick, Bob and Leslie the apparent cause
was the relationship to the real and earthly persons of the mother
and/or the father; in Patrick and Bob's case the latter was too
absent, but he was too overwhelmingly present in Leslie's case. In
the case of Patrick his Virgin' mother, so seductive and so
plausible to the neighbours, with her Janus-like double­
facedness, must have seemed mysterious to her little boy, so that
she came to appear to him as goddess and witch. As for Bob, he
longed so much to reach that fascinating creative spring, that
muse to which only women, it seemed to him, could have any
access, while Leslie's masochism appeared to be rooted in the fact
that his mother, and so many others, all rendered willingly and
selflessly homage and devotion to his famous father, so that
refusal to join them or even any signs of competition with him
was experienced by him as rebellion i f not blasphemy.
If my hypothesis is valid, if behind the masochistic phe­
nomenon lies an archetypal need to worship something transcen­
dental and sublime, what effect could this knowledge have on our
clinical work and on our reflections about the wider world?
I believe that our transference reactions to our masochistic
patients may well be affected if we become aware that there
might be a link between masochism on the one hand, and the
shadow side of the need to worship and to venerate on the other.
For instance, it may stir us to ask: what is the patient seeking out
as a, for him valid, object of veneration? How can we help him to
recognize there his own unfulfilled potential? Has he been
tempted to idealize it and then to project it?—in which case he
may come to feel intense envy and murderous rage towards the
recipient of his projection, because it may have left him feeling
empty and destitute. On the other hand, he may have projected
onto the worshipped personage—be it human or divine—not
idealized characteristics, but shadow characteristics like envy,
rage, fanaticism, murderousness and so on; in other words,
feelings and impulses which had remained unconscious and thus
unacknowledged as belonging to himself. In that case veneration
and worshipfulness may have fastened on to an evil, sadistic,
MASOCHISM 253

diabolic and pseudo-heroic figure. The gang leader, the terrorist,

the demagogue, the self-styled freedom fighter, any of them may
satisfy his impulses to surrender, to follow and to abandon the
sense of personal responsibility, while justifying at the same time
the experience and the enactment of what consciousness and
conscience has forbidden and condemned.
The need to venerate, i f i t is indeed an archetypal need,
intrinsic to us, men and women, cannot be squashed or eradicated
easily or quickly. Nor should it be. For it is the origin not only of
much that is evil but also of much that is great and good and
beautiful, and what man has made and achieved.
By scrutinizing the object worshipped, the analyst may be able
to help throw light on what in a person—or in a group of
persons—has remained in the dark, in unconsciousness; and so he
may discover what is there to be struggled with, to be developed
further, to be confronted, to be transformed. Such an examination
could then help assess the health or the sickness, the positive or
the negative potential in the worshipful attitude. It is also
important to assess whether this need to venerate and worship
dominates over all other needs; and, furthermore, whether the
search for pain, for submission and subjection of the self is the
primary or even the only purpose and goal. Such an overview may
assist one to recognize to what extent one is dealing with a more
or less natural, or with a masochistic, disposition.
There are undoubtedly very many more themes to discuss in
relation to masochism. I have, for instance, left aside the problem
of masochism and the feminine and the masculine principle. I
have also left out masochism and the trickster; and indeed many
other themes that may be relevant to masochism. But each of
them needs, I believe, a whole paper to itself to do it some justice.
However, there is one sentence in Jung's paper on The
psychology of the trickster figure' which prophetically touches, I
think, though i n a personalized form, on what I have set out to
suggest here, namely that there is a link between masochism and
the search for meaning, for spirit. It seems appropriate that I end
this paper by quoting Jung. He writes:
The unpredictable behaviour of Trickster, his pointless orgies
of destruction and his self-appointed sufferings, together with
the gradual development into a saviour and his simultaneous

p—i'
254 ROSEMARY GORDON

h u m a n i s a t i o n . . . these are j u s t the transformations of the

m e a n i n g l e s s into the meaningful and reveal t h e t r i c k s t e r ' s
compensatory relation to the s a i n t . [CW 9i]

REFERENCES
Gordon, R. (1978). Dying and Creating. Library of A n a l y t i c a l Psychol­
ogy, Vol. 4. London: K a r n a c Books.
Hauser, A . (1965). Mannerism. London: Routledge & K e g a n P a u l .
Humbert, E . (1980). L e prix du symbole. Cahiers de psychologie
Jungienne 25.
Joseph, E . (1982). Addiction to near-death. International Journal of
Psycho-Analysis 63:4.
K h a n , M. (1979). F r o m masochism to psychic pain. I n Alienation in
Perversion. London: Hogarth Press. [Reprinted 1989, London: K a r n a c
Books.]
K l e i n , M. (1957). Envy and Gratitude. London: Tavistock Publications.
Lawrence, D. H . (1943). The woman who rode away. I n Full Score.
London: The Reprint Society.
Milner, M. (1939). An Experiment in Leisure. London: Chatto & Windus.
Neumann, E . (1954). Origins and History of Consciousness. London:
Routledge & K e g a n Paul. [Reprinted 1989, London: Maresfield
Library.]
Williams, M, (1958). T h e fear of death (Part 1). Journal of Analytical
Psychology 3:2.
(1962). The fear of death (Part 2). Journal of Analytical
Psychology 7:1.
CHAPTER THIRTEEN

The psychopathology
of fetishism and transvestism
Anthony Storr

This early work of Storr's has stood the test of time remarkably
well. Indeed, its concerns are as relevant now as they were over
30 years ago. For instance, Storr's intention of showing that the
teleological viewpoint can add something to the conventional
psychoanalytic one, and his criticisms of Freud's interpretation of
the Medusa mythologem, are directly relevant to the project of a
book such as this.
Then there is Storr's use of a phrase like 'subjective
masculinity' (to depict what it is that some perverts and fetishists
lack). This is anticipatory of the approach of Robert Stoller, who
argued that gender identity, looked at from a psychoanalytic
standpoint, is an internal matter, not a behavioural one.
The third theme that I would like to highlight concerns the
way Storr conceptualizes the interplay of masculine and femi­
nine, male and female factors in psychopathology. On the

F i r s t published i n The Journal of Analytical Psychology 2:2, in 1957.

Published here by kind permission of the author and the Society of
Analytical Psychology.

255
256 ANTHONY STORE

personal-historical level he is referring to the relationship with

the parents, as individuals and as a couple. On a more
impersonal, archetypal level, he is touching on something of
great complexity and importance: the struggle to wrest phallic
power from the Great Mother and the unforeseen problems for the
individual when that is attempted by means of identification.
Finally, Storr's reflections on what Western societies demand
of men and how that affects their gendered self-conception show
that, in this area at least, not a lot has changed since 1957.
A.S.

Introduction

he subject of the sexual perversions and anomalies, with

the possible exception of homosexuality, has hitherto been
• A . regarded as a field in which the concepts of Freudian
psychoanalysis are especially applicable. Analysts of other
schools have made few contributions to the study of these
conditions; and psychiatrists who are more interested in classi­
fication than in treatment have been content to relegate these
cases to the diagnostic scrap-heap of psychopathic personality.
Since I believe that the theoretical concepts of analytical
psychology can further our understanding of these conditions, I
have attempted to put down in this paper various tentative
conclusions from my own experience with patients. Most of the
paper is concerned with the perversions of fetishism and
transvestism; but there are also some remarks on sadism,
masochism and male homosexuality.
The psychoanalytic explanation of the perversions of fetishism
and transvestism can be found in the papers of Freud, Fenichel
and Gillespie. Can analytical psychology add anything to the
psychoanalytic point of view?
One of the most valuable insights which Jung has given us is
that symptoms, however bizarre or unpleasant they may seem,
have a positive value for the development of the personality. I f
this concept is applied to the study of the sexual perversions, it
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 257

can, I believe, be demonstrated that these disorders represent a

striving towards normality rather than a flight away from it.
Moreover, we can also detect in the perversions evidence of the
compensatory function of the unconscious, which is such an
important concept in analytical psychology and comparatively
neglected by psychoanalysis.
Psychoanalysis is principally concerned with tracing the
genesis of symptoms, analytical psychology with their prospec­
tive implications. I hope to show that the teleological point of
view can add something to the reductive.
Space forbids an exhaustive survey of the psychoanalytic
literature on fetishism and transvestism; but, although later
writers lay greater Stress on the sadistic impulses of the pervert,
Freud's original contention that these disorders are closely linked
with castration anxiety remains unchallenged.
Freud pictures a small boy, who, through the experience of
infantile masturbation, has already learned to value his penis
highly; but who lives in fear of losing it on the ground that his
parents disapprove of his sexual activity. His fear is enormously
increased i f he happens to see the female genitals. They are
beings who have had their penises removed, and so it is all the
more likely to happen to him. He must never experience this
shock again; and so he phantasies that women possess penises
after all, and the fetish represents the female penis.
Gillespie (1956), in his recent paper on The general theory of
sexual perversion' says of this:
Ever since the analysis of Little Hans Freud stressed the fateful
conjunction for a little boy of an external castration threat for
masturbation with the observation of female genitals, leading
the boy to the conclusion that castration really may happen to
him. Now few will be disposed to deny that such experiences
may have an important crystallizing effect and may give
conscious form and expression to the fear; but as a full
explanation for such a dominating and far-reaching anxiety
Freud's theory seems to depend too much on accidental and
external factors, too little on endopsychic ones. [p. 4]
My own experience i n the treatment of perverts leads me to
agree with this statement emphatically. Perversions are the
258 ANTHONY STORR

outward and visible signs of a far-reaching disturbance in

endopsychic structure; and external factors, such as the experi­
ence of seeing the female genitals, are usually only important in
so far as they reflect the endopsychic situation.

Impotence and castration

One of the striking features of the behaviour of persons suffering
from sexual deviations of the type under discussion is that they
can only feel themselves to be potent, or fully potent, under
certain specified conditions. The fetishist needs his fetish, the
transvestite his cross-dressing, before he can experience the
subjective feeling of full masculine potency: and they are
partially or completely impotent unless these special conditions
are present.
It follows from this that such people, consciously or uncon­
sciously, feel themselves to be less masculine than their fellows.
It is my contention that the essential background to these
disorders is not so much the fear of castration as the feeling of
being castrated; and it is found that this feeling of being lacking
in masculinity extends far beyond the specific difficulty in
performing the sexual act.
In reviewing the histories of patients with any form of
perversion one often finds that they have been unable to compete
with other boys at school; can seldom defend themselves i f
attacked, and seldom attack others; are poor performers at
games; rarely attain any position of authority in their early
years; and often fail to live up to their intellectual promise. They
thus, whether consciously or not, feel inadequate in many
respects compared with other men; and this is expressed
metaphorically as castration, or the condition of not possessing
the most characteristically male attribute, namely, the penis.
It is clear that these patients usually have a great deal of
repressed aggression, a characteristic which is fully recognized by
psychoanalytic writers. In many cases of fetishism the sadistic
element is obvious. Perverse phantasies often contain the
aggressive elements, which are not allowed to emerge in real life
in relation to women. The compensatory function of the
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 259

unconscious is particularly obvious here. The phantasies contain

just those elements which are lacking in conscious behaviour; and
the milder and less effective these patients are in their day-to-day
behaviour in relation to others, the more violent their sexual
phantasies are likely to be.
However, the point I wish to make here is that these patients
are not so much frightened of castration as convinced that they
are castrated. Two clinical examples may serve to illustrate this
point.
(1) A homosexual patient of 40 came to see me because he
was greatly troubled with the sado-masochistic perversion of
tying himself up. During the course of treatment he dreamed
that he had no genitals; and that he was about to leave his
room to look for them. But his way was barred by another man
who stood in the doorway with a sword in his hand.
The patient was actually i n love with the other man who
appears in the dream and attributed to him all the masculine
virtues. He felt himself to be worth very little in comparison
with this man whom he so much admired, and projected on to
him all the masculine qualities which he himself had failed to
develop. The contrast between the patient's own feeling about
himself as castrated and his feeling about the other man as
possessing masculine strength in the shape of a sword is
clearly demonstrated. The dream also illustrates how the fact
of his projection on the other man bars the way to his own
development. So long as he continues to feel that he has
nothing and the other man has everything, he cannot get any
further.
(2) The second example comes from a man of 28 who also
was homosexual. He remembered having the following dream
in childhood, probably before the age of nine: T was in a
bathroom, surrounded by a whole group of large men. I go
round from one to the other cutting off their penises and
collecting them in a basin.'
There again is the contrast between the smallness of the
patient and the largeness of the men. But in this instance the
patient is not content to remain passive, he takes active steps
to possess himself of the phallic power of the animal.
260 ANTHONY STORR

The subjective feeling of being inadequate as a man, i.e.

castrated, may be present even i f the patient can perform the
sexual act with apparently full satisfaction. A further case
illustrates this point.
(3) A man of 28 consulted me with the single symptom of
having a compulsive interest in circumcised penises. He felt he
had to look at medical books, read anything he could about the
operation of circumcision, and tended to speculate about the
penises of other men.
This patient was perfectly potent with women, and had had
several affairs: he was engaged to be married, and had never
had the slightest sexual difficulty. Nor had he any particular
homosexual inclination, at any rate at the conscious level. He
himself was not circumcised in childhood, and had believed
from early years that men who had had the operation were
stronger, tougher, and more masculine than himself When he
was about seven years old he had retired behind some bushes
in the garden to pass water in company with his brother and
another little boy. They naturally enough compared penises, as
small boys commonly do. (In later life these same small boys
compare bank balances, cars, jobs, and other trappings of
masculine achievement—but the underlying idea is the same.)
On this occasion, the visiting child said to my patient that he
did not like his (the patient's) penis as much as his brother's;
the brother had been circumcised, whereas my patient had not.
Later on, the compulsive interest in circumcision developed.
He even went so far as to have the operation performed on
himself in adult life, hoping in this way to establish himself on
an equal footing with other men. But this attempt to treat
concretely and literally a condition which was psychological
and symbolic was, naturally enough, a failure; in spite of being
himself circumcised, his compulsive interest in circumcision
remained exactly the same.
I have already stressed the fact that this patient was, at a
conscious level, sexually normal and fully potent with women.
Before his heterosexual life had become established, he had
masturbated while looking at pictures of the circumcised
penis: but by the time I saw him, this tendency had
disappeared, and the symptom was of comparatively little
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 261

importance to him. It is obvious that some psychoanalysts

would at once say that this man was unconsciously a
homosexual; and this may be true in the wide sense in which
Freudian analysts use the term; but there was remarkably
little evidence of it in the sense of his being attracted by men or
boys. The most obvious fact about him was his sense of
inferiority compared with other men and his intense competi­
tiveness, which was largely unconscious.
The relevance of this case to the main theme of this paper may
not be immediately obvious: but I want to make the point that I
do not believe it is possible to understand the sexual perversions
from one point of view only. In the cases I have seen, the
psychopathology has been as much a matter of a struggle for
power as of sexual guilt and repression. The basic, archetypal
theme is the feeling of castration or masculine inadequacy on the
part of the patient; the symptom represents an attempt to
transfer masculine power from a person who is thought to possess
it to the patient who is thought to be lacking in it.
It is a convention of our Western civilization that men are
expected to achieve something, to make some mark in the world;
and, however potent a man may be sexually, he still may feel
inadequate if he has not achieved whatever he may be capable of
in the way of worldly success. This particular patient had passed
through school and university in a safe and comfortable fashion,
and had arrived in a safe and comfortable job in a well­
established firm of stockbrokers, where he was paid a good salary
and had remarkably little to do. It would have been possible to
take the view that this was all he was good for had i t not been for
his symptom, which drew attention to the fact that he felt inferior
to other men, and therefore could be assumed to have potentiali­
ties within himself which were not finding expression in the
external world. This view was confirmed by his revealing that he
had in the past had phantasies of achieving great things, but,
owing to his too comfortable existence in the present, had not
made any great effort to put his phantasies into effect. He was, in
fact, of exceptionally high intelligence; but he had never been
able to make adequate use of his gifts as he did not believe in
them. This could in part be attributed to the fact that his father
had never shown any particular regard for him; and he had at an
262 ANTHONY STORR

early age come to feel that, in the eyes of men, at any rate, he was
of very little account. No such conviction existed in the case of
women, with whom he was very successful: and this I attribute to
the fact that his early relationship with his mother was more or
less satisfactory.

Homosexual fetishism
In this case the circumcised penis was treated like a fetish. It is
not generally recognized that homosexual fetishes exist. Fetish­
ism is usually described only in heterosexual terms. Neverthe­
less, Walker and Strauss (1948) describe two cases in their book
on Sexual Disorders in the Male: and they make the interesting
remark, with which I fully agree, that: 'It is exceedingly likely
that many cases of homosexuality could be interpreted as "phallus­
fetishism" (p. 184).
,

If I am right i n thinking that the characteristic feature of

patients suffering from perversions is their subjective feeling of
being castrated, or lacking in masculine potency, then one would
on theoretical grounds expect that part of their drive towards
self-realization would be concerned with finding their own
masculinity which they feel to be lacking. I f people feel
themselves to be lacking in some quality which is nevertheless
present in themselves but unconscious to them, they are attracted
by persons who display this very quality. I believe this to be true
of heterosexual attraction also; but it is especially obvious in
many cases of homosexuality. The refined, delicate type of
homosexual is usually most strongly attracted by a tough,
aggressive, muscular male, often of a lower social class than his
own. Marcel Proust (1941, Vol. 7) who, from personal experience,
knew a great deal about homosexuality, describes homosexuals
as 'lovers from whom is always precluded the possibility of that
love the hope of which gives them the strength to endure so many
risks and so much loneliness, since they fall in love with precisely
that type of man who has nothing feminine about him, who is not
an invert and consequently cannot love them in return; with the
result that their desire would be for ever insatiable did not their
money procure for them real men, and their imagination end by
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 263

making them take for real men the inverts to whom they had
prostituted themselves* (p. 21).
It is often a tragic fate for homosexuals to be so attracted by the
people with whom they are least likely to be able to make a
relationship. This type of homosexual is really being driven to
seek through projection what he feels to be lacking i n himself. He
attributes to his beloved object all the qualities of tough maleness
which are unconscious in himself; and it is only when he has been
able to withdraw this projection and realize his own jmaleness
that the attraction ceases to exercise compulsive power over him.
In the same way, a man who has completed his masculine
development and who is faced with the problem of the anima may
learn to withdraw this projection from women and achieve a new
integration. The compulsive element of falling in love will then
disappear and will be replaced by an increased conscious capacity
for relationship.
I have quoted a case where the penis itself was treated as a
fetish. Here is another example in which hair, a very common
fetish object, had the same meaning for the patient.
(4) A dark-haired young man consulted me on account of
homosexual feelings. One of the chief features which attracted
him in other men was fair hair. It seemed to him that
fair-haired men possessed all the qualities of masculine
self-assurance and potency which he felt to be lacking in
himself; and he had often had the phantasy of dyeing his own
hair a lighter colour in the hope of emulating them. This case
seems to me to be exactly parallel to the man who was
attracted by circumcised penises. Both patients are attracted
by a single aspect of another person which seems to them to
epitomize and represent their idea of masculinity. Both choose
characteristics of other people which are the opposite of those
which they themselves possess and both try to emulate the
people they are attracted by, in one case by having an operation,
in the other by the phantasy of dyeing the hair.
(5) Another homosexual admitted that from his earliest
years he had had a compulsive interest in corduroy trousers.
He remembered being sexually excited by the sight of a man
wearing these garments when he was aged about 5. Later on,
264 ANTHONY STORE

he made a collection of corduroy trousers. When he put them

on he felt an access of sexual feeling, and either used to
masturbate, or would repair to a public lavatory to find a
young man with whom he could have sexual relations. He was
an excessively immature, mother-fixed boy who had always
been brought up to be smartly dressed: corduroy trousers
would have been thought vulgar by his mother, and, although
i t is commonly believed that corduroy trousers are effeminate,
in this particular instance they had the significance of
garments which were worn by men who were more masculine
than himself.
In these cases, the fetish represents a means whereby the
patient can identify himself with someone more masculine. These
are special instances of what has been called 'apprentice love',
and are analogous to the normal adolescent attractions towards
older men which are felt by most developing boys. These
attractions have a positive, educative value: a fact which was well
recognized by the Greeks, for they serve to evoke in the
adolescent qualities of masculinity which might otherwise
remain unconscious and therefore only potential. In the same
way, homosexual fetishes have a positive value for the develop­
ment of the personality; a fact which is not clearly brought out in
other psychopathological studies. It is most important in treat­
ment that the fetish should be accepted and given value by the
therapist; for i t is only when the patient can accept it himself that
his development can proceed to a point where he no longer needs
it. A l l these cases illustrate the compensatory function of the
unconscious, a theory put forward by Jung: what is consciously
lacking in the patient—in these instances, certain aspects of
masculinity—is to be found in the unconscious; and what is
unconscious in the patient is to be found in projection upon other
people or part-aspects of people. In the homosexual cases so far
discussed, the fetish object clearly represents the penis. Most
authorities, with the exception of Strauss and Walker, do not
recognize the existence of homosexual fetishism: they confine
their description of cases to those in which the fetish by which the
patient is attracted is clearly something associated with the
female, such as feminine undergarments or jewellery.
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 265

Heterosexual fetishism
The psychopathology of the heterosexual type of fetishism is
disputed. Hadfield (1950), for example, says: 'In all cases of
fetishism we have analysed, the fetishistic object proved to be a
breast substitute: for the breast is the first loved object of the
infant, even before the mother herself becomes so' (p. 376). Freud
and Fenichel, on the other hand, are quite categorical in their
view that the fetish represents a feminine, (maternal) penis. My
own view is that the fetish is a magical object which has both a
phallic and a maternal significance. If I am right in thinking that
the fetishist feels himself to be castrated, then one can say that he
has identified himself with a woman. The phallus is, as it were,
given up in order to preserve this identification. But sexual
activity is impossible without the phallus, and so the problem is
raised for the fetishist of how he can preserve his feminine
identification and at the same time engage in phallic activity.
This is rendered possible if the woman shows evidence of being
phallic; which explains the necessity of the fetish being present
before the patient can be active sexually. The identification with
the phallic woman is carried a step further in the case of the
transvestist.
The double significance of the fetish is brought out by the
following case.
(6) A young man was sent to me on account of a total
failure to keep a job or> succeed in any examination. He had
previously been diagnosed as schizophrenic, and although he
was not frankly psychotic, he certainly showed many symp­
toms of a hebephrenic type.
The fetishism which he presented was as follows. He was
compulsively attracted towards boys who were crippled and
especially those who wore supporting irons on their legs. He
himself wished to wear irons, and got an erection when he put
on a home-made substitute. He used to read anything he could
get hold of about homes and hospitals for cripples, and knew a
good deal about poliomyelitis and its results. If he had the good
luck to see a cripple in the streets he would follow him for
miles.
266 ANTHONY STORR

The apparent origin of this symptom was extremely

interesting. When the patient first went to school, one of his
schoolfellows was a crippled boy who wore an iron on his leg.
This boy was brought to school every day by his mother in a
car, and was given a good deal of special attention as he was
unable to walk. My patient was very envious of this; for his
relationship with his own mother was a bad one, and he dearly
wished to have for himself the extra love and attention which
the crippled boy received. The leg-iron became for him
something which had a double significance. On the one hand, it
represented masculine potency, exactly as in the cases
previously quoted: on the other, it had the significance of a gift
from the mother which gave support and added strength. He
longed to be passive and helpless in order to get maternal
affection: at the same time, he wanted to be masculine and
active, a wish that found expression in a passionate interest in
football. When he identified himself with the crippled boy by
putting on his homemade leg-iron he was obtaining maternal
affection in phantasy; and he was then able to feel more secure
and more sure of himself as a man, with the result that he
could experience his own sexuality.
It seems to me probable that this case throws some light on the
opposing views held by psychopathologists. I have already
mentioned that some authorities claim that the fetish has a
phallic significance; others that it represents the breast. In some
cases at any rate i t probably represents both at once. All these
patients are men who are uncertain of their masculine powers. It
might be postulated that for a male child to develop normally two
things are needed: first, a mother who will give him the affection
and security which every child needs; second, a father with whom
he can later identify. Either or both of these necessities may be
absent: and i t may be that, in cases of fetishism, the fetish
represents whichever of these two requirements has been most
conspicuously absent.
It is quite clear that in some cases of heterosexual fetishism
the maternal, or breast, element is the most conspicuous.
(7) A man came to an out-patient department with the
complaint that he had a compulsive attraction towards
feminine jewellery, especially bangles. He had had a vicious
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 267

and neglectful mother, and as a small child frequently went to

bed feeling miserably unhappy. But he found that if he took
one of his mother's bangles to bed with him he felt more at
peace; and he stole one from her dressing-table which he kept
for some years. The maternally comforting and supporting
aspect of the fetish is clearly shown in this case. He wished his
girl friends to wear bangles because he felt so uncertain of
himself as a man that he wished every woman to display some
evidence of being a mother as well as a potential mistress.

In the fifth book of the Odyssey (Homer, 1935), the tale is told
of how Odysseus made a raft and set sail from Calypso's isle: and
of how Poseidon saw him, and raised up a tempest which all but
overwhelmed him. But Ino, the daughter of Cadmus, came to his
rescue, and told him to discard the clothes which Calypso had
given him and to take her veil instead:

Here, take this veil imperishable, and wind it about thy breast;
so is there no fear that thou suffer aught or perish. But when
thou hast laid hold of the mainland with thy hands, loose it
from off thee, and cast it into the wine-dark deep far from the
land, and thyself turn away. [Odyssey, Bk. V, 1. 340]

When Odysseus finally reaches land safely, he does as he is

told, and returns the veil to the water. He has received the
feminine support that he needed in his extremity; but, once the
danger is over, he must not keep it any longer, but must once
again rely on himself.
Some fetishes have the significance of Ino's veil. They seem to
represent a magical protective device which safeguards the man
against the dangers of being overwhelmed by the unconscious; a
safeguard that is particularly needed in the potentially danger­
ous situation of sexual intercourse. I t seems that whenever a man
is faced with any dangerous situation requiring him to exhibit
the sum of his masculine strength, he likes to have a feminine
symbol to support and strengthen him further. When the
mediaeval knight sought to prove himself in a tournament, he
often carried a token of his lady's favour, such as her glove, into
battle with him: an outward and visible sign that she loved him;
and no doubt he felt all the more confident because of it. In the
last war, fighter pilots used to take stockings or brassieres with
268 ANTHONY STORR

them which their girl friends had given to them. It might be

argued that this is merely an example of adolescent boasting; but
it is only those who are uncertain of themselves who need to
boast.

The phallic mother

It is clear, then, that the fetish has a double significance, both
masculine and feminine. The image of the phallic woman, which
is found in these conditions, is of great interest. Mascuiine
symbols are constantly found in association with mother god­
desses, especially with terrifying figures such as Hecate, whose
symbols are the key, the whip, the dagger, and the torch. Witches
ride on phallic broomsticks, and the various mother goddesses are
frequently pictured as having phallic attributes. The phallic
woman is an archetypal figure found in various representations
all over the world. The existence of this figure is a living
expression of the psychological truth that everything has origin
from the mother, who is therefore symbolically both masculine
and feminine.
Fetishists and transvestites are persons whose ego develop­
ment is incomplete. They are not established as males with a
separate existence and a consciousness of their own masculine
potency. The power still belongs to the phallic mother, and their
problem is to wrest the phallic power away from the mother and
gain possession of it. The fetish is a magical device whereby this
is attempted, and hence has a positive significance.
In transvestism, the patient assumes female dress not because
he wishes to be a woman, but because he wishes to obtain the
phallic power which is still felt to belong to the woman.
(8) A man of 28 complained that he had the compulsion to
dress in his wife's clothes about twice a week. He then
masturbated. He was having normal sexual relations with his
wife at the same time, but she was not particularly active
sexually. He therefore felt rather reluctant to approach her
sexually as often as he would have liked. When he put on her
clothes, he described his sensations as those of 'support and
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 269

comfort'; he especially dwelt on the tactile sensations aroused

by wearing stockings, which he described as 'comforting'. The
maternal element in this is obvious. At the same time, he felt
enormously self-confident in female clothes, and experienced
an access of male potency. By identifying himself with a
woman, he became, paradoxically, more of a man.
In this particular case, the archetypal theme was thrown
into prominence by the personal background. The patient's
father was a weak man, a nonentity with whom he-could not
identify in such a way as to evoke his own latent masculinity.
The mother was a strong character who had always dominated
the home and who 'wore the trousers'. She was thus
particularly fitted to receive the projection of the great mother
with the phallic attributes: and this projection was later
transferred to the patient's wife.
One way of overcoming the great mother is to identify with
her: this is the method adopted by transvestites. Another is by
having intercourse with her. Neumann (1954), in The Origins
and History of Consciousness, says: 'Jung's second conclusion, the
significance of which has not yet been generally accepted in
psychology, demonstrates that the hero's 'incest' is a regeneration
incest. Victory over the mother, frequently taking the form of
actual entry into her, i.e. incest, brings about a rebirth. The
incest produces a transformation of personality which alone
makes the hero of mankind' (p. 154).
Some primitive tribes require the adolescent to have inter­
course with the mother. By thus reducing her to a human level,
by putting her on a par with other women, the boy overcomes her
power over him and attains masculine independence.
(9) An epileptic male patient of high intelligence was both
a sadist and a fetishist. He wanted to tie up women and beat
them: he also wanted to wear mackintoshes. He was an
extremely immature individual who had always felt inade­
quate compared with other men.
His earliest recollection of mackintoshes was that his
mother had given him one when he was about six. He was
extremely pleased with it, and he put it on in front of a mirror
with nothing on underneath. He then experienced an erection
270 ANTHONY STORR

and sexual excitement. He occasionally repeated this proce­

dure in adult life, obtaining a feminine mackintosh, putting it
on, and masturbating: but for the most part he wanted women
to wear mackintoshes and then to have intercourse with them.
The mackintosh in the first instance, therefore, had the
significance of a gift from the mother which resulted in his
'becoming sexual': a transfer of phallic power from her to him.
Why should he later want to renounce this and, as it were, give
it back to the woman again? Since his problem was to overcome
the mother, it seems probable that what he wanted to do was to
act out the archetypal theme of overcoming the mother by
having intercourse with her: and this situation could not be
complete unless the woman showed evidence of being a phallic
woman by wearing a mackintosh.
This interpretation is borne out by his sadistic wishes. His
phantasies were all concerned with proving himself to be
stronger and more powerful than the woman, which he could
only do by overcoming her.
The archetypal theme of overcoming the terrible mother and
thereby gaining possession of her phallic power is well illustrated
by the story of Perseus.
Perseus was the son of Danae and Zeus. His ultimate destiny
was to overcome the father, firstly in the shape of Polydectes, a
king who desired to marry Danae: and secondly in the person of
Acrisius, his maternal grandfather, who had originally perse­
cuted his mother by shutting her up in a tower. But before
Perseus could deal with the paternal side and reign as king, he
had to deal with the maternal side in the shape of the Gorgon.
Pallas Athene appears to him in a dream and tells him about
Medusa. Perseus then goes to the court of Polydectes, who is
pressing his unwelcome attentions upon Danae. Polydectes
laughs at Perseus, because the latter has no gift to bring him,
unlike the other young men who are attending the court. Thou
sayest that thy father is one of the gods. Where is thy godlike gift,
O Perseus?'
We see here that Perseus compares unfavourably with the
other young men. They have all got something which he has
not—and it may be recalled that at the beginning of this paper I
suggested that in the cases I have described the basic condition
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 271

was one of the patient feeling himself to be lacking something

which other men possess.
When Polydectes taunts him, Perseus accepts the challenge
and says: The gift of the gods shall be thine. The gods helping me,
thou shalt have the head of Medusa.' He has determined upon the
fight with the dragon, but realizes that he cannot undertake it
unaided. Athene appears again, this time accompanied by
Hermes. Perseus receives from them, or from the nymphs to
whom they direct him, the following articles: first, a sword with
which to cut off the Gorgon's head; second, a wallet into which to
put it when he has cut it off; third, a shield in which he may see
Medusa reflected, and so avoid being turned to stone by facing her
directly; fourth, a pair of winged sandals, to carry him swiftly and
safely over the seas; and fifth, a helmet which renders him
invisible.
As Neumann (1954) points out, the hero's path can only be
trodden 'to its triumphal conclusion with the help of the divine
father, whose agent here is Hermes', and with the help of Athene,
whom Neumann takes as representing a new, feminine, spiritual
principle (p. 216). I have already pointed out in my clinical
examples that the child needs to receive affection from both
parents, a male and a female contribution, if he is to overcome the
fear of the mother and attain his full masculine stature. Perseus
is given both a weapon which he can use actively, at one level
corresponding to the phallus; and also magical means of
protecting himself, the shield and the helmet, which are
comparable to Ino's veil and represent maternal support and
protection. It is by means of the positive relationship with the
parents that the danger of remaining too long under their
domination is overcome. It is obvious that all the gifts which
Perseus receives from Hermes and Athene can be interpreted at
various levels: they are true symbols, and represent masculinity
and spirituality, the intellect and the power of consciousness as
well as the instinctive basis of masculine development.
Perseus sets off, overcomes the Graeae, who are related to the
Gorgons, and eventually cuts off Medusa's head and puts it in his
wallet. Medusa's head is of great interest psychologically. Freud
wrote a paper on i t in 1922, in which he attributes the phallic
attributes of Medusa to the fear of castration. He says:
272 ANTHONY STORR

The hair upon Medusa's Head is frequently represented in

works of art in the form of snakes, and these once again are
derived from the castration complex. It is a remarkable fact
that, however frightening they may be in themselves, they
nevertheless serve actually as a mitigation of the horror, for
they replace the penis, the absence of which is the cause of the
horror. This is a confirmation of the technical rule according to
which a multiplication of penis symbols signifies castration.
The sight of the Medusa's head makes the spectator stiff with
terror, turns him to stone. Observe that we have here once
again the same origin from the castration complex and the
same transformation of affect! For becoming stiff means an
erection. Thus in the original situation it offers consolation to
the spectator: he is still in possession of a penis, and the
stiffening reassures him of the fact. [p. 105]
%

I cannot agree with this view. The Gorgon's head is hardly to

be interpreted as a reassuring object, in spite of the multiplicity of
snakes; on the contrary, it is described as extremely terrifying.
Being turned to stone, and thus completely immobilized, is surely
not parallel to having an erection, a condition which is usually
the precursor of an increase in masculine activity. The theme is
surely that of being 'petrified' in the face of an overwhelmingly
powerful figure which possesses both male and female character­
istics: in other words, the great mother in her most destructive
aspect.
It is the task of the hero to free himself from the influence of
the great mother by overcoming her, and thus gaining possession
of her phallic power, which he still lacks. Perseus puts the
Gorgon's head in his wallet—presumably the sack or wallet
which every man carries about with him, and which is still
known by its Latin name of scrotum.
He is then able to free Andromeda from the sea-monster, a
theme that I cannot elaborate here. He then uses the head to
dispose of Polydectes and his court, whom he turns to stone by
displaying it. But before he uses the head i n this way, he has to
return the sword, the shield, and the winged shoes to Athene and
Hermes: an exact parallel to the returning of Ino's veil to the sea
by Odysseus directly the immediate danger is over.
Perseus's final accomplishment is also interesting. He returns
to find Acrisius, the maternal grandfather, who was responsible
THE PSYCHOPATHOLOGY OF FETISHISM AND TRANSVESTISM 273

for the trouble in the beginning by shutting up Danae in a tower.

Here Perseus takes part in a competition with the other young
men in throwing the discus. But before he takes part, he takes off
his helmet and cuirass and stands naked before the assembled
crowd. In fact, he has reached a stage of masculine development
in which he can afford to reveal himself fully, just as he is: for he
has overcome the mother, and can now compete effectively with
other men. Of course, he throws the discus much further than
anyone else: and, equally inevitably, a gust of wind catches the
discus, it strikes Acrisius, and kills him. Perseus can now ascend
the throne and reign happily with Andromeda.

Summary

I have tried to show in this paper that fetishists and

transvestites are persons who, because of a certain type of
immaturity, feel themselves to be inadequate as men: that their
symptoms are an effort to remedy this situation, by an attempt to
transfer masculinity from other person to themselves, whether
this person be male or female: and that this attempt is paralleled
in the mythological theme of the hero's struggle with the bisexual
dragon: and I have also attempted to show that the opposing
views of other psychopathologists can be reconciled if this
interpretation is accepted.

REFERENCES
F e n i c h e l , O. (1945). The Psycho-Analytic Theory of Neurosis. New York:
Norton.
(1953). The Collected Papers of Otto Fenichel, First Series. New
Y o r k : Norton.
F r e u d , S. (1922). Medusa's head. Standard Edition 18. London: Hogarth.
(1927). Fetishism. Standard Edition 21. London: Hogarth.
Gillespie, W. (1956). T h e general theory of sexual perversion. Interna­
tional Journal of Psycho-Analysis 37:1.
274 ANTHONY STORR

Hadfield, J . A . (1950). Psychology and Mental Health. London: A l l e n &

Unwin.
Homer (1935). The Odyssey of Homer (translated by B u t c h e r & Lang).
London: Macmillan.
Neumann, E . (1954). The Origins and History of Consciousness
(translated by R. Hull). London: Routledge & K e g a n P a u l ; New York:
Pantheon. [Reprinted 1989, London: Maresfield L i b r a r y . ]
Proust, M . (1941). Remembrance of Things Past 7. London: Chatto &
Windus.
Walker, K . , & Strauss, E . (1948). Sexual Disorders in the Male. London:
H a m i s h Hamilton.
CHAPTER FOURTEEN

The androgyne:
some inconclusive reflections
on sexual perversions
Michael Fordham

Fqrdham observes that Jungian analysts have neglected the

perversions. He also suggests that Jungian interest in imagina­
tion and phantasy can go on in an excessively disembodied way.
For these reasons, Fordham's approach to perversion makes use
of terms and concepts of his own and those of psychoanalytic
writers (Freud, Klein, Bion and Meltzer).
This enables Fordham to point out parallels between Bion's
theory of beta elements, alpha elements, and alpha function and
Jung's idea of the archetype, with its instinctual and spiritual
poles. The androgyne, itself an archetypal image, acts as an
organizer for polymorphous and physical sexual activities. In his
use of the image of the androgyne, Fordham is emphasizing the
part played in internal life by images of which the individual may
not be aware.

F i r s t published i n the Journal of Analytical Psychology 33:3, i n 1988.

Published here by k i n d permission of the author and the Society of
Analytical Psychology.

275
276 MICHAEL FORDHAM

Fordham makes a further suggestion about why it is that

perverse mental process leads or does not lead to actual
perversion: could this have something to do with psychological
type? He concludes that, though interesting, this is not sufficient
as an explanation.

A.S.

I
have chosen to write on the subject of sexual perversions
partly because there is virtually no literature on the subject
from Jungian analysts. Besides that, I am encouraged to
make the attempt because the late Kenneth Lambert, for whom
this paper was originally written and delivered at a memorial
meeting in Cambridge, was one of the few Jungians who
contributed to a small volume on paedophilia. His article reached
a high standard, so I can be said to be following his lead and thus
pay some tribute to him. Like myself, he had been influenced not
only by Jung but also by the English school of psychoanalysis and
especially by Klein, Bion and Meltzer, though I am not sure that
he assimilated much of Meltzer's essay Sexual States of Mind
(1973). In addition, we both paid particular attention to childhood
and infancy. A glance at the chapter headings of his book,
Analysis, Repair and Individuation (Lambert, 1981), reveals one
more aspect of our common ground: our interest in the interaction
between analyst and patient: 'Resistance and counter-resistance',
'Reconstruction', 'Transference and countertransference',
'Dreams and dreaming'. He was concerned with the practice of
analytical psychology set within the concept of the self as the
transcendent function. The self stands behind the process of
individuation, dependent not only on the ego but also on a
dynamic concept of the organism integrating and deintegrating.
These studies by Kenneth Lambert greatly furthered the work of
what has come to be called the London school of analytical
psychology based on the Society of Analytical Psychology.
Though Jung's later writings pay little attention to infancy
and childhood, both Kenneth Lambert and myself have done so
and understood the importance of infantile sexuality in the
genesis of perversions. Jung gave little indication that he thought
T H E A N D R O G Y N E : S E X U A L PERVERSIONS 277

either subject important. In saying this I do not wish to assert

that Jung paid no attention to the perversions; indeed, one of his
seminal cases in The psychology of the unconscious' (CW 7),
where he develops his theory of the collective unconscious and its
archetypes, is a homosexual. That man had exalted religious
dreams, and Jung understood them in relation to initiation. He
cited primitive rituals i n which the adolescent member of a tribe
is submitted to homosexual intercourse so as to bind him into the
male community life.

A definition
I do not think that this kind of homosexuality, encompassed
within a ritual, can be classed as a perversion since the initiate
then goes on into marriage, where he presumably performs his
sexual function well enough. Such a reflection demands a
definition of perversion, but it is not so easy except for extreme
forms, especially those that are sadistic, masochistic or otherwise
shocking. Indeed, we seem not to have gone much further than
the notion, initiated by Freud, that any sexual activity that
prevents genital heterosexual intercourse, or replaces it, must be
counted a perversion. That could be somewhat bettered by adding
that, in perverse sexual activities, infantile sexual phantasies
and practices are exploited and become a more or less persistent
dominant feature in an individual's sexual life.
It is now well known that, although Jung paid scant attention
to perversion, he did not think that human beings could be
regarded simply as male or female. Even though their bodies
proclaimed radical differences, he maintained that they each nur­
tured within their psyche male and female elements, which he
termed the anima in the case of a male and the animus in the case
of a female. I have not been able to find anything about gender
identity in Jung's writings, but I think it justifiable to say that he
assumed such a conception. That is to say, he assumed that the
mental and emotional life of the sexes should be in line with the
physical configurations of each and that the possession or absence
of a penis, breasts and the internal organs making child-bearing
possible should be sufficiently recognized for these organs to

p—J
278 MICHAEL FORDHAM

function in a healthy and productive fashion. It is by making that

assumption that I can regard his relative absence of interest in
the perversions comprehensible.
The anima and animus, and the archetypes, are conceived to be
innate; they are not conceived as only physically sexual
structures but are shaped by personal genetic and cultural
experience.
The forms in which these archetypes function facilitate the
relations between men and women by positive projective identi­
fications that mitigate the essential mystery of the opposite sex
(if negative they can lead to disagreeable illusions and conse­
quent quarrels). Each archetype commonly expresses itself as
moods and phantasies in the male or firmly held opinions in the
female. The tendency of the animus to become forceful and rigid
has given it a bad name. So I must add that, if functioning well,
the animus facilitates a woman's organized mental life. Thinking
of the functioning of the archetypes in this way helps us to
recognize some of the roots of the process of identification with
the opposite sex in both men and women, and how, if excessive, it
can lead to lesbianism and homosexuality, as Freud so brilliantly
demonstrated in his essay on Leonardo (1910c), and also used in a
positive sense to understand the root of Schreber's delusion. But
we must remember that the animus and anima are archetypes,
and so their functioning does not conform to directed thinking,
but to primary process thinking and to emotional actions and
reflections.
I will now hypothesize that it is the dynamic energy in animus
or anima identifications which may result in a man experiencing
himself as a woman or a woman as a man. This state can lead to
the perverse use of physical organs by making them simulate the
normal form of intercourse. That effort may not be enough,
however, and the delusion of being a man or a woman can lead to
the demand that surgeons construct the desired organs by plastic
surgery.
You will not expect me to believe that perversion is merely a
matter of homosexuality or lesbianism. The term refers to a
positive galaxy of behaviours: sadism, masochism, voyeurism,
transvestism, masturbation, paedophilia and so on in their many
forms, and it is not absent by any means from heterosexual
activities. As an example of what this means, a male married
T H E ANDROGYNE: S E X U A L PERVERSIONS 279

man with five children could not become potent unless he

imagined his wife was a prostitute and he became angry with her
because she never had an orgasm. Besides this, he enacted other
perverse voyeuristic activities in private, and because these were
all acted upon I would class them as perversions. I say this
because I am not inclined to think of phantasies as perversions
proper.
The next of Jung's propositions that I wish to consider relates
to the forms in which archetypes can express themselves. He
compares them to the spectrum in which the colours are arranged
in a sequence from red to violet (cf. CW 8, para. 384). We know
that at each end there are infra-red and ultra-violet waves, which
are not perceptible. By this analogy he seeks to express the idea
that while there are a large number of forms in which the
archetypes can express themselves and of which we can become
conscious at either end, there are the absolute unconscious
entities called instinct and spirit. I do not need to take into
account the extremes and will confine myself to considering how
at one end physical actions predominate and at the other
phantasy and mental life—either being possible with relation to
any possible archetypal configuration. I like Jung's analogy
because it depicts the relation of archetypes to each other, merging
into each other yet having a definite position. It also infers their
relation to the whole in the light from which the colours are
derived.
With this formulation in mind I read with much interest Bion's
(1962) ideas about alpha and beta elements because he postulated
that, by means of alpha function, beta elements can be
transformed into alpha elements—the prototype of dream,
phantasy and myth. Jungians had not developed such a detailed
hypothesis, though there were indications that the study of myths
and other ethnological material facilitated the transformation.
To some, Bion's way of putting it is difficult because he is
trying to develop 'Alice in Wonderland mathematics*. If, however,
his formula is translated to mean that an infant has a basic
archetypal system which functions first at the infra-red end of the
spectrum, and we consider alpha function in terms of maternal
reverie (internal to the infant as well as operated by the mother),
or when an infant seems to be in a similar state, looking as
though he is having thoughts or phantasies when this is
280 MICHAEL FORDHAM

unlikely, or when he is in a mindless state, then we might say

that he is having proto-thoughts or proto-phantasies, to coin two
phrases which may be enlightening.
Another feature of Jung's work was that not only did he
analyse myths and religious matter but also used them to start
forming a geography of the psyche, which some of his followers
have developed, a particular example being in Creation Myths by
von Franz (1972).
An archetypal figure which has relevance to the subject under
consideration is the androgyne. In his study of the transference,
in which Jung uses an alchemical text as a paradigm of the
transference, he found that the symbol for the end of the
alchemical process was an image of a hermaphrodite, the
androgyne. In a contradictory statement, he asserts: ' I have never
come across the hermaphrodite as a personification of the goal [as
the alchemists do] but more a symbol of the initial state,
expressing an identity [of the ego] with anima or animus' (CW 16,
para. 533). He considers the sexualism of the alchemical material
to be due to the undeveloped state of the alchemical mind which
\ . . knew nothing about the psychological problem of projection
and the unconscious'. These quotations occur in the middle of
discussion of the uniting symbol as it appears in individuation
through transference analysis.
I must interpolate that I doubt Jung's explanation. It may,
however, be that his statement is condensed. My own experience
suggests that the androgyne can remain primitive when knowl­
edge of projection is available not only intellectually but also in
emotional experience.
Elsewhere Jung refers to the androgyne (e.g. in the Mysterium
Coniunctionis, CW 14) in a historical perspective. It appears as
Adam in the anthropos doctrines of the Gnostics in Paracelsus. In
alchemy it has a number of forms: Rebis and Mercurius, among
others. In, Christianity itself Jung mentions a doctrine of the
bisexual nature of Christ, while I have been impressed by the
reports of St. John of the Cross, who records that in the initial
stages of the mystical life God satiates and intoxicates the mystic
with his breast of love. As a rough statement we can regard these
images as projections or introjections, according to whether the
experiences are internal or external.
THE ANDROGYNE: S E X U A L PERVERSIONS 281

You will perceive by now that a Jungian has a special interest

in imagination and phantasy but is orientated in a way that these
can become disembodied. Partly because of that I have found the
work of Melanie Klein particularly helpful with her interest in
unconscious phantasy which can be equated with archetypes. I
have also been influenced by Bion and Meltzer.
I will now consider two cases that interested me because of the
contrast they present. One man is predominantly homosexual,
the other is heterosexual in practice and cannot understand why
he ever had a serious homosexual relationship.

Case 1
The first case concerned a man in his middle thirties, whom I will
call James. He had a male lover, and the couple were stable,
which made their relationship 'respectable'. They had lived
together for several years, and it was, on the whole, mutually
satisfactory. The arrangement, that each was allowed freedom to
make sexual experiments with other men, sounded somewhat
forced, but it worked fairly well, though it could cause pain when
the desires of one of them were left unsatisfied by the
'experiments'. They were, however, basically loyal to each other.
James was overtly the more sensitive of the two, the smaller and
the more feminine in the sense that he wanted to talk about and
discuss difficulties in their relationship, whereas his lover, who
was presented as the more masculine, a man of few words,
preferred to ignore them or brush them off.
Sexual activities had not so far featured much as problems in
his analysis. They seemed to be based mainly on part object
relationships, by which I mean they were activities to produce
comfort when skin contacts were important, whilst genital, anal
or oral acts produced excitement. The pair made periodic
excursions to 'gay' clubs, where they hoped to encounter other gay
men with possible novel practices that produced new forms of
excitement, though these excursions were usually disappointing.
Apart from that, James visited lavatories where he knew gay
men congregated, but again the encounters were disappointing
because his hopes or phantasies were not realized. In these
activities it was more apparent that he was attempting to find
self-satisfaction.
282 MICHAEL FORDHAM

In these excursions especially, he functioned on a part-object

basis. He explored the uses to which his hands and penis could
produce excitement in the orifices of his own body or in that of his
temporary partner. The emphasis was on over-excitement rather
than on pleasure. In his relationship to his permanent partner,
James was, as I have said, the more feminine, so although much
of their relationship was on a part-object basis, he, James, acted
as a container and aimed to work at the relationship so as to
foster it. His partner, who was bigger than he was and had a close
relationship with his father, had scant use for James's feeling
approaches; when painful subjects arose he tended to cut off
altogether. At work, though, they could develop a useful and
productive combination.
At no time did James explore his life with the aim of curing
himself of his homosexual practices through his analytical
endeavours, but he mentioned that several times he had enjoyed
sexual intercourse with women and that it is much pleasanter to
penetrate the vagina than the rectum. On each occasion the
friendship with the female terminated after making love. Why
that was so remains uncertain, though I explored, without
success, the possibilities that the woman was degraded by
submitting to him or he was afraid of being absorbed into her. He
was attracted to women none the less, i f they were intelligent,
lively and pretty. He practised one other perversion, apart from
genital masturbation: he found great satisfaction in anal
activities, passing big stools and letting them squeeze down his
legs. As an alternative, he would go into a wood and defecate
there or find a place where there was as much liquid mud as
possible, undress and roll about in it. He also liked his bed to be
dirty as well as the room in wich he worked.
You may or may not be surprised to hear that this man was a
highly intelligent and competent executive: moreover, he had a
capacity to develop and generate new and original ideas in his
work, though he had not reached the status and recognition he
longed for. It is, I think, relevant to add here that in his
transference he learned to differentiate his female and masculine
characteristics, and with it came the realization that his
maternal and paternal behaviour made for the successful
operations that he deployed in his work, so that one can say that,
in a mental and emotional sense, his work was sexual.
THE ANDROGYNE: SEXUAL PERVERSIONS 283

A prominent feature of this man's analysis had been his

interest in gaining insight mostly of a mental kind; in this there
is an almost complete absence of phantasy. His strong ethical and
moral standards are important. They inhibited his sexual
development and hence the recognition that sexually he had
become his mother's penis, which was far from his consciousness.
His bisexual homosexuality could be understood on that basis and
also the nature of his transference.
I will now turn to a particular aspect of the, patient's
transference. He struck me as working particularly hard at his
treatment. He regularly brought some problem that had arisen
between interviews and made discoveries that were beneficial.
But from time to time I began to find his work boring and tended
to feel drowsy, and on more than one occasion actually went to
sleep. I t was a state of affairs that is unusual, indeed rare, as I
have always had difficulty in understanding how to get bored. He
noticed it, but was tolerant; he understood how dull his talk
might be, and I got the impression that he himself was also
inclined to think so. He surmised that I must have heard what he
said over and over again from other patients. He also brought in
my age as an excuse for me; that was partly true. There is a
danger here that the collusive element in the transference could
take over, and the analysis will then be in danger of breaking
down or becoming sterile. After some time I located what it was
that made me 'bored*. I thought he was conducting his analysis on
the basis of a conception of how an analysis should proceed. I do
not mean to say that his good work was not productive, nor that
my interventions were not useful to him, but there was the trend
that I will attempt to define which needed analysis and further
understanding.
It was apparent from the rather brief references to his parents
that his mother was the dominant partner in her marriage and
that his father was in important respects unsatifying to her.
Taking that in relation with his transference to me, I concluded
that there was an unconscious collusion with his mother to fulfil
herself in a way that his father could not. I could point out that in
his development he had been scholastically precocious, but when
his mother died during his adolescence he fell into a depression,
which so decimated his achievements that he was no longer able
to follow his scholastic pursuits, and that interfered with his later
achievements.
284 MICHAEL FORDHAM

This is a good place to comment on the initiatory element in

homosexual practices. My patient felt a loyalty to the male group
to which he belonged. He held that this was general among
homosexuals—it was disloyal to engage in heterosexual activities
or to become heterosexual. Comparing this with the primitive
rituals to which Jung refers, one has to conclude that the ritual
element had been interrupted or not completed. Perhaps that
ritual element is being expressed in his analysis and possibly
may be completed—I put that as a hope because in my analyses of
homosexuals I have seldom found they become heterosexual.
Whatever other benefits they get from their struggles with
themselves, and they can be considerable, the change to
heterosexuality does not take place.

Case 2
Henry, my second case, is 37 years old. He has been married twice
and has one child by each marriage. His first wife was his
girlfriend at school, whom he married when he was 22. Their
sexual relations were unsatisfactory in that, to his chagrin, he
was frequently impotent.
Before this his sexual development has not been seriously
deviant. As a boy he had explored genital differences with a girl
and been initiated into masturbation by a male friend; so his
failure with his wife was humiliating and had led to strained
relations between them. He links his sexual inadequacy with
women to a growth disorder from which he suffered. He did not
grow properly at first; he was small and skinny, characteristics
that made him much teased and sometimes bullied at school. In
his humiliation he started a sequence of sexual phantasies during
adolescence which he enhanced by taking drugs like cannabis
and LSD, though he used them in an experimental way and was
not addicted. The main period of experimentation took place
when he developed a number of phobias with persecutory
colouring. He felt his job was killing him, so he left it and went off
with a brilliant and unstable friend, John, whom he found
inspiring. With and through him, he discovered art, literature
and politics and played rock-and-roll music in John's band.
During his analysis he retailed a sequence of memories. John
had a girlfriend, whom he subsequently married. She was
THE ANDROGYNE: SEXUAL PERVERSIONS 285

exceptionally beautiful, slim below and with large generous

breasts—the type Henry especially admired and who usually
excited him sexually. He, John and this woman engaged in
various sexual exploits, including stripping.
One day the three of them went by car to the country. The
woman was told by John to strip, which she did, and Henry was
also instructed to strip. John told the woman to sit on Henry's
knee, which she also did. To his surprise and consternation Henry
found he had no erection. John then carried the woman off into
the car and had intercourse with her. From behind Henry noticed
the woman's legs as they negotiated the objects in the car. He was
asked to kiss her face while John was occupied below, but he did
not enjoy doing this and he desisted.
It was after that episode that he went to a hotel and performed
intensive anal masturbation in which he then and afterwards felt
himself to be a woman being copulated with by the devil's
enormous penis.
At this period he felt very desperate, but finding he could 'chat
up women' he started making relationships with them, though he
was liable to be impotent and sometimes afraid of his impulse to
attack their breasts, especially when they were very large. His
self-esteem was restored by a passive woman, with whom he
made love for hours on end—even 'all day'.
I will not expand further on this man's rich and polymorphous
sexuality, except to say that it was while he was working on the
feminine part of himself and his quite strong and sometimes
frightening homosexual phantasies that he became puzzled as to
why, in his adult life, he had never behaved sexually with one of
his male friends with whom he had had close and intimate
relationships. He was convinced all the same that by nature he
was androgynous—a better word to use, I think, than bisexual.

If we consider these two cases together, they have in common

homosexual and heterosexual trends; the one is acted on, the
other expresses itself in autoerotic acts (especially anal mas­
turbation) and dramatic phantasies. In the first there were no
anxieties about impotence or sexual inadequacy, in the other it
was a matter of great importance, for i f he was not potent his
self-esteem was shattered; but I never heard of the first patient
being impotent, his penis was a reliable organ.
286 MICHAEL FORDHAM

It is quite evident that each dealt with his infantile sexuality

in different ways. James's sex life operated at the infra-red end of
Jung's spectrum, that of the other, say, in the middle of the
spectrum. I f we use Bion's formulation, we can say that in
relation to sexuality the alpha function had not operated much to
produce alpha elements, the precursors of phantasy. In his case
we can infer that the failure of the alpha function was due to his
being an extension of his mother. This kind of extension is
complicated and can be observed in mother-infant observation
when a mother will project her animus into her son so that he
becomes forced by her potency to ever greater achievement. I f
that persists and the child is gifted, then we have the groundwork
for his developing into a female-male androgyne. I am of the
opinion that James had developed along that line. I would cite in
favour of this hypothesis that his mother was much the more
powerful of his parents and that he has not yet mentioned any
period of mourning over her death; she is part of him and in that
sense is not dead.
To continue with this construction, we have to account for his
mental achievements. That must be due to innate intelligence,
but even so there must have been a capacity to convert beta
elements into thoughts. I would speculate that this was
established in relation to the breast. Bion (1962) has a good
formulation here: a no breast is a bad breast within the infant if it
struggles to extrude i t either by evacuating it as excrement or
transforming i t into a thought, which for my patient became food
for the mother's animus and later pressured him into mental
achievement.
In contrast, and it is the contrast I wish to highlight, my second
patient was positively flamboyant: he had developed a rich,
varied sexual life, and he turned readily to women for personal
consolation and sexual satisfaction. They usually responded,
though the woman that he fell passionately in love with, and who
was sexually dramatic, eventually rejected him. He soon fell into
the arms of another one.
This was quite the contrary with James, who did not lack male
sexual partners but, in other respects, could not have been less
like my second patient. I never heard him refer to any part of a
woman's body except her vagina. Pre-genital relationships did
THE ANDROGYNE: SEXUAL PERVERSIONS 287

not take place with women; he was sturdy and boyish. He gave no
evidence of appreciating a woman's physical beauty, nor did he
phantasize about what she might be like in her mysterious
insides.
One might profitably consider these two cases with respect to
type theory: the first patient being a sensation type with thinking
and feeling as secondary functions; the second an intuitive and
also with thinking and feeling as secondary functions. Though
these ideas do something to facilitate description, they do not
focus enough on the psychopathology of the two cases. Why had
the initiatory process in James stopped at so-called initiatory
practices, and why had the other's polymorphous sexuality
burgeoned in acts as well as phantasy, growing into a very real
appreciation of women? The former was not lacking in homosex­
ual phantasy, while the latter had embarked on heterosexual
activity which did not, however, develop. We can speak of each as
androgynous with a different emphasis.
We are, I think, getting to know more about how it is possible
for these variations to develop, partly through transference
analysis, partly through constructions about the patient's infancy
and childhood, and more recently through studies on mother­
infant observation. A recent construction by Masud Khan (1979)
is derived from observations on transitional objects. He considers
that there is, in the case of perversions, a 'collated internal object'
which is placed in the space between mother and infant whose
content is a mixture of male and female objects. This collated
object seeks a real partner, but according to Khan it can never be
actualized and so leads to disillusionment. It is this which leads to
the sense of alienation sometimes found among the perverse. I
cannot say that my cases showed the characteristics Khan
requires; indeed, the sense of alienation and precarious identity
applied to the heterosexual patient at one time more than to the
other, and that has now largely been repaired.
I have isolated a form of transference exhibited by the
homosexual which indicated that he was conducting his analysis
on a deeply unconscious premise which I was supposed to hold,
and it may be assumed that I did so with great fixity of purpose,
almost driving me to become unconscious in a very concrete way.
One of the characteristics of the collated internal object is that i t
288 MICHAEL FORDHAM

contains the mother's dissociated unconscious. We are back to

J u n g , according to whom the act of a mother was the major factor
in determining most childhood disorders. L i k e so many early
insights, it became prematurely generalized, but that does not
make the perception less significant—it can be thought about and
developed and modified i f necessary. Jung's view was one-sided
and failed to take into account the part played by an infant or
child in introjecting the mother's masculine unconscious or
animus. For example, to do so the child must have developed far
enough to experience his mother as a woman with a penis
(without testicles, be it noted) which can be continued in beta
elements, sexual acts or translated into mental life and achieve­
ment. That is a possibility which would be fostered by a strong
mother with firmly held moral principles and a weak father, the
picture of his parents that he gave. Such a construction is, I think,
plausible.
Kenneth Lambert worked on constructions which had been
sadly neglected by analytical psychologists. I think that they can
give a valuable perspective on a patient's conflicts and make it
easier to sort out what is infantile and perverse i n a n adult and
what is polymorphous and valuable in a n adult. They assist in
distinguishing what J u n g distinguished as the androgyne; that
is, a symbol for the initial state on the one hand and of the goal on
the other.

Summary
After a brief introduction on the relevance of the animus and the
anima, Jung's model of the spectrum to indicate the range of
possible archetypal experience is related to Bion's postulate of
beta and alpha elements.
Two cases are then described. Both are bisexual, but one is a
practising homosexual while the other channels his homosexual­
ity into very intense masturbatory phantasies. The possible
origins of the differences are then discussed i n the light of Jung's
and Bion's conceptions and also the 'collated internal object' as
defined by Masud K h a n .
THE ANDROGYNE: SEXUAL PERVERSIONS 289

REFERENCES

B i o n , W. R. (1962). Learning from Experience. London: Heinemann.

[Reprinted 1984, London: Maresfield Library.]
F r e u d , S. (1910c). Leonardo da V i n c i and a memory of his childhood.
Standard Edition 11. London: Hogarth.
K h a n , M . (1979). Alienation in Perversions. London: Hogarth. [Reprinted
1989, London: Maresfield Library.]
L a m b e r t , K , (1976). The scope and dimensions of paedophilia. I n W.
K r a e m e r (ed.), The Forbidden Love. London: Sheldon Press.
(1981). Analysis, Repair and Individuation. Library of Analy­
t i c a l Psychology, V o l . 5. London: K a r n a c Books.
Meltzer, D . (1973). Sexual States of Mind. Strath Tay, Perthshire: Clunie
Press.
von F r a n z , M.-L. (1972). Creation Myths. Zurich: Spring Publications.
CHAPTER FIFTEEN

The archetypes in marriage

Mary Williams

This paper, which has not been published before, has enjoyed a
vogue amongst trainees at the Society of Analytical Psychology,
probably because of the way in which Williams makes use of
animus/anima theory to enlarge the more recent clinical concept
of unconscious collusion within a couple. She shows how the
parental images, themselves a blend of the personal and the
typical, influence partner choice and also the on-going vicissi­
tudes of marriage. Finally, her summary of Jung's idea of there
being a container and a contained in marriage leads on to further
discussion of the impact in marriage of projected parental
imagery, containing, as it does, infantile wishes and desires.
Thus, classical Jungian theory is intertwined with a more
developmental approach.
A.S

F i r s t presented as a lecture to the Analytical Psychology Club,

London, i n 1971. Published here for the first time by kind permission of
the author.

291
292 MARY WILLIAMS

I
n this chapter I discuss anirna and animus figures and their
spell-binding power in marriage. I also give an account of
clinical research in which I took part at the Tavistock Clinic
under the aegis of Henry Dicks, in which he looked anew at the
phenomena unfolding before our eyes. Only those working
hypotheses developed and tried out over the years that confirm
and elaborate Jung's findings are discussed.
First of all, I would like to discuss the meaning of terms I use.
The concept 'archetype' is understood as a psychosomatic entity,
an understanding Jung moved towards in his later work and
which has been developed by Fordham, Stein and others. This
enables us to grasp something of the experiences of infancy which
may occur again in marriage in which continuous body intimacy
is the vehicle of psychic experiences of the union of com­
plementary opposites. In infancy the mother and baby join on the
nutritive level through the mouth orifice finding the nipple, and
in adulthood the man and woman join on the genital level by the
vaginal orifice finding the penis. These complementary images
are innate potentials waiting to be activated. These are part
images of the anima and animus which as archetypal images
spring from the feminine and masculine elements in men and
women, respectively. When experienced in projection, the ordi­
nary man and woman are perceived as possessing a fascinating
power. The first carriers of the images are the parents, whose
special characteristics may modify the typical image to a greater
or lesser extent, depending on the degree of ego development
achieved. To be able to see a person as a complicated whole
human being is an achievement of maturity, rarely reached, says
Jung, for this ability rests on the degree of self-realization
achieved.
A less familiar concept I use is that of collusion. This is an
unconscious transaction by which one partner 'carries' certain
contents for the other as if by agreement. Its function in marriage
is to preserve those illusions that have influenced the choice of
partner. R. D. Laing, in his book, The Self and Others (1961),
describes collusion as follows:
The one person does not wish merely to have the other as a hook
on which to hang his projection. He strives to find in the other,
or to induce the other person to become, the very embodiment of
THE ARCHETYPES IN MARRIAGE 293

that other whose co-operation is required as 'complement' of the

particular identity he feels impelled to sustain (p. 101).
'Successful' collusion occurs when the partners support
mutually projected roles based on shared ideal images. The
non-ideal, even horrible, will be discounted, denied or otherwise
defended against in order to preserve the feeling of security
obtained from the ideal images. In the simplest kind of successful
marriage, the partners may even call each other 'Mum' and 'Dad',
like the children do, and become 'Darby and Joan' characters in
their old age. The shadow side of such marriages is located in the
neighbours' goings-on and in the sensational press. As no
personal development takes place within these marriages,
however, the death of one of them is a disaster that is quickly
followed either by the decline of the other or by another marriage.
What, then, is the criterion of a successful marriage in a more
mature sense? I would say that it depends on a sufficient degree of
ego development before the 'fatal compulsion', as Jung calls
falling in love, to weather disappointments and to work through
them towards a more real value judgement of the partner's
strengths and weaknesses in relation to those of the self. Only
then is a partnership built on mutual co-operation possible.
It will be noted that the idea of unconscious choice of partner
appears in Laing's definition. I am reserving his choice by
complement to refer to heterosexual choices based on an image of
the opposite-sex parent. The choice by contrast is an addition from
Dicks (1967) which involves much psychopathology that I do not
deal with in this chapter. The notion of unconscious choice is as
old as Plato, at least. He had the idea that man and woman were
once one, that they got separated and spent their lives trying to
find the other half again. Jung's discoveries in this respect were
more scientific. In the course of his word-association experiments
in the first decade of this century, he found that there was a high
correlation between responses of mothers and daughters and
fathers and sons. Following up on the marriage partners of each,
he found the choice was most often of someone with characteris­
tics of the opposite-sex parent as revealed in the tests. Thus,
identification with the parent of the same sex led to the choice of a
partner resembling the other parent. He did not pursue those
marriages that revealed other characteristics.
294 MARY WILLIAMS

When people fall in love, the fascinating parental image is

transferred to the love object with a similar intensity and blind
affect as was experienced by the young child towards the parent.
The other one is sensed as a completion or complement, owing to
the projection of the ideal images. The two yearn to become one
flesh.
The state of fusion brings about the reverse feelings to that of
the union of complementary opposites. It seems as if they are
familiar to each other, even identical. 'We felt we'd known each
other all our lives', 'We seemed to have everything in common', are
expressions often heard. Jung wrote of this state in 1925 in an
article entitled 'Marriage as a psychological relationship': 'The
greater the area of unconsciousness, the less is marriage a matter
of free choice, as is shown subjectively in the fatal compulsion one
feels so acutely when one is in love'—the state of 'primitive iden­
tity' of the loved one with the self, each presupposing in the other a
psychological structure similar to that of the ideal image. Nor­
mally sexual intercourse strengthens this feeling of unity and
identity, 'not without good reason, since the return to that con­
dition of unconscious oneness is like a return to childhood' (CW 17,
paras. 324-325).
In the same article, Jung talks about collusion, though he does
not call it that, but the phenomenon of the container and the
contained. The illustration he gives, however, is of partners who
carry certain contents for each other. The woman contains the
emotional life of the man, and he contains her spiritual life, by
which Jung explains he means her complexities and potentiali­
ties. The man being over-complex and therefore apt to dissocia­
tion seeks for unity through what he sees as the woman's
simplicity, but he disturbs the very thing he needs by seeking it
in her. Conversely, her need for him to give her simple answers
increases his dissociation. I have had a few such cases. They drive
each other crazy and need an intermediary to interpret each to
the other.
Dicks has another hypothesis that covers similar ground.
'Subjects may persecute in their spouses tendencies which
originally caused attraction, the partners being unconsciously
perceived as a symbol of "lost" because repressed aspects of the
subject's personality.' I would add, following Jung, that it may not
only be repressed parts but those not yet developed. In passing, I
THE ARCHETYPES IN MARRIAGE 295

would like to point to the attraction between opposite psycholo­

gical types which seem to me to fall into this category. I f they
cannot take on trust what they cannot understand, a dreadful
enmity may ensue.
Absence or attenuation of sexual intercourse are the most
usual presenting symptoms in couples seeking help, but there are
crisis points that threaten the twosome and precipitate referral.
They include pregnancy, discovery of a lover or other secret life, a
disturbed child, a disturbing adolescent, a problem relative, and
various forms of loss and separation from familial figures.
Jung noted that neuroses that flower on marriage contain a
'counter-argument' against the spouse for not being like the ideal
parental figure.
Dicks arrived at a similar conclusion. His first hypothesis
runs:
Tensions and misunderstandings between partners result from
the disappointment which one, or both of them, feel and resent,
when the other fails to play the role of spouse after the manner
of a preconceived (ideal) model or figure in their fantasy world.
.., The parties treat each other as if the other were the earlier
object.
He goes on to say,
Regression occurs in the means used to coerce or persuade the
parent image with the old, childish resources of revenge or of
gaining favour. Forbidding and rejecting qualitites are attri­
buted and evoked each by the other. ... The bad object is
shuttled to and fro ... the essence of collusion.
The traditional cultural stereotypes play an enormous role
even in sophisticated people, as they correspond pretty closely to
the archetypal forms. They not only influence the individual's ego
ideal but may be used in attacks on the partner. For instance, a
common type of marriage seen at my clinic is between an
apparently weak, often semi-impotent man and an aggressive,
demanding woman from whom he progressively withdraws. She
attacks her husband for not being a man, but she was attracted to
him in the first place because he seemed kind and gentle and
would look after her. She really feared that the challenge of male
potency would expose her own inadequacies as a woman. He was
296 MARY WILLIAMS

attracted to her because of her spontaneity and apparent warmth

and was appalled to find an insatiable demon. Afraid of her
devouring nature, intercourse becomes out of the question—
which suits them both admirably. A main variation of this theme
is of the complaining victim wife of a tyrannical husband.
I was interested to find descriptions in Jung's Two Essays (CW
7) regarding animus/anima problems in marriage which could be
comments on these marriages. They follow a comment on the
value of initiation rites.
Just as the father acts as a protection against the dangers of the
external world and thus serves his son as a model persona, so
the mother protects him against the dangers that threaten from
darkness of the psyche. In the puberty rites, therefore, the
initiate receives instruction about these things of 'the other
side', so that he is put in a position to dispense with his mother's
protection. The modern civilized man has to forgo this primitive
but nonetheless admirable system of education. The conse­
quence is that the anima, in the form of the mother imago, is
transferred to the wife, and the man, as soon as he marries,
becomes childish, sentimental, dependent and subservient, or
else, truculent, tyrannical, hyper-sensitive, always thinking
about the prestige of his superior masculinity. The last is of
course merely the reverse of the first. The safeguard against
the unconscious, which is what his mother meant to him, is not
replaced by anything in the modern man's education. Uncon­
sciously, therefore, his ideal of marriage is so arranged that his
wife has to take over the magical rdle of the mother. Under the
cloak of the ideally exclusive marriage he is really seeking his
mother's protection, and thus he plays into the hands of his
wife's possessive instincts. His fear of the dark incalculable
power of the unconscious gives his wife an illegitimate
authority over him, and forges such a dangerously close union
that the marriage is permanently on the brink of explosion
from internal tension—or else, out of protest, he flies to the
other extreme, with the same results, [paras. 309-311]
Take for example, the 'spotless* man of honour and public
benefactor, whose tantrums and explosive moodiness terrify his
wife and children. What is the anima doing here? ... Wife and
children become estranged; a vacuum will form round him. At
first he will bewail the hard-heartedness of his family, and will
THE ARCHETYPES IN MARRIAGE 297

behave if possible even more vilely than before. That will make
the estrangement absolute. ... Then follow remorse, reconcilia­
tion, repression, and in next to no time, a new explosion.
Clearly the anima is trying to force a separation, [paras.
305-306]
Personally, I have not found this happening unless the woman's
animus is involved, so we will see what Jung has to say here.
Later, when describing the animus, he writes:
The men who are particularly suited to [animus] projections are
either walking replicas of God Himself, who know all about
everything, or else they are misunderstood word-addicts with a
vast and windy vocabulary at their command.... The animus is
(also) a jealous lover. He is an adept at putting, in place of the
real man, an opinion about him ... if the woman does not stir
his sentimental side, and competence is expected of her rather
than appealing helplessness and stupidity, then her animus
opinions irritate the man to death. Men can be pretty venomous
here, for ... the animus always plays up to the anima—and vice
versa, of course—so that further discussion becomes pointless,
[paras. 328-333]
It is, perhaps, not strange that a pair of lovers, trapped by the
mutually projected ideal images and encapsulated from the real
world, remain relatively immune from interference from the
shadow sides of these images. This immunity may even weather
quite lengthy periods of cohabitation, for the familial figures
which carry it are as yet excluded from the magic circle. Their
inclusion in marriage—as the marriage certificate makes plain, if
not the actual ceremony, which may exclude them—sometimes
has immediate and dramatic results. A pall descends as the
partners notice the black side of the image. They cry, often in
unison, 'You are not the man/woman I married!' or, as a New
Yorker cartoon put it: 'I'm beginning to think you never were the
man I married!' True, but they are not yet seeing each other but
the reverse side of the image.
Another factor has entered—that of the incest taboo. Jung
describes incest as an expression of the libido which serves to hold
the family together. I t could be defined as 'kinship libido'. It
seems that while the feeling between couples is of that cosy
familiar kind of intimacy, it is still incest, but good. The
298 MARY WILLIAMS

anti-libidinal forces—those that split the family apart^-bring in

the feeling of taboo with its unclean and dangerous connotations,
and attraction turns to disgust.
When negative aspects of the images gain the upper hand,
these may be as collusively adhered to as were the real ones. One
can fall in hate as well as fall in love. It is a fearsome experience
to observe a chronic sample in which the therapist is ignored
while two people, each feeling the victim of the other, accuse each
other of similar crimes. It appears that the libido has gone into a
fight for survival based on the mutual need for self-justification.
In one couple the death of a child had brought this need to a head,
and the imputation of blame had made it impossible to mourn the
death together. Albee's play, Who's Afraid of Virginia Woolf?
describes this situation well. In it, the child they never had is the
shared object of fantasy and mutual recrimination. This gives us
a hint as to what the trouble is about. The injured and resentful
child in each partner is fighting against acknowledging depend­
ence on untrustworthy parental figures. They cannot trust each
other with their loving selves, for this would make them
vulnerable to real hurt. What we see is essentially a game,
however deadly, in which the characters are pawns in the hands
of the mutually hated and feared parental images. Its illusory yet
powerful quality gives the observer an eerie impression. Such
marriages are usually as immune from intervention, as is the
idealizing couple.
The way in which images are shared is another aspect of
collusion, for which I am indebted to Teruel's (1966) research. He
saw couples together for diagnosis and remained relatively
passive in order to allow the interaction to develop. He noticed
that the first object (or objects) significant to both which was
brought into the interview represented the disturbing factor in
the marriage. This might be the mother or father of one of them,
for instance. He called this the phenomenon of the emergence of
the dominant internal object (p. 232). References to the character­
istics of this object were taken to be statements about the nature
of the shared internal object, e.g. that it was disgusting, violent,
inadequate, dead, etc. He proceeded to show how one partner
might contain the disturbing object for both of them, in which
case that one would be carrying a 'double charge' and might even
be clinically ill. In other cases, the object would be thrown from
THE ARCHETYPES IN MARRIAGE 299

one to the other as described by Dicks and, of course, to the

therapist in the transference.

Case material
The first case study shows the influence of parental deaths and
broken illusions, the second a drama of rivalry presented through
an asthmatic child; in the third, I follow the vicissitudes of a
shared image of an envious old witch through the treatment of a
couple.

Case study 1: Mr and Mrs C

Parental and other ghosts are potent sources of marital distur­
bances where mourning is incomplete. Mr and Mrs C were a young
couple plunged into a mourning situation from the start of an
already guilt-laden relationship. When seen, they had been
married only six months after a year of partial cohabitation,
during which a child was born.
She was a perky girl who dramatized herself, he a depressed­
looking young man. Almost at once, Mrs C brought her dead
father into the interview. He had died suddenly when she was
three months pregnant. When she realized she was pregnant, she
had wanted John to meet her father, but he put it off until it was
too late. ' I hold that against him', she said. Mr C sighed. 'We could
be happy, but whenever anything goes wrong, she brings this up.'
She retorted, T i l never forget. I felt robbed, and that you'd robbed
Daddy too. ... Then the whole pregnancy was awful. . . . People
made me feel a tramp. . . . I loathed the child inside me.' A string
of recriminations followed, proving how the husband was
responsible for her shame and degradation and how disloyal he's
been. He'd even suggested the child might not be his, and once
she had found him with another woman.
Mr C took it all—he blamed himself for not thinking of
marriage and for hurting her by this attitude. He insisted,
however, that he had never wanted her to abort, though he
admitted that the pregnancy was not real to him even when she
was big. Then Mrs C admitted that she had tried her best to get
300 MARY WILLIAMS

rid of the baby, but her feelings changed after her father died, and
she went into a panic when she bled. She just had to have the
baby then. She said it amazed her that she hadn't thought of
marriage either, not for months after the baby was born. She
returned to the attack. 'Marriage made no difference. ... John
was as inconsiderate as ever.'
Mr C showed some resentment for the first time. 'No', he said,
'marriage made no difference. She still refused to meet my people
or to entertain my friends.' Mrs C used this remark to prove how
inconsiderate he was and added, ' I like men who are kind and
understanding.' Bitterly, he murmured, 'Like your father.' Mrs C
started to extol her father. ' I know I'm very jealous of people who
have such a man. ... I could always rely on him in trouble. ...
Mother never wanted to know . . . how could she marry again so
soon!... She has even taken this man into the house which Daddy
built. . . . It's so disloyal.'
It was becoming clear that Mrs C was off-loading the image of
the 'inconsiderate' father who had left her in the lurch as well as
her own feelings of guilt and disloyalty to him, but as yet there
was no evidence as to why Mr C so readily accepted the burden. I
therefore asked him about his parents. He said his father drank,
and his mother told him constantly what an awful life she had
with him because of this. Until she died a year ago of cirrhosis of
the liver, he had been blind to the fact that she was the real
alcoholic. He had got to know his father since then and felt awful
for having despised him. I've had to reassess all my convictions',
he said, 'but I still love my mother. I can understand how my wife
feels. My mother saw the baby before she died. This hurt my wife,
as her father didn't even know of his existence.' Mrs C wept. ' I
wanted the ashes, but it was too late—they'd been scattered. At
least, I wanted his name engraved in the Remembrance Book, but
John saidwe couldn't afford it.' She had a shock, too. When her
father died, she found out that her parents had never been
married. Father still had a wife alive, 'and he was so moral and so
strict with all of us!' she said.
This couple were struggling with the need to preserve the
image of the ideal lost parent in the face of shocking evidence to
the contrary. However, it was Mrs C's father's ghost who
dominated the marriage and persecuted both of them. Mrs C's
success as his avenger seemed to be due to her greater need to
THE ARCHETYPES IN MARRIAGE 301

keep intact the ideal image with which she was identified and so
to project the immoral, inconsiderate and deserting one into her
husband. For his part, he accepted this image as a punishment for
having despised his own father in collusion with his mother. That
he had presented the still idealized mother with his child before
her death and had 'robbed* his wife of a chance to get her father's
blessing added envy to injury, though this was a fantasy Mrs C
imposed on her husband, who knew at the time that he was
supposed to ask for money for an abortion—an admission neither
of them could make.
Clinically, the incestuous implications were at present secon­
dary to the more primitive theme of intense ambivalence towards
the lost ones and fear of the power of the dead. An interpretation
in these terms and of the need to mourn together was meaningful
to them both, which suggested that in spite of the severity of the
symptoms, Mr and Mrs C would be able to work through them.

Case study 2: Mr and Mrs D

The problems of this couple illustrate the involvement of a child
as the presenting symptom, so often seen in child guidance
clinics. Also illustrated is the crisis point at the birth of the
symptom-child in which the repetition of familial groupings
facilitated the activation of the image.
Mr and Mrs D were sent by the hospital where Susan, aged 7,
the younger of two girls, was being treated for asthma. It was
believed that the marriage might break up, since the wife
discovered that her husband had been unfaithful to her.
Mrs D started off, speaking in a rapid monotone for both of
them. She gave a bright picture of the marriage—they enjoyed
the same things, and so on—only the sexual side had been
unsatisfactory for four or five years now. She put it down to
Susan's asthma. They had to split up because the child had not
been able to endure being left alone. They were constantly
disturbed at night... their tempers frayed . . . they were tired ...
Mrs D had started work again part-time a few months ago, and
Susan had slept through most nights since. I t can't be
coincidence', she said, 'it helped me to go out and have people to
talk to.... I'd felt closed in and constricted.' She could see why her
302 MARY WILLIAMS

husband had to look outside the home when Susan was so ill ...
she's neglected him. She turned to her husband for confirmation.
Mr D answered by addressing me. ' I haven't the same feeling
as my wife. I wasn't conscious of her preoccupation with Susan.
I'm not worried about the lack of intercourse, except as it affects
my wife. I have no desire for intercourse with her.' He also
objected to being excused for his affair. ' I am responsible for what
I do. I am not a child. I don't regret the affair. It was an addition,
not a criticism of my wife.'
Mrs D had been looking hurt but was now annoyed. 'He told me
she was young, gay and attractive and thought he was God
Almighty. He wants to be king-pin all the time. . . . He was put
out when Susan became the pivot of my life.' Mr D retorted
blandly, 'Of course I'm king-pin to you, the children and
everybody in my business. None of you could do without me.' She
flared up. 'I've decided to accept that invitation abroad. You can
look after the children while I enjoy myself. ... I feel I've lost my
identity. ... I was something before I married, and now I am
nothing ... just a drudge looking after everyone else. I want to be
looked after for a change.' Mr D looked relieved. ' I used to admire
you for your independence. By all means, go.' It seemed he also
felt closed in and constricted.
The prognosis for marital therapy did not seem favourable,
owing to the intense rivalry for the king-pin position, coupled
with Mr D's impregnability. In fact, he dropped out almost
immediately, having 'more important matters to attend to'.
None of the background figures appeared in the diagnostic
interview and were not necessary to make an assessment of the
case, but their respective family groupings were of great
significance. It was the birth of the second girl that helped to
recreate the pattern of the original families of each and to
activate the omnipotent king-pin image.
Mr D was 'an afterthought' and therefore virtually the only
child of old parents. Father was 'king-pin', and mother was
absorbed in meeting his demands. In consequence, Mr D was
brought up by his older sister and two aunts. They all doted on
him until he was a certain age, when they expected him to be a
'messenger boy', he said. He had resented bitterly doing anything
for these three women and was now again faced with three
females, all expecting something of him. It was his wife's
THE ARCHETYPES IN MARRIAGE 303

'independence' that had attracted him, and the first child was 'no
trouble'. Mrs D was the younger of two sisters who were violently
jealous of each other. Her father was also 'king-pin' and her
mother 'nothing more than a slave' to him, she said. The birth of
the second girl completed the likeness to their original family
patterns in important particulars. When both the image and the
family pattern in which it first arose correspond in both partners,
the charge coming from the relevant image assumes huge
proportions.

Case study 3: Mr and Mrs X

In this last case, I would like to show the vicissitudes of the
presenting mother image as treatment progressed and the
emergence of a second one, the split-off father figure. The case
also demonstrates the phenomenon of sharing, in that the images
belonging to the wife were taken over by the husband as more
dramatic representatives of his inner world than those based on
perceptions of his own parents. The role of transference is also
illustrated. The treatment was completed in the comparatively
short time of five months, perhaps because the images were so
clear.
Mr and Mrs X, both aged 30, arrived with a protesting boy
toddler, the youngest of their three children. My face must have
fallen at this complication, for, before I had spoken, the wife, a
fiery redhead, turned on her neat, tense husband and said, ' I told
you so! We should have left him with mother.' Her mother, and
the passing back and forth of the toddler who wanted the one who
was not holding him, absorbed the rest of the interview.
Mrs X put forward, and Mr X agreed, that her mother was
trying to sabotage the marriage, that she was an envious and
jealous woman who aimed at preventing or breaking up all happy
relationships, and that she was 'sex-obsessed'. The worst of it was
that they were dependent on her to baby-sit. 'Once she moves into
the house, it's a job to get her out again!' they said. It then
appeared that Mrs X had tried to make her allegedly undersexed
husband jealous by entertaining an old admirer, now married,
and was furious because he didn't rise. At the same time, she
accused him of having a 'dirty, sniggering attitude towards sex',
which, from the stories about her mother, was what they both
304 MARY WILLIAMS

objected to in her. Mr X defended himself with logical argument

but with desperation against her attacks. He also made an
accusation: that she had tried to sabotage his studies and prevent
his advancement.
Perhaps this is enough to show that her mother represented the
shared image of the envious old witch who was out to stop them
enjoying themselves, and that each tried to push it into the other
one. Mrs X was more successful in this. I noticed that Mr X paled
when she managed to do so, and I was hardly surprised to hear
that he suffered from dyspepsia.
Progress in treatment can be assessed by following the fate of
the dominant image, so I will pick out some references to it. Mrs
X accused her husband of leaving her to cope with her
sex-obsessed mother, which he did by falling asleep when she was
present. Deducing that they both feared their own sex obsessions,
Mrs X confessed that she was terrified of becoming like her
mother with sexual frustration, which would, of course, be all Mr
X's fault. She volunteered with a sneer that her husband was
terrified of sexual activity because his mother had warned him
that too much sex was bad for the health. This he denied—he had
picked it up from boys at school. I said it sounded as if their fears
of dirty sex referred to forbidden pleasures such as masturbation
and to punishment for it. Mrs X turned on her husband again.
That's just about what his love-making amounts to!' Mr X paled,
and there was an uneasy silence. I remarked that talking about
sex as we were doing seemed equivalent to performing in public,
which was what they felt her mother did, and now it was myself
who was embarrassing them. They both blushed and then
laughed uncertainly.
On another occasion, when Mr X was looking ill , Mrs X
attacked him for drinking sherry on an empty stomach though
she had warned him he would suffer for it. Mr X rallied and
accused her of being just like his mother, fussing about his health
whenever he enjoyed something and then trying to prevent him
doing it. Mrs X later returned to the attack by asserting that her
mother had been asking her husband to visit her behind her back.
Mr X was put out as he had to admit that he had once been to see
her. He was then accused of liking her smutty jokes. As it
happened, Mr X had recently asked to see me alone for 'sex
instruction', and I had refused. Mrs X did not know this, but it
THE ARCHETYPES IN MARRIAGE 305

was what she would suspect in the transference of their joint

fantasies, which were to become progressively clearer.
More direct references to myself as the sex-obsessed mother
followed. Mrs X said she had heard that this was a Freudian
clinic, and Mr X said, 'Freud saw everything as sexual, didn't he?'
I said I thought they were envying me my association with such
an exciting father figure. Mrs X then told me about her father.
Her parents were separated, but she had kept in touch with her
father, much to her mother's fury. She reported that father had
an uncanny way of phoning her when her mother was with them,
and Mrs X had to fight for her right to see him. Again Mr X
experienced the drama through his wife's parents, his own being
seen as tolerant of each other. He did say, however, that father
was 'uninterested' in his achievements—in fact, he had taken
him away from school early, seeing 'no point' in further
education. Fear of outdoing his father and of his envy was a new
factor, which accounted for Mr X's acute status anxiety at work as
well as his potency fears.
Relaxing slowly, they started to come in giggling like a couple
of adolescents and played provocative games with each other and
with me. After this playful phase, they were able to tell me that
they were having satisfactory intercourse for the first time in
their marriage.
At the agreed last session, I enquired after her mother, who
had not beep mentioned for some time. They both spoke of her
with tolerance, even concern. 'Poor old thing, she can't help i t . . .
she's not so bad really . . . she's a great help to us.' The charge had
lifted from the once dreaded figure and from myself and had
found its place in the attraction between them. The advent and
working through of the Freud-father image in the transference
coupled with a reduction of power of the envious and jealous
mother image seemed responsible for this result.

Conclusion
I have outlined the views of Jung on the interaction of anima and
animus figures in marriage and have shown how his original
research into choice of partner was rediscovered by Dicks. The
306 MARY WILLIAMS

factor of collusion which preserves the illusions coming from the

archetypal images about the nature of the partner is a
worked-out addition useful in treatment.
Personally, I found Teruel's work on the shared image in
marriage particularly useful. To see it in live culture acting on
the couple and being thrown from one to the other leaves one in
no doubt that it is not only shared but is a 'charged' or numinous
entity which may be too 'hot' for any one person to hold for long
without getting hurt. An exception to this rule is seen in Case 2,
where the husband was identical with the image. This gives an
impregnability that is unlikely to be dispersed by psychotherapy;
indeed, the individual would see no point in coming. The
transference, or 'throwing' of the image to the therapist, is
illustrated in the last case reported.
Another attribute of the archetype is that it holds an energy
charge which implies the presence of positive and negative poles.
It is held that splitting occurs in the service of survival. We see
this splitting happening in the phenomenon of falling in love on
which so many marriages are based. This phenomenon has been
seen as a regression to the original twosome where the hated one
is not the one who is loved. 'He/she is not the person I married' is a
common phrase expressing this dichotomy. But marriage itself is
based on the archetypal theme of the union of complementary
opposites, not in one individual as in the individuation process,
but in projection onto the spouse, who is first embraced as
representative of the wonderfully seductive inner image. This
ideal image may survive the irritations of everyday living for
some years, or its terrible counterpart may appear at once, as it
did in Case 1, in which the negative aspect of the idealized father
figure on his death (desertion) was promptly projected into the
spouse, a guilty man who was 'forced' to carry it.
There is a social or group factor at work too. The marriage
ritual reunites lovers with their family groups, as the marriage
certificate, i f not the ceremony, makes plain. It serves to
reactivate just those 'bad' images the lovers hoped to avoid. As
Mrs X remarked, once her mother comes into the house, it's a job
to get rid of her. This case and others show how the specific
characteristics of the image hinge on the individuals' experiences
of significant persons in their lives and how this can change with
THE ARCHETYPES IN MARRIAGE 307

treatment. Case 2 also shows the importance of family groupings

in determining the flash point for the activation of an image.

REFERENCES
Dicks, H . (1967). Marital Tensions. London: Routledge and Kegan P a u l ;
New York: Basic Books.
L a i n g , R. D. (1961). Self and Others. London: Tavistock.
Teruel, G. (1966). Consideration for a diagnosis in marital psychother­
apy. British Journal of Medical Psychology 39:3.
CHAPTER SIXTEEN

The analyst
and the damaged victims
of Nazi persecution
Gustav Dreifuss
with comments by
Gianfranco Tedeschi, Jacques Mendelsohn,
Debora Kutzinski, and Mary Williams;
reply by Gustav Dreifuss

The Holocaust was an event without parallel in human history. It

was perhaps the greatest collective disaster we have ever known.
Dreifuss shows that the analyst of a patient who has suffered
during the Holocaust has to be aware of certain clinical
consequences of the patient's profoundpsychic injuries—such as a
tendency to disclaim the capacity to make use of analysis (on
account ofhaving been damaged in the first place). What is true
of the Holocaust may be relevant to any collective trauma, and
the sense ofguilt at having survived, well known in connection
with Holocaust victims, may also be found in other situations.
What Dreifuss says about the meaninglessness of the Holo­
caust experience, and how this is taken up by the commentators,
is also of great interest. For the question 'why was I born the
person I am' is one that crops up in the analysis of nearly
everyone at some time or other.

F i r s t published in the Journal of Analytical Psychology 14:2, i n 1969.

Published here by kind permission of the author and the Society of
A n a l y t i c a l Psychology.

P—K 309
310 GUSTAV DREIFUSS

The theme ofthe relationship between Judaism and Christian­

ity is important for at least two reasons. First, because here, as
elsewhere, we can see that analytical psychology has developed
Jung's ideas on Jewish psychology'. Second, because the figure of
the Jew often crops up in the analytical material of non-Jews—
these days, representing someone to envy as often as the
traditional shadow personification.
A.S.

great deal has already been written about the problem of

the persecution and systematic extermination of one
JL JL third of the Jewish people, which took place during the
Second World War: historians, psychiatrists, jurists, sociologists
and others have worked on and written about it (von Baeyer et
aL, 1964; Cohn, 1967; Eitinger, 1964; Flannery, 1965; Frankl,
1964; Gilbert, 1963; Gyomroi, 1963; March, 1960; Trautmann,
1961; Venzlaff, 1967).
I want to approach the problem from the point of view of my
daily analytical experience in Israel. I find myself in continual
confrontation with the fact of millions murdered and of countless
other victims of persecution, which induces such a feeling of awe
that it does not seem possible to do other than stand silent. Yet it
seems to me to be the duty of all of us, through work on the
shadow and through the development of our capacity to love, to
contribute to an improvement of relationships between men so as
to reduce the danger of the extermination of peoples.
Since I began to work in Haifa only in 1959, my personal
experience is limited to those victims of persecution who had
begun psychiatric or psychological treatment immediately after
the war and for various reasons needed a new therapist. Some
were relatively young people, between 20 and 30, who were
rescued as children and came to Israel in a children's convoy, or
who were hidden with Christian families or in monasteries while
their parents perished.
When I think of the many people with whom I have worked
analytically for more or less lengthy periods during the last nine
years in Israel, I find scarcely anyone who has not directly or
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 311

indirectly suffered from the Jewish persecution. This is evident

when we consider that the bulk of immigration took place after
1933 and, moreover, that every immigration resulted in the end
from a fateful belongingness to the Jewish people.
Thus one sees how greatly the persecution in particular, and
Jewish destiny in general, has influenced the population of Israel.
Statistics (Dvorjetski, 1963) showed that 30 per cent of the
working population (that means 500,000 people) were survivors
of the Nazi persecution.
In contrast to the Jews who live dispersed throughout the
world, the Jew in Israel is, for the first time in almost 2,000 years,
a member of the majority in his country. He governs himself; has
all occupations open to him. He may be a farmer, an industrial
worker, or an intellectual. These facts have of course had a
powerful influence on the psyche not only of those persons who
have been damaged by persecution, but also on all the Jewish
inhabitants of Israel. The return of the Jewish people to the land
of their fathers—to the soil of their Biblical past—has had the
effect of reactivating the chthonic images of the mother
archetype, which may result in a development of the animal
figure as well as of masculinity. This circumstance has caused a
transformation in the Jewish character in an astonishingly short
time and has also made a partial rehabilitation possible for many
persecuted persons.
In what follows I would like to illustrate my experience with
numerous cases of persecution damage by a brief reference to one
victim of persecution.
I refer to a married man, father of a three-and-a-half-year-old
son and a six-month-old daughter, who was 30 years of age at the
beginning of therapy. The traumatic events of the time of the
persecution which are important for us here are described in
abbreviated form. Tadek, as we shall call my patient, comes from
a good middle-class Jewish Polish family who lived in Warsaw.
At the outbreak of the war he was eight years old. The family
lived in a Jewish quarter which was later designated a ghetto.
The mother died of typhoid fever in 1942, when Tadek was 11
years old. His father was selected from among his colleagues at
work, deported to Auschwitz and murdered. After the ghetto
uprising Tadek was hidden by a Pole and shut up in a room. He
312 GUSTAV DREIFUSS

was much afraid of being discovered, talked softly to himself and

prayed to a picture of Marshal Pilsudski that he might be
rescued.
In 1944 his host could not keep him any longer, so Tadek joined
the Polish resistance, but was captured and shipped off in a train
to Auschwitz. He succeeded in jumping out of the moving train,
was found and taken to the hospital of a small Polish city in a
state of exhaustion. He was able to keep the fact that he was a
Jew a secret, and passed himself off as an orphan. With a
temperature of 104° F (40° C) he succeeded in preventing the
nurse from undressing him and thus discovering his Jewish
identity.
After his recovery he was delivered to a monastery. There he
succeeded in imitating the behaviour of the other pupils at
prayer, and no-one suspected him. A t communion he had great
anxiety about biting into the wafer, for fear it would cause an
outflow of blood; he had read in an anti-semitic newspaper that
this happened to Jews who took communion, since they were not
baptized. After the end of the war there was still another pogrom
in this Polish city, but he was shortly afterwards taken out of the
monastery by an aunt with whom he had been able to establish
contact. Then he spent a period in various camps for displaced
persons in Europe, was interned i n Cyprus after the Exodus
catastrophe, and in 1948 he finally arrived in Israel. He was then
17 years old.
Since his arrival he has been almost continually in dermatolo­
gical, psychiatric and analytic treatment on account of psoriasis,
anxieties and compulsive neurotic symptoms. He came to me in
1961 at the wish of his wife, who could not stand him any more.
As she reported it, he called her a whore, hit her, never gave her
credit, and was stingy. She was herself in psychotherapeutic
treatment and said she wanted her husband to have treatment
again, since his former (woman) analyst had died three months
after he started with her. However, it soon became clear that she
wanted to get rid of him and hoped that I would influence him to
divorce her.
Even this summarily presented biographical material allows
us to recognize what traumatic experiences Tadek had been
exposed to. A childhood dream at the age of 11, in July 1942,
when his mother was already dead, reads as follows: 1 am
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 313

walking along a street in Warsaw with my parents. Suddenly a

German comes and kills me with his rifle. My parents leave me
lying on the street. They run away. I think: why have they left me
alone?' And a year later, while he was being hidden by the Pole,
he dreamt: T have died, and am waiting to be buried. The men
bury me in the earth. It is dark, but I see a lighted script: "He is
dead" and I think: in which family will I be born again?'
To be deserted by the parents, to be killed, death; these are the
motifs of his dreams. Is i t possible that the motif of rebirth gave
the boy the strength to stand the difficult trials which awaited
him in the ensuing years?
After a week of treatment, Tadek had already submitted pencil
and crayon drawings. The picture which is important for my
purpose was painted after approximately six months and was
described by the patient himself in the following manner: 'Above
all the cross, the symbol of eternal love. Under it the infinite, the
unknown, Man. In the middle a heart, pierced through. Blood
drops down and falls into a basin. The blood is above the Star of
David, the Jewish symbol which is bound all around with the
chain of servitude.'
The picture, which is painted in a very rational, unspon­
taneous and abstract style, expresses mainly the difficult feeling
problem of the patient, and his suffering. The chain of servitude
shows his own servitude—his lack of freedom—which portrays
itself in his obsessive-compulsive neurosis and in the distur­
bances of his emotional life. On the basis of his own associations
it shows, moreover, the servitude of the Jewish people as a whole,
who were exposed to persecution and pogroms during the 2,000
years of their exile.
The Star of David at the bottom of the picture represents to a
certain degree his own basis, his ground, his Jewish heritage,
whereas the cross is suspended above it. The time in the
monastery was traumatic for the patient as he needed to keep his
Jewishness a secret, and participation in the activities of
monastery life seemed to him to be a constant lie. I n addition
there was always the fear of being discovered to be a Jew.
Participation in the mass, religious instruction, and the
activities of the youths of the monastery naturally brought Tadek
into an intensive relationship to Christianity. From the point of
view of religion (Christianity above, Judaism below) the picture
314 GUSTAV DREIFUSS

shows the heart in the middle as the centre of life and feeling, of
what is humane. But the cross as well as the Star of David are
symbols of wholeness.
One can also regard the heart in the middle of the picture as a
symbol of the self. In Jewish texts it is viewed as a superordinate
organ, as the centre between the brain and the liver (Hurwitz,
1952, p. 145). In numerology, the word 'heart' has the number
value of 32, which is the sum of the 10 original numbers and the
22 letters of the Hebrew alphabet and represents in this manner a
symbol of the self. And in Tadek's picture the heart is injured!
Whether this being pierced through, this being struck in one's
totality is, in our case, a temporary condition or an expression of
permanent damage, I do not dare to judge.
Through misfortune breaking in from without, the youth was
not only robbed of his parents. He also had to fight for his life
alone in the ghetto and was in continuous fear of being discovered
while alone and shut up in his room. In the monastery, too, he
lived in continuous fear. He had thus developed a need for
warmth and security which he now sought to satisfy within his
family. But his wife could not forgive herself for having married
such a sick man; she is herself a weak personality who feels
unloved. She does not love her husband at all; rather, she hates
him and constantly expresses her aggressive feelings towards
him. In short, the marriage was badly disturbed and the wife
continually threatened divorce, an idea which was remote from
the patient's thoughts. Symptoms of this situation were intensi­
fied tics and sexual impotence.
Through therapeutic endeavour on the part of the analyst for
his wounded soul and, in the beginning, an unconditional
motherly acceptance, through devotion to the unconscious,
through written expression of the traumatic experiences, through
participation in painting and modelling courses, a certain
transformation took place in the course of the years. It also
showed itself in an improvement of the relationship to his wife,
for he was able to sacrifice, at least partially, his demands that
she should be a good mother.
Tadek is afraid of his own aggression; for example: about a
year and a half ago, he heard a documentary programme (Tevet &
Clegg, 1967) on the radio in which the fate of one of the victims of
Nazi persecution was portrayed. Years later this man became a
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 315

murderer and has been imprisoned in Israel for some time. The
implication of the radio programme was that the terrible youth of
the murderer was the reason for his criminality and for the
murder. Tadek got very excited during the programme and
dreamed afterwards that he was being driven into the gas
chambers with a lot of people. But he succeeded in working his
way away from them and out of the building. At the gate he
realized that his wife had remained behind and that he could not
rescue her any more.
Tadek told me the dream almost without affect; of his
excitement there was nothing more to be felt. It seems to me that
the dream shows, among other things, his fear of being separated
from his wife by some kind of outer fate, without the possibility to
intervene. On the subjective level one might also speak of the
danger of a loss of soul. Through his creative activity as a
successful scientist, and especially in his modelling, Tadek
experienced the opposite of destruction. Thus he was able, some
months after this dream, to explain to his wife out of a newly won
masculinity and security, and during a marital quarrel, that from
now on he would stop fighting her; that peace and warmth in the
family were more important than being in the right. This
declaration brought about an immediate improvement of the
marriage relationship.
Tadek has to develop himself further, in spite of his past
experience of the persecution. He was nearly killed, was nearly
murdered. That fate ordained him as a victim, even though not a
complete victim, of the persecution is no reason for him not to
solve his personal problems. This statement applies to those
damaged by persecution in general, with the exception of certain
severe cases of 'serious damage of the fundamental bio­
psychology' (Winnik, 1967) or of the 'destruction of the fun­
damental function, namely the possibility of regeneration'
(Gumbel, 1967).
After this admittedly short account of an individual fate
resulting from the persecution, I want to go over now to more
general Jewish-psychological problems. The personal fate of
Tadek is inseparably bound together with the fate of the Jewish
people, i n particular with those like him who lived in a Catholic,
European country which was occupied by the German army, a
doubly hostile environment. Moreover, the experiences of Tadek
316 GUSTAV DREIFUSS

and of all persecuted persons is a form of suffering that is

meaningless. Tadek's question, which sounds at first naive, as to
why he was born as a Jew in Poland and not for example in the
United States, is that of a modern Job: it is asked by every victim
of persecution, insofar as he is still able to do so; and we analysts
most certainly have to ask the question.
The analyst in Israel is confronted on the one side with the fate
of the Jewish people in the dispersion, and with the special cases
of persecution damage; on the other side, he faces changes in the
psychology of the Jewish people in Israel. The transformation and
renewal of the Jewish character which has ensued from the last
decades has happened partly because of an activation of the
earthly aspects of the mother archetype. It has resulted in a
strengthening of consciousness, which revealed itself especially
during the renewed threat of destruction of the Jewish people in
1967.

REFERENCES
Baeyer, W. R. von, Hafner, H . , & K i s k e r , K . (1964). Psychiatrie der
Verfolgten. Berlin: Springer.
Cohn, N . (1967). Warrant for Genocide. London: E y r e & Spottiswoode.
Dvorjetski, M. (1963). Adjustment of detainees and subsequent readjust­
ment. Yad Vashem Studies on the European Jewish Catastroph
Resistance 5. Jerusalem: Y a d Vashem.
Eitinger, L . (1964). Concentration Camp Survivors in Norway and Isr
London: A l l e n & U n w i n .
Flannery, E . H . (1965). The Anguish of the Jews. New Y o r k : M a c m i l l a n .
F r a n k l , V . E . (1964). Man's Search for Meaning. London: Hodder &
Stoughton.
Gilbert, G . M. (1963). The mentality of S S murderous robots. Yad
Vaskem Studies on the European Jewish Catastrophe and Resis
Jerusalem: Y a d Vashem.
Gumbel, E . (1967). Psychiatric disturbances of holocaust C S h o a " )
survivors. Israel Annals of Psychiatry and Related Disciplines 5:
Gyomroi, E . L . (1963). The analysis of a young concentration camp
victim. I n The Psychoanalytical Study of the Child 18:484.
Hurwitz, S. (1952). Archetypische Motive in der Chassidischen Mys
Zurich: Rascher.
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 317

March, H . (ed.) (1960). Verfolgung und Angst in ihren leibseelischen

Auswirkungen. Stuttgart: Klett.
Tevet, S., & Clegg, V . (1967). Alouette [The Lark], Jerusalem: Israel
Broadcasting Authority.
T r a u t m a n n , E . C . (1961). Psychiatrische Untersuchungen an Ueber­
lebenden der nationalsocialistischen Vernichtungslager. Nervenarzt
32.
Venzlaff, U . (1967). Erlebnishintergrund und Dynamik seelischer
Verfolgungsschaden. Basel: Karger.
Winnik, H . Z. (1967). Psychopathic effects of Nazi persecution. Israel
Annals of Psychiatry and Related Disciplines 5:1.

COMMENTS

Gianfranco Tedeschi (Rome)

I think that the past experiences of the anti-semitic persecutions,
lived either directly or indirectly, are not so important in
determining the neurosis in Jews as the process of assimilation.
By this term we mean identification with cultural systems other
than Jewish Weltanschauungen. This identification gives rise to
the ego alienation of the Jew from his original archetypal
constellations expressed by the Jewish culture; therefore the
frequent processes of unconscious hypercompensations become
sources of neurosis.
The loss and the falsification of Jewish identity is lived by
many Jews as a great threat to their spiritual survival, since the
need for differentiation as a Jew is a basic quality of his deep
collective psyche. The Jewish people were the first in history to
express in their existence, and to witness, the great religious
value of the individuation process, articulating this with God's
will. In the Bible, indeed, the admonishment 'Be holy because I
(the Lord) am holy' is very frequent. The Hebrew term Kadesh
[holy] means also separatedness, distinctness from. The Midrash
says, 'Be different from the other peoples as I (the Lord) am
different from the other gods.' The Jewish people have lived this
differentiation process mainly on a level of their sociological
318 GUSTAV DREIFUSS

group (the House of the sons of Israel) rather than a psychological

personal dimension.
Even today many Jews try to realize their identity through the
great collective themes, patterns of behaviour and values that
characterized the fundamental outlines of Jewish culture. It often
happens that through neurosis the Jew becomes conscious o f
those values, as well as of the basic culture features, and the
endopsychic concomitant dispositions that help him to define
himself as a member of a group (sociological individuation).
Frequently this moment is very important in finding an answer
to the process of assimilation.
This period can be followed by another one by which the Jew,
once he has defined his cultural identity, will take a position in
relation to it. Then, by the process of definition and clarification
of himself vis-a-vis the group, he will finally achieve personal
individuation. The process of assimilation is not confined to the
Jews of Western civilization, but it is actual in Israel, as
expressed for instance in the Israelism' rather frequent among
the generations born in Israel.

Jacques Mendelsohn (Givatayim, Israel)

Gustav Dreifuss is right to stress the importance of being able to
make sense out of a painful experience when one is working
through one, if that process is to have a positive outcome. But in
the case of a terrible catastrophe, such as when millions of people
are murdered simply because they are Jews, any attempt to make
sense of it in a general way lies quite beyond my powers.
It is different, however, when any one man who went through
that hell has to struggle with the task of making his own personal
sense out of it, and not one of us is spared from finding some way
of living With this still-open wound. There are two different
attitudes towards this—which I shall illustrate with examples—
that seem to me to throw a little light on the ways in which this
problem is approached; one shows how not to do it, the other
opens up future possibilities, reaching beyond oneself.
I take my first example from a recent discussion in an Israeli
newspaper. An orthodox Jew wrote: 'God is a great Zionist. For he
allowed so many Jews to be destroyed during the Diaspora that
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 319

they finally grasped that Israel is the only place to which they
belong.' The cold logic of such an argument rouses in me only
instinctive repulsion. God is seen fundamentally only as Fate
that rules in an absolute and distant way over the lives of men,
without allowing them to participate in his plans, however
meaningful his intentions may be. The paradoxical result of such
an attitude would be, among other things, to present men who go
through such destructive plans not only as the victims but also as
the blind tools of this God of Fate, not responsible in any way for
their actions.
Another danger of such a point of view is that one's whole
environment and what results from such a catastrophe appear
thoroughly bad and hostile, and one can become fixated in such
an attitude. Even if, as I have said, making sense of such
happenings is not yet possible, it is at least comforting to see that
the greater part of the younger, growing generation in Israel do
not see blind fate as the ruling principle in life, nor do they look
upon the world outside our own small country as totally hostile.
I shall illustrate this more hopeful, positive and productive
attitude by quoting two remarks made by my son when he was
eight years old. We were travelling round Europe with him and
visited a great number of churches in all the different countries.
Suddenly he came out with: These Christians really deserve to be
pitied—they seem to be scattered all over the face of the earth.'
Out of his own sense of security in having his own homeland, he
clearly wished it could be as good for everyone else. He again
expressed this idea of the problem of belonging together when he
asked another question: Ts the sky over Israel joined up with the
sky over the rest of the world?'
This time apparently he was expressing a need to feel
connected with the whole world, and was rejecting the notion of a
favoured isolation. I f his first comment rests on an earthbound,
maternal and protective archetype then his second one seems to
refer to a spiritually uniting archetype of a heavenly father. And
then all men without exception would be equally the children of
the same supreme father.
It stands to reason that an atmosphere such as this would in
the cases Dreifuss has brought before us create a positive basis for
any psychotherapeutic attempt.
320 GUSTAV DREIFUSS

Debora Kutzinski (Tel Aviv)

My contribution must of necessity be very personal: it contains
the experience of one who survived five years in concentration
camps and who became a practising analyst.
In every depth analysis the patient meets evil: inside himself,
in others, in nature, in the world. It seems that of all evil—death,
illness, natural catastrophies—the most difficult to bear is man's
inhumanity to man. In analysis it is this experience which
comprises the focus in the patient who has survived the
holocaust. It is the central problem of his suffering, which
constellates the specific task that the analyst has to face. Only in
the temenos of a real personal relationship (and I deliberately
refrain from using the terms transference and countertransfer­
ence as being too technical) will the victim be able to regain a
constructive attitude towards life.
But it is just at this point that the analyst may fail: he feels
inadequate, has guilt feelings because of his total lack of personal
experience, and he may be even overcome by the account of his
patient's sufferings. The patient needs exactly the opposite:
strength and firmness side by side with love and understanding;
but above all he needs the unrelenting demand to accept fate and
embark on the quest for its meaning.
When Dreifuss is asked by his patient why he was born a
Polish Jew and not in the U.S.A. (why not even as a Nazi?) then
the answer can only be: everybody has his personal destiny, his
individual measure of joy and suffering. The struggle for the
meaning of fate is perhaps the most important factor in the
regeneration of the soul in the persecuted victim. This is why I
would take issue with Dreifuss's statement: The experience of
the persecution is a form of suffering which is meaningless.'
In order to make the analyst understand better the psychic
situation of his patient during the holocaust I would like to add
that from personal experience I found it extraordinary to witness
how the soul itself preserved its balance in the death-camps by
regressing to an almost vegetative level. No developed conscious­
ness registered the insanity and inhumanity in which one lived.
The only task was to survive each single day. The collectiveness
of the situation was helpful for psychic survival, and there
developed something which I would call a collective self,
sustaining all of us. It is this help from the collective self which
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 321

was withheld from Dreifuss's patient as he was isolated from the

collective and had to deny even his identity as a Jew.
The struggle to find the meaning of her fate reveals itself in
the following dream of a holocaust survivor: Longing for peace
she goes with her children to Sils Maria and there has a picnic.
Strangely enough the picnic takes place in the shadow of Israeli
tanks standing abandoned nearby in the forest. Suddenly she
notices Arabs seizing one of the tanks and then approaching,
firing wildly at the unarmed group. The picnic party are
completely encircled and everything is lost. The Arabs, now
Nazis, start to fill trenches around them with dynamite,
intending to burn them alive. The dreamer—to her astonishment
unchallenged—leaves the circle and finds herself suddenly
beyond the frontier in Italy, Behind her is an inferno and her
children are dead.
She realizes now that hell, as in 1945, has again expelled her
and that hers is to be the way of the Eternal Jew. She does not
know if she can bear her fate and considers two possibilities:
either to commit suicide—then she must not meet her analyst, as
he would try to prevent her—or to become pregnant this very
evening and to return to Sils Maria with new life in her, to be able
to take her burnt children in her arms. To her question, how is
one to find the way back to Sils, she is answered that one must go
in a hearse and only via Merano. (In summer 1968, while the
dreamer was staying in Merano, soap made from the fat of gassed
Jews in Auschwitz was found there.)
Essentially the dream means: there is no peace for you
anywhere. Your fate is that of the Wandering Jew, the experience
of eternal tides, death and rebirth, sacrifice of the children, the
voyage through the nether world (Merano) and new life.

Mary Williams (London)

Dreifuss has conveyed movingly the feeling of awe accompanying
the task of analysing the victims of mass persecution, particu­
larly, it would seem, with regard to shadow problems on account
of the impersonal and therefore meaningless persecution of which
he speaks. He also conveyed how such confrontation burdens the
analyst with the feelings of guilt and shame of which the patient
322 GUSTAV DREIFUSS

is 'innocent' and which are only evidenced in 'not me' psycho­

somatic symptoms and in compulsive behaviour.
Such feelings may induce the analyst to avoid shadow
interpretations altogether, so helping the patient to remain the
innocent victim of circumstances, and perpetually ill ; or the
burden may become so heavy that it is flung back before there is
enough good ego feeling to endure it. Dr Dreifuss seems to have
steered between these opposites intuitively, but not without
considerable suffering, perhaps because the conflicts were
inevitably shared.
The main conflict in the patient seemed to me to be one of
loyalties, inherent in being one of a minority group in a hostile
culture, but particularly so for Tadek as his rescuers were
Christians, the enemies of his people and a threat to his Jewish
identity; yet there is evidence that he longed to be born again a
Christian in order to be saved both physically and spiritually
from the soul-destroying anti-semitic image of a Jew. Thus he
prayed to the Marshal's photograph, not to his God who had
deserted him as he felt his parents had. The most striking
evidence is in the painting in which the central item is the 'sacred
heart' of Jesus, however else it may be interpreted. It might have
been taken straight from a Catholic illustration and, as he must
have learnt in the monastery, this heart was pierced so that all
men might be saved through the forgiveness of sins. Confession
had to precede communion with the Saviour or Jesus would bleed
again.
Furthermore, the Catholics taught until recent times that the
Jews killed Christ, for which sin they became wanderers on the
face of the earth and, curiously enough, like Christ who had
'nowhere to lay his head' were, like him, 'despised of men' and, in
the final solution, ignobly executed. This myth of divine
retaliation through reversal of roles makes the persecuted Jew an
eternally suffering Christ figure seeking a predestined end. In
human terms, however, it works against the instinct for
self-preservation and becomes the perversion of masochism by
which the innocent victim seeks his persecutors.
I felt the worst feature of Tadek's terrible story was that he
was so constantly rescued. Survivor's guilt in his case would seem
to be confused with collaborator's guilt and the shame of having
to survive by such means. The maximum of survival anxiety is
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 323

shown in the dream of leaving his wife behind in Auschwitz.

Loyalty with its associations of regard and love threatens
survival and must be abandoned.
Reflecting on the factors leading to the possibility of regenera­
tion, I feel we would have to know more about the early
relationships and genetic constitution of individuals before the
effects of the hostile environment impinged. Were Tadek's 'good
enough' in Winnicott's terms? Perhaps his capacity to accept help,
to dare to remember, to use his imagination, and therefore to
trust, suggest that they may have been.

REPLY
by Gustav Dreifuss
I do not think that a distinction between the problems of
assimilation and anti-semitic persecution is desirable with
regard to the neurosis of the Jews, as Tedeschi makes it.
Persecution and anti-semitism in our time seem to me to be a
proof that assimilation is an illusion. We only have to recall the
powerful movement of assimilation in pre-Nazi Germany and the
horrible disappointment in which i t ended. It seems to me that
whenever the level of consciousness is lowered, as happens in the
psychology of the masses, anti-semitism can erupt like a volcano.
Although the psychology of Jews living in Israel may in the
course of years develop differently from that of those living
elsewhere, there is still a strong connection between the Jewish
people inside Israel and outside it. This showed itself especially at
the time of the renewed threat to the Jews in Israel in the
summer of 1967. Then, in the widest circles, among assimilated
Jews and even among Christians, something was touched,
perhaps unconsciously. Because of this sudden apparent danger,
memories of Auschwitz were revived and a basic experience broke
through and showed itself in, among other ways, an almost
incredible readiness to help. It could indeed be said that Israel, or
Jerusalem, as a symbol, is, in spite of assimilation, still alive in
the Jewish and Christian soul throughout the world.
I do agree with Tedeschi that a Jew may find in the
individuation process a new and living relationship to his
324 GUSTAV DREIFUSS

Jewishness, but it should also bring him to the awareness that by

his individuation he does not solve the potentially dangerous
anti-semitism of his host-nation. New anti-semitic outbreaks
have lately shown that this danger is real i n Poland, France and
A m e r i c a (New Y o r k ) .
I would not call the problem of the Israeli J e w a process of
assimilation, but rather one connected with the general problem
of our time, a spiritual or religious crisis like that in the
C h r i s t i a n world. Mendelsohn's remarks on the linking of the fact
of the millions of dead with the foundations of the state of Israel
or the coming home of the Jews to their original home are very
much to the point. I n addition, I would remark that it is really
difficult or almost impossible to unite the genocide of the Jews
with the dominant image of God.
Because of these difficulties I try to understand the catas­
trophe as a punishment for sins, in the same way as the friends of
Job attempted to do. O r I go back to the archetypal image of death
or destruction coming before rebirth (for instance Gog and
Magog), by proving w i t h Biblical quotations that there will be a
great destruction before the coming of the Messiah. The deeper
reason why people choose such a meaning may lie in the fact that
they are somehow unable to accept the darkness, the antimony of
the self, the collective shadow. I do agree w i t h Mendelsohn's
interpretations of the remarks of his eight-year-old son. They
illustrate what I had only hinted at: the influence of a new Jewish
reality on the psyche of the Jew living in Israel.
I n the discussion that took place directly after my lecture, I did
not answer the contribution of Mrs. Kutzinski. I want to clarify
two points:

(1) T h e persecution of the Jews as a collective phenomenon

resulting i n the death of millions seems to me meaningless, just
as k i l l i n g i n wars, for instance, is senseless. B u t I do agree that
the m a i n question for the persecuted victim who survived is his
struggle to find a meaning i n his personal fate. However, owing to
the severe injury I mentioned in my paper, most of the victims I
met i n practice or otherwise are not capable of undertaking this
quest for meaning.
(2) W i t h regard to the dream of a persecution victim related
with the interpretation that the personal experience of the
THE ANALYST AND VICTIMS OF NAZI PERSECUTION 325

holocaust brings back to the dreamer the meaning of the way of

individuation, I can only say that being on the way with all its
implications is an experience over and beyond the Jewish fate. In
other words, the archetype of the 'wandering Jew* is in every soul;
the Christian must withdraw this projection from the Jew and the
Jew must be aware so as not to be the bearer of this projection and
identify with it. In my opinion another important feature of the
dream is the atmosphere of dread and despair, due to the
traumatic experience of the holocaust and the fear of war with the
Arabs. I would not be astonished if the dreamer herself were not
also a victim with an irreparable injury. . . .

Mary Williams' comments bring so many new and interesting

points that I feel unable to discuss them adequately i n the small
space at my disposal. My contribution will therefore of necessity
be incomplete.
There is indeed a danger that the persecution victim's analyst
may avoid shadow interpretations. I hinted at this problem by
saying that Tadek had to develop further, in spite of his past
experience of the persecution. But according to psychiatric
evaluation, Tadek is a victim with an incurable injury. This has
to be borne in mind when his case material is studied, and this
could only be done in fragments in this paper.
With regard to the conflict of loyalties mentioned above, it
must be added that although Tadek was rescued by Christians, he
was himself very active in trying to save his life by fighting for
food in the ghetto and jumping down from the train on the way to
Auschwitz. And last but not least, he could have chosen to remain
in the monastery and make a career in the hierarchy of the
Church. But his urge to find other survivors of his family was so
great that he made contacts and finally left his refuge with his
aunt.
The dream where Tadek leaves his wife behind in Auschwitz
has also to be understood as a reaction to the actual aggression of
his wife at that time. It was she who wanted to leave him. So the
dream confronted him with his shadow, here the potential
murderer.
The remark on early relationships with regard to regeneration
is interesting. But according to Simenhauer (1968, p. 306 ff.) i t is
beyond reasonable doubt that the previous personality plays a

L
326 GUSTAV DREIFUSS

relatively small part in the psychic sequelae of ex-prisoners of

Nazi camps.
I feel completely at a loss to discuss the most interesting
remarks with regard to the persecuted Jew being an eternally
suffering Christfigure.May I only state that this seems to me to
reflect christological thinking. The survival of the Jewish people
after 2,000 years of persecution and the loss of one-third of its
members in our century, and the building up in return of an
'old-new country' remain for me a myth where some meaning
may only be found in a universal context furthering conscious­
ness.

REFERENCE
Simenhauer, E . (1968). Late psyche sequelae of man-made disasters.
International Journal of Psycho-Analysis 49:2-3.
CHAPTER SEVENTEEN

Working against Dorian Gray:

analysis and the old
LuigiZoja

The project of Zoja's paper is far wider than its title implies. In
addition, there is a salient critique of Freudian theory, in which
the psychoanalytic contribution is linked with several problema­
tic features of our culture. Then there is an analysis of the
culture's main problem: ignorance and fear of death. This, in its
turn, is connected to a radical undercutting of the authentic
patterns of life so that all of us, not just the old, suffer from
anomie and ontological anxiety.
One other feature of the paper to which I should like to draw
attention concerns Zoja's use of puer and senex. These terms,
which may be unfamiliar to some readers, refer to differing
psychological and emotional outlooks (and are not intended to be
restricted to males). They are not developmental concepts, though
they can be employed in that vein—for even old women and men

F i r s t published i n The Journal of Analytical Psychology 28:1, i n 1983.

Published here by kind permission of the author and the Society of
Analytical Psychology.

327
328 LUIGI ZOJA

can be seen to have puer or puella characteristics; similarly, the

senex can be seen in the character of babies. Clearly, each of us
will have both puer and senex in her or his make-up. The puer
suggests the possibility of a new beginning, revolution, renewal,
and creativity generally. The senex refers us to qualities such as
wisdom, balance, steadiness, generosity towards others, farsight­
edness. Each 'position' can become pathological: unmitigated
puer is redolent of impatience, overspiritualization, lack of
realism, naive idealism, tendencies ever to start anew, being
untouched by age, and given to flights ofimagination. Pure senex
is excessively cautious and conservative, authoritarian, obses­
sional, overgrounded, melancholic, and lacking imagination. The
injury that our culture has done us concerns the forcible splitting
of an archetypal interplay between puer and senex.
A.S.

Youth! Youth! There is absolutely nothing in the world

but youth!

[The Picture ofDorian Gray, Oscar Wilde]

Analysis

A nalytical therapy began officially with Freud, and, as we

all know, treatment was soon restricted to young
patients. 'Never trust any patient over 30' could then
have been—and now often is—the slogan of many orthodox
Freudians, analogous to the slogan of the student revolt in the
1960s and not in my opinion a coincidence, because we can now
see that the Freudian point of view anticipated and paved the
way for many radical changes in society, the most obvious among
which being the emphasis on sex. But I want to deal here with the
youth-centred vision so apparent in our culture today and the
accompanying repression of most of the archetypes surrounding
old age, and to dare to raise the question of the extent of the
contribution of Freudian thought to contemporary gerontophobia.
I do not pretend to have the answer, but I suggest that if in fact
the Freudian Weltanschauung has exerted this influence, it has
probably done so indirectly by centring psychic life on and around
ANALYSIS AND THE OLD 329

sexuality, which in its turn is biologically and archetypally

linked with youth.
Jungians, on the other hand, seem to me to be better equipped
theoretically to work with the old than are Freudians: we are
linked more to the archetypes and less to the Zeitgeist and are
therefore less influenced by the 'juvenilistic' culture of this
century. Jungians have often included the elderly among their
patients, though generally perhaps this is due more to an absence
of negative prejudices than to any specific rules about therapy.
Nevertheless, none of us to my knowledge has undertaken any
systematic study of the problems of analysis with the old; so,
without any claim at being exhaustive, I would like to try to
relate our therapeutic practice to a very simple framework and to
examine its roots.
In a country like mine, culturally a part of Western Europe but
much below it in average income per capita, analysis in general is
a natural target for radical intellectuals, who attack it for being
too expensive and therefore beyond the reach of most people. At
first sight this certainly seems to be a well-founded criticism, but
I want to consider it briefly and see if it really is pertinent in the
case of the old. The State in modern societies is held to have some
responsibility for the welfare of the old, so we might ask if it could
not offer them some psychological help. Unfortunately, in recent
times State funds have become almost bankrupted by a geometric
escalation of costs that cannot be controlled, of which those
allocated to the old show the greatest and least controllable
increase. Firstly, the direct rate of increase is higher than that of
any other social cost: not only does the outlay per person
constantly mount, but also the older section of the community
forms an ever-growing percentage of the total population.
Secondly, assistance to the old moves, economically speaking, in a
vicious circle: it indirectly swells other costs such as special
housing, hospitals and so on; and, in so far as it is successful, it
promotes the growth of an irreversibly dependent category of
person in contrast to other social policies which aim at helping
dependent people to become independent.
Further study of public assistance for the old also reveals that
it consists almost entirely of material aid, decided upon by
relatively young bureaucrats or politicians rather than by the
recipients themselves, and often resulting in failure to meet their
330 LUIGI ZOJA

true needs. This is, of course, a n enormous issue with prevailingly

sociological implications w h i c h I do not intend to explore further
here, but it is impossible for a depth psychologist to avoid the
impression that such contradictions arise because society is often
motivated more by unconscious guilt feelings towards the old
than by their real needs. Indeed, our society must conceal a great
deal of guilt towards old age, i f we think that this century has,
radically and for the first time i n history, expropriated the
traditional role of the old: by inventing retirement, it has taken
away most of their socio-economic role, and by inventing the mass
media and mass culture it h a s dispossessed them of their
psychological, truly archetypal role as guardians and transmit­
ters of wisdom, traditions and collectively accepted values.
Psychotherapy with the old is less costly i n my experience than
is analysis in general, because they do not usually require such a
high frequency of sessions. Once a week is normally sufficient for
the elderly person whose psychological as well as biological
rhythms have slowed down, and part of the enormous sums
already being misused on aid for the old could easily be shifted
from material to psychological help. However, to finance psycho­
logical assistance for them is to make a choice that is basically
socio-political rather t h a n psychological, and that tacitly creates
a sociological category of 'the old', which i n itself might
paradoxically turn out to be psychologically harmful. O u r culture
already tends to view the old and young, senex and puer, as
socio-political rather t h a n a s psychological categories—as polar­
ities of a n archetype i n J u n g i a n terms—and to pose the problem
in economic terms implicitly reinforces this onesidedness. Analy­
tical work is concerned w i t h old/young as intrapersonal and not
chronological polarities: when these are emphasized as inter­
personal, the individual is inevitably regarded as belonging to
either one or the other, and it is worth asking i f such a rigid
separation does not do even more harm to the in-dividuality
(Latin: non-divisibility) of the psyche than i n the case of other
archetypal polarities. T r u e , a m a n deals with psychic feminine
elements, his anima, a l l his life and vice versa, but he usually
retains his masculine role and identity at a conscious level. I n the
opposition young-old, a rigid identification of the ego with one of
the poles is even more damaging because every old person is a
young one transformed, and most young people will become old or
ANALYSIS AND THE OLD 331

are, at least, ageing every day. When, however, a sociological

split occurs, the inner dynamism of the two poles is devalued, if
not totally repressed, and young and old adopt a schematic view
of each other at the expense of their individual complexity. We
can see from the disappearance of positive archetypal roles based
on old age and not carried out in spite of it (a distinction to which I
shall return later), that this over-simplification has led to youth
becoming the representative of value and old age of non-value: the
archetype puerlsenex becomes split, and its vitality in the individ­
ual is lost because of the absence, or underestimation at least, of
one of the polarities.
To come back to the economic criticism of providing and
assisting analysis for the old, we have to recognize that here we
come up against obvious material limits. However, looked at
theoretically, it is precisely the main objections—public assist­
ance already costs too much and the old form such a relatively
large section of the community—which demonstrate that we are
talking about the richest societies in history. Furthermore, from
this standpoint, we are reinforcing sociological categories to the
detriment of psychological realities, and might even uncon­
sciously accept the modern prejudice which tends to view old age
as characterized by a basic deficiency of youth—rather than with
a specific character—related less to the concept of youth than to
concepts such as in-validity, un-employment and so on.
I now want to consider the second, more complicated,
controversial and subtle criticism levelled at analysis by the
radicals. They maintain that analysis is an instrument of
conformity which aims at readjusting people to modern society
and its ideology of production. This objection frequently seems
valid because very often a student does indeed return successfully
to his studies or a worker to his work as a result of analysis. For
us analysts, however, this is just 'a' result and not 'the' result and
is only the outer and not even inevitable manifestation of the
main process of individuation. This point is further clarified by
the old distinction between support therapy and analytical
therapy: the task of the first is to face difficult outer circum­
stances, while that of the second is undoubtedly individuation
although it may often also indirectly assist the first. It therefore
seems to me that psychotherapy for the elderly falls clearly into
the category of analysis in spite of the relatively low frequency of
332 LUIGI ZOJA

sessions more often associated with support therapy than with

depth analysis: after all, the distinctive feature of psychological
work is its basic aim and not the speed at which it proceeds. The
real task and goal of analytical work with old people cannot be to
readjust them to life, especially to an efficient and productive one,
but is most certainly to help them gradually to detach themselves
from life and to cover, without traumas, the archetypal path of
life which is the path towards death.
Another distinction familiar to Jungians and leading to a
similar conclusion is made by Hillman in the introductory
chapters of Suicide and the Soul (1964). He gives a clear
differential definition of analytical activity, differential in that
he superimposes it upon several other activities, including
medicine, and then focuses on and identifies their respective
elements. This method enables him to show the great difference
between analytical and medical work: the basic value, the 'root
metaphor' of the first lies in the life of the soul, that of the second
in biological life. The analyst can stay with death and work on it
without fighting it, since the experience of death is essential for
the soul albeit unhealthy for the body; but the physician can only
oppose himself to it, because for the body death is not an
experience but the end of experience, and physical dying cannot
be valued as an initiation—a beginning—as it can psychologi­
cally, but only as a termination. Hillman uses this distinction in
discussing suicide and emphasizes that the analyst, unlike the
doctor, should not necessarily fight the idea of it, but should
rather work it through. We would do well to recall Hillman's
argument here since the geriatrician, whose task is to fight death
by constantly delaying it, is in opposition to the analyst whose
work with the old searches for a natural, untraumatic 'physiolo­
gical' link with death even if the topic is not actually mentioned.
In short, we can say that the medical model fights against death
by trying to exclude it, whereas the analytical model includes it
as a major element in psychic life and, in the case of analytical
work with the old, as the main element and the main problem to
be faced. It therefore appears to me that the criticism of analysis
as a mere tool of readjustment can only stem from the idea of
analysis as an activity based on an old-style medical model,
revealing that the criticism itself, which pretends to be progres­
ANALYSIS AND THE OLD 333

sive, is in fact unconsciously linked to an epistemologically

outdated concept.
As I have already said, we often find a student returning to his
books and a worker to his work at the end of an analysis. Many
parents of depressed students will suggest analysis and pay for it;
even though they do not know what analysis really is, they find i t
natural to do anything in order to reconcile their children to their
studies, and many up-to-date social insurances will pay for
analytical treatment for someone whose phobias or compulsive
ideas keep him away from his work. But let us suppose my father
has recently retired, he suddenly feels useless and cannot accept
it and becomes moody and depressed. Should I dare to suggest an
analysis to him, and will I be generous enough to offer to pay for
him? Will I not simply side with those who say 'he's facing a
difficult moment, but he has to accept it'? Of course he has to
accept it—but is that all?
Few things are more distressing than the deep suffering of a
young person facing the sudden loss of his lover: all at once
feelings and sexuality are denied their usual expression. An
elderly couple has also to face a similar loss since the
simultaneous death they may long for is an archetypal need and
not a significant statistical reality—a striking analogy, by the
way, with the modern myth of simultaneous orgasm. An old
person who loses his partner is not less lonely than a young one,
but his loneliness has little if any remedy: one can scarcely start
being promiscuous in old age, but many recent studies have
shown that sexuality knows no age limit, and that it is cultural
prejudice that makes old people give up their sex life (cf. de
Beauvoir, 1972). In Dostoievsky's The Adolescent, when the old
prince Sokolski wants to remarry, the whole family ostracizes
him and even threatens to send him to the asylum. We may
reproach these relatives for their egocentricity, but our culture
has not changed much in its prejudices against the elderly who
still seek physical and spiritual love, and we have no concern at
all for their sexuality, which offends our aesthetic taste. Taboos
on sexuality may have fallen, and we can now even watch sex
between humans and animals at the movies, but you may have
noticed that they are always young and healthy—both the
shepherd and the sheep.

P—L*
334 LUIGI ZOJA

Nobody is very drawn to doing psychological work with the old,

and although traditionally this has been the field of the clergy,
they, like everyone else at present, seem more concerned with the
young. I f we fail to help an adolescent, someone who is entering
upon life, he might reproach us later; but not so if we fail to help
someone whose main goal is to enter death—a dimension which is
out of reach. I f we add this to the economic consideration—
psychotherapy with the old is a bad investment because they will
not be going back to 'their duty' since they have no productive
duty—we can see why so little analysis is undertaken with them.
Yet, is it they who do not respond to analysis or we who do not
respond to them? Was not analysis originally meant for
everybody, the old as well as the young? Some might answer it
was not, because psychoanalysis was born with Freud, and his
concern was life and sexuality and his interest in death was
bounded by his atheistic ideology. This remains an open question,
however, since there are some significant elements in his work
which could be seen as pointing in the opposite direction: for
example, why did he take Virgil's phrase, Flectere si nequeo
superos Acheronta movebo ['if heaven be inflexible, hell shall be
unleashed'—Aeneid vii, 312] as his motto and why did he call his
discipline psychoanalysis when dvdXvoig means not only melting
and dissolution but also death? Simple slips?
However that may be, Freudians today are without doubt less
concerned with the elderly than are Jungians, and i t may be
worthwhile summarizing briefly their respective schools of
thought, which have given rise to these differences in practice.
First of all, as regards therapeutic technique: Freudians are
usually more rigid than Jungians, who adjust more readily to
individual needs. This is very important with elderly people,
upon whom one cannot impose strict rules and whose long­
accustomed ways have to be accepted. Secondly, the Jungian
viewpoint, being more teleological than causal, places less
emphasis on anamnesis, a feature which is paradoxically a help
in analysis with old people. They are, of course, free to speak
about their past, but to try to trace the link between their present
anxiety and its possible aetiology is not usually so essential for
them. They already know—or believe they know—what was
wrong in the past, and the relative rigidity of their conscious
ANALYSIS AND THE OLD 335

attitudes makes it difficult for them to accept new explanations.

The main cause of their anxiety lies in the future, in the
archetypal goal of life which is death, and the aim of'soul-work' is
to create a link between the present and that future even if death
is not explicitly touched upon by patient or analyst. This, at least,
is the way in which I have dealt with those elderly patients I have
worked with. Many of their dreams concerned the future and
often contained what seemed to me to be symbolic hints of death,
such as the entering of an endless ocean or a kingdom beneath the
ground or the sea, or the crossing of a channel and the discovery
of anew land; there were relatively few dreams where I felt it
necessary or relevant to bring an objective exploration of the
actual past into the discussion.
The Jungian approach, with its frequent resort to mythology,
prepares the ground for another kind of link with the past.
Indeed, the old patient needs to turn back and to build his
life-myth; in a way, he must complete the circle begun in his
youth, when he strove for individuation: then he fought to
differentiate his psychic life from the archetypes, now he must
give it back to them, and to create this myth might mean
harmonizing and fusing his memories with a mythical pattern.
Memory becomes selective in old age, and if we believe in the
hypothesis of the unconscious psyche, we assume that such
selectivity is not random but follows an unconscious project. The
analyst assists the patient in this natural process which is now
not remembering but forgetting—a 'selective anamnesis' or an
'ana-amnesis'.
The theoretical differences between Freud and Jung account
even more obviously for the wider interest in the old displayed by
Jungians. Jung's work is a general psychology, that of Freud is a
psychopathology, and, as I have already pointed out, it is quite
out of place to approach the psychic suffering of the old by trying
to heal them in the traditional sense. It is true that Freud
introduced the concept of davaxog, but thanatos has a negative
sense, it is the denial of life, whereas for Jungians death as the
last step in the individuation process can become an active
presence without automatically pathological implications, a real
process in itself; death can be viewed 'not as an event, but as a
process' (Gordon, 1978).
336 LUIGI ZOJA

Old age
After having considered the criticisms made of the role of
analysis in our society, I would now like to look briefly at those
made of old age. I think we would all agree that the situation of
the so-called 'third' age in the Western world today is both
striking and unprecedented. Unfortunately, most studies on the
subject either approach it from a socio-economic point of view and
are only an indirect help to depth psychologists, or those that do
take psychological factors into account, do so only from the angle
of consciousness. Simone de Beauvoir, for example, in her
important book Old Age (1972), presents a wealth of sociological,
anthropological and historical material most convincingly, but
then says: Time is carrying the old person towards an end—
death—which is not his and which is not postulated or laid down
by any project' (p. 217). I think that depth psychologists would not
be so categorical and would probably distinguish between
conscious and unconscious purpose (where de Beauvoir speaks—
in translation—of project). Except in the case of suicide, death is
certainly not a conscious 'intention' of the old but is, in a way, the
archetypal intention of life as a whole; even Freud, without of
course speaking of archetypes, formulated a similar hypothesis
(1920g). For my purpose here, however, it will suffice to single out
those main aspects of present-day culture which may be thought
to influence the psychological situation of the old.
The first of these is the growing medicalization of life
(Foucault, 1967; Illich, 1975). Until a few generations ago
'normal' birth and 'normal' death took place at home and were
ministered to by the family hierarchy, an arrangement that
showed a deep inner respect for the archetypal patterns of life.
Today, 'normal' birth and death occur in hospital or a similar
institution and are attended by a hierarchy of technicians who
are strangers. Looked at from a psychological rather than a
sociological point of view, this means that even before he loses his
physical life the old person is deprived of his psychological life: he
is denied his archetypal role of the wise old man. Whereas in
times gone by the approach of death enhanced this role and the
old person became the representative of a wisdom freed from the
burden of petty daily needs, now it forces him to give up his
autonomy and take on the passive role of a patient. The
consequences for the old are dramatic, in spite of undeniably
ANALYSIS AND THE OLD 3 3 7

better 'health* care; a French study quoted by Simone de Beauvoir

(1972) shows that of those sent to a nursing-home, 54% die in the
first year, of whom 29% die in the first month (p. 256). Whether
we believe i t or not, archetypes are indeed an essential part of
life, and deprivation of archetypal experience can kill—we know,
for example, that to be deprived of dreaming is more intolerable
than to be deprived of sleep.
The second transformation in our culture which is critical for
the old is the taboo of death. In the short span of a couple of
generations, our over-optimistic, hypomanic and one-sided soci­
ety has burdened death with a silence and repression hitherto
unknown in the history of man. Our culture is ashamed to speak
of death, and our average citizen is ashamed of death and
therefore ashamed of dying. Mourning likewise has become
something to hide, as i f it were, in Gorer's words, 'an analogue of
masturbation' (1965, p. I l l ) , and the whole topic of death—
according to Aries (1975) and to most of those who have studied
it—has in recent years taken over the role of sexuality towards
the end of the nineteenth century. Today only a minority of
people have seen somebody die, to witness which was the rule in
past centuries. Nowadays both doctors and relatives usually
consider it their duty to conceal a patient's fatal condition from
him. They do this on the 'psychological' ground that the lie has a
placebo effect and can help the patient to some sort of recovery,
but here again the concept of 'psychology' is reductive, and there
is no consideration of the unconscious and archetypal element. In
earlier times i t would have been unthinkable to deprive someone
of a gradual preparation for the final moment and of the
possibility of harmonizing the conscious and archetypal endings of
life, and it was not only in the East but also in the West that people
thought their ultimate task was to prepare themselves psychologi­
cally for i t .
We often read that people used to make a will before going on a
journey, to which our usual reaction is: 'How dangerous
travelling must once have been!' But this also is a somewhat
reductive attitude, and the culturally dramatic change lies not in
the safety of travel but in our attitude to death. It is a relatively
recent development that a will should be concerned only with
money matters; it used to be a witness to an inner preparation for
death, an apotropaic act like taking an umbrella so that it will
338 LUIGI ZOJA

not rain. Sudden, unexpected death was traditionally a most

dreaded occurrence, a dread still reflected in popular beliefs about
restless ghosts haunting their place of death. These people are
usually supposed to have died young or suddenly—more espe­
cially to have been murdered—and, their preparation for death
not having been completed, they are unable to die completely.
The fear of sudden, unritualized death was universal—a subi­
tanea et improvisa morte libera nos, Domine [from sudden and
unforeseen death, deliver us Lord]—in complete contrast to our
attitude today, and how intense it was can be gauged when we
think of the enormous amount of physical suffering it would at
least have spared in times when medical care was rudimentary
and anaesthesia virtually non-existent.
In those days the entire preparation for death was a great
happening and an important ritual. The old person was believed
already to possess wisdom, and with the approach of death this
wisdom reached its climax: no matter how insignificant and lost
in the crowd a person had been in life, the words he spoke before
dying were considered to contain teaching for everybody. By
reason of old age and especially the approach of his death, Mr
Nobody finally became Somebody—even more, he became a
Teacher. The person who had passively accepted life became
active at the last; the person who had nothing to give could now
make psychological gifts to others, and for us Jungians i t is
interesting to note that an essential path of individuation was
thus always provided even for the most collective person and that
it coincided with old age. This erstwhile function of the last
chapter of life is particularly significant if we compare it with
what happens nowadays, when nursing homes and hospitals tend
to transform i t into the most collective and anonymous episode i n
life. The active role which, after a passive life, the old or dying
person could once assume has turned into its opposite; modern
Western man has, theoretically at least, a series of opportunities
to develop his personality and to differentiate himself inwardly
and outwardly from the crowd, but these constantly decrease
during old age to the point where he is no longer a subject but a
patient, a passive object of medicine and its sophisticated
technology.
Over the past hundred years the Italian population has
doubled, but the number of the old has increased sevenfold. This
ANALYSIS AND THE OLD 339

means that in our society old age is statistically present as never

before, while psychologically i t is tending to disappear. Current
values, which are reflected in the mass media and advertising,
have rendered our society both hypomanic and ^juvenilistic'. One
has only to turn on the radio or television to notice that the 'Mr
Average* advertised and appealed to has to be terribly extrovert,
active and healthy—in a word, he is basically young. According to
the advertisements, he needs a lot of goods, but goods can be
substitutes for individuation and belong to the world of youth; a
car or liquor, for instance, are sold to you because you are young
or they make you feel young. If the advertisements or the media
do address themselves to the older person, it is precisely in order
to ask him to disown his age, and if he wants to remain a
client—and he usually does, or he will be lost to society—he must
betray and repress his archetypal reality.
Furthermore, when we see mass culture extolling the energy of
some old man in power such as Reagan or Brezhnev, it is
impossible to avoid the impression that such men incarnate the
myth of eternal-youth-in-spirit-of-age rather than of dignified
ageing. Even if we take into consideration the fact that the old
are a disadvantaged group in society, we know that the
sociological problems of such a group cannot be solved at the
expense of those psychological ones inherent in falling prey to a
false ideal or neurotic identity. It is known that black leaders fear
the risk of becoming too like the whites and feminists of apeing
masculine roles, but we somehow assume that the old person
wants to renounce his identity and at bottom wants to be more
healthy and active—in short, younger. Our average man has
bowed to some myth of eternal youth, and we are forced to ask if
this is pathological and could lead to disaster, as in the story of
Dorian Gray; we can certainly see that every old person suffers
potentially from psychic injury and that the whole of society is
unbalanced when deprived of one of its polarities.
Another aspect of the problem is that it is now considered bad
taste to speak about old age and death. There are thousands of
specialists studying the misunderstandings between the middle­
aged and their children, but I have not seen any studies on the
psychological difficulties of communication between the middle­
aged and their elderly parents. As a consequence of, and in
compensation for, this one-sided attitude, the collective way of
340 L U I G I ZOJA

dealing with old age usually takes the form of emotionally

charged prejudice—the generation gap—or of ambivalent curios­
ity; in short, of projections. Similarly, we avoid the subject of
death in daily conversation; and what was once called the War
Ministry is now hypocritically renamed the Ministry of Defence;
and then we discover to our surprise that books on death become
best-sellers, and a fatal street accident automatically draws a
crowd, gathered there not to pray but to comment. Are these
people trying unconsciously to reconstruct a collective ritual
around death? In any case it is certain that life and death have
never been so far asunder as now, unlike every other age in
Western culture which provided many rituals in preparation for
and surrounding death. According to Aries (1975), death was
once, and especially in the eighteenth and nineteenth centuries,
literally a major public ritual. Family and acquaintances would
visit the dying person and speak with him about death; children
of every age would also be brought in because it was felt that
through death they could learn about life, and even the passing
traveller on hearing that someone was dying often considered it
his duty to attend.
I want now to turn to the so-called primitive societies, where
the ritual surrounding ageing and dying is in even greater
evidence. In the total absence of mass media or even books, the
transmission of culture itself is entrusted to a large extent to the
old: in our culture the mass media are infected by gerontophobia,
a phenomenon that is probably more than coincidental when we
realize that they and old age are engaged in mutually exclusive
competition. Since the old are relatively few in number in
primitive, underdeveloped societies, the ritual importance of
becoming old and of dying is stressed and enhanced. The whole
process tends to follow a pattern of initiation and becomes
particularly significant in the light of the concept of individua­
tion. For the primitive, every 'correct' death has its initiation
aspects, and every initiation corresponds to a psychological death.
Myths of the origin of death are quite common in Africa, North
America and South-East Asia and are curiously similar to some
modern existentialist writings (cf. Eliade, 1976; Gordon, 1978, p.
60f.; Herzog, 1966; Radin, 1952). Looked at from a Jungian
standpoint, these myths reveal an extreme effort to grasp why
this most intolerable of all events takes place. The need to find a
ANALYSIS AND THE OLD 341

reason is so desperate that some of them even tell us that man

deliberately chose death (Gordon, 1978, p. 67). So difficult is i t to
resign himself to the idea, and so great is the fear of having to
acknowledge that he is at the mercy of uncontrollable forces, that
man prefers to face it by taking sides with those forces. In every
culture man tries to come to terms at least with death and to link
it with its psychic life, and by so doing to recognize it as a natural
event. The psychological effort, however, is tremendous and does
not always succeed, so that it is often a problem to track down a
proper archetypal image of death. Some primitives believe that
there is no natural death, and every death corresponds to a
murder (Freud, 1912-13). Nevertheless, whenever primitive
cultures manage to come to terms with death—and most of them
do—they link i t with life as its final ritual step for which old age
is the natural preparation.
The initiatory pattern does not only mean that death is an
initiation and every initiation is a symbolic death, but also
usually implies a second birth. This birth, unlike the first one, is
spiritual and must be ritually created by the active participation
of the dying person and his spiritual assistants, as was once the
case in Europe (Eliade, 1959). Eliade says that wherever death
has the significance of a second birth, it also becomes the
paradigm of every momentous change (ibid.). Here I come back to
my quotation from Simone de Beauvoir and the distinction
between conscious and unconscious intention of dying: i f a
'natural' death requires ritually created elements, then it follows
that a 'normal' death, especially in old age, involves some
intention. Such intention is largely but not wholly unconscious
and archetypal; we know, for instance, that often in Eskimo and
nomad societies an old person was expected actively to accelerate,
while psychologically preparing for, death.
The notion of death as rebirth that has to be actively achieved
implies that it cannot be attained automatically and by everyone,
and many peoples consider i t essential to practice for it in
advance throughout the entire lifespan and not only in old age.
The prototype for such practice and the most complete anticipa­
tion of death is ecstasy, for which the best preparation is
shamanic apprenticeship, or at least the assistance of shamans
who are experts in ecstatic states. Ecstasy is an anticipation of
death in that it follows the same archetypal pattern: it is usually
342 LUIGI ZOJA

accompanied by initiation rituals and brings about the separation

of soul from body (ibid.). Preparation for death is an archetypal
need which has been almost totally repressed in Western society.
Traces of it, however, can still be found when an outwardly
'normal' and young person daydreams about his own death. Of
course this can be viewed reductively as a narcissistic symptom,
but why should it not also be an exercise through which he learns
to experience 'sympathy' with the whole pattern of his individua­
tion and to recover the unique meaning of his existence and his
death?
What has been said about ecstasy is valid for dreams and all
psychic states where the ego relinquishes its leading role and
makes way for unconscious contents. Many cultures believe that
the soul literally leaves the body in dreams and travels to all
those places that are later remembered, and that if somebody
meets in his dream people who are dead, he has obviously visited
the kingdom of the dead. The older a person becomes, the more
frequently will the people of whom he dreams inevitably be
already dead, and if he remembers his dreams and uses them to
good advantage in analysis, he will be undergoing what modern
terminology calls psychotherapeutic treatment and will at the
same time rediscover a long-repressed archetypal ritual. In this
way he can recover an archaic pattern in which individuation is
sought through a psychic exercise in preparation for death.

Conclusion
In the near future, neither the economically poor nor the peoples
of the Third World, but the old, will in many respects be the
'damned of the earth'. Every modernization seems to bring about
a growth-in their number and a radical alienation of their
identity—a striking analogy with Marx's analysis of the working
classes in the nineteenth century. This loss of identity is both
psychological and sociological, subjective and objective. Once
upon a time the old person knew that he concentrated many
collectively recognized values in himself, but now the mass media
prove to him that he is the prototype of the loss of accepted values.
Public institutions administer gigantic funds to help thf old,
but this does nothing to restore the lost value of their archetypal
ANALYSIS AND THE OLD 343

role: the State seems to think that the ideal assistance is to make
them forget their age and their approaching death; there is, in
short, no concern for the unconscious psyche. As the producer
sells his goods, so the State supplies its aid only i f the elderly
repudiate their identity, a blackmail that is constantly at
work—'Come free of charge to the public holiday resort, and you
will feel as lively as you did in your twenties': 'Accept this
motorized wheelchair—it's better than a Cadillac/ Thus neither
words nor money are spent on the real issue. The old dp not need
so much to travel physically, for which they are dependent on the
guidance of the young, thereby emphasizing their alienation, but
to travel inwardly along the path where eventually the young
will follow their guidance. The already difficult task of individua­
tion in old age is thus at risk of losing a favourable ambience for
its development.
Youth too is affected by the cultural one-sidedness which
represses old age, and most of us do not know what to do with our
'old' side. We look around desperately for some sort of archetypal
wisdom, and, finding no answer, we try to quench our thirst with
handbooks of 'grandmother's recipes'. Already as teenagers,
many suffer from a neurotic ambivalence about getting old and do
not know how to deal with the images of old age which
increasingly populate their dreams. I have encountered in my
practice, and in case discussions with colleagues have heard
about, several girls who could only reach orgasm when fantasiz­
ing being possessed by a very old man.
Analysis has in principle the possibility of healing, and not just
the healing of a single patient but of the repressed side of the
whole culture. The rediscovery of the sexual drive by Freud, and
of the archetypal patterns of the psyche by Jung, were radical
revolutions, but as far as the condition of the old person is
concerned, the official 'radicals' today seem only to be interested
in his outer well-being and to look at his relationship to life
against a medical and economic model. We analysts are
theoretically in a position to compensate this one-sidedness in
both the individual and our culture; dreams and visions in their
purest form have traditionally signified a journey of the soul to
the underworld, and to communicate constantly with them is the
best archetypal preparation not only for life but also for death.
Jungians often speak of vsxvia, the journey to the land of the
344 LUIGI ZOJA

dead, but only seldom do we guide somebody for whom the

"vsHvid is an urgent and concrete task. Why is this so? Analytical
treatment involves more than psychological work; it involves the
spending of money. To what extent do we analysts yield to
present collective values by agreeing that even though expensive,
analysis is a good investment if it helps a still relatively young
person and thereby saves a lot of future public expenditure? The
Health Service in Germany has looked at this financial aspect
and has decided on these grounds to pay for treatment. While this
is certainly an admirable extension of health care, one wonders
none the less whether it will not draw our attention even further
away from the soul. To regard healing as an investment could
eventually, in Hillman's words, confirm and clinch the 'root
metaphor' of economics which pictures old age as a negative
investment. Furthermore, to conceive of healing as an exclusively
medical matter could convert the whole of old age into a chronic
terminal disease. By so doing it would validate the root metaphor
of the medical model and at the same time show up its natural
limitations, since medicine perhaps provides 'prevention', but
certainly not 'preparation', for the most natural of all events.

Summary
The evaluation of old age by a sociologist probably cannot be
reconciled with that of a depth psychologist, since the former
tends to split the complementarity of the puer and the senex
archetypes and to give them opposed values. Opposition instead
of complementarity means the denial of the values of old age as
such and transforms it into a pathology. Depth psychologists—
Jungians at least—substantially reject such pathologization and,
in my opinion, should not confine their rejection to a diagnostic
attitude but should try to conceive of analysis for the old as an
initiatory rather than a clinical process. This suggested concep­
tion of analysis as initiation (initium, meaning a beginning) aims
at viewing.old age not simply as a loss of youth but as a
psychological state attained gradually and with difficulty but
worth entering into (initium in its turn derives from in-eo, to
ANALYSIS AND T H E OLD 345

enter). At the same time by implication it hopes to reaffirm

wisdom as a quality of experience and points to the importance of
a psychological preparation for death.

REFERENCES
Aries, P. (1975). Essai sur VHistoire de la Mort en Occident, du
Moyen-Age d nos Jours. Paris: Seuil.
Beauvoir, S. de (1972). Old Age (Appendix I V ) . London: A n d r e Deutsch
and Weidenfeld & Nicholson.
Eliade, M . (1959). Naissances Mystiques. Paris: Gallimard.
(1976). Occultism, Witchcraft and Cultural Fashions. Chicago,
I L : University of Chicago Press.
Foucault, M. (1967). Origin of the Nursing Home. London: Tavistock.
F r e u d , S. (1912-13). Totem and Taboo. Standard Edition 13. London:
Hogarth.
(1920g). Beyond the Pleasure Principle. Standard Edition 18.
London: Hogarth.
Gordon, R. (1978). Dying and Creating: a Search for Meaning. L i b r a r y of
Analytical Psychology, Vol. 4. London: K a r n a c Books.
Gorer, G . (1965). Death, Grief and Mourning. London: Cresset Press.
Herzog, E . (1966). Psyche and Death. London: Hodder & Stoughton.
H i l l m a n , J . (1964). Suicide and the Soul. London: Hodder & Stoughton.
Illich, I. (1975). Medical Nemesis. London: Calder.
Radin, P. (1952). African Folktales. New York; Pantheon.
INDEX

abstinence, rule of, breaking, 57-59 analytical environment, see

acting out, preventing, 63 environment, analytical
Adler, G., 1, 6 analytical treatment, criteria for,
affective mode and psychopathology, 10-13
15 androgyne, 275-89
affects, 90-91 anger, infant's, 32
aggressor, identification with, 31 anima
Agrippa, C , 41 figures, 292
alchemical material, sexualism of projections, 37
[Jung], 280 animus
alchemy, 37, 199 /anima [Jung], 278
studies of [Jung], 40-41 problems, 296-97
alcohol, as defence against over­ negative aspects of, 298
stimulation, 59-62 figures, 292
aliveness, 218 anorexia nervosa, 71-88
alliance, analytic, content of [Jung], definition, 73
158-59 and envy, 81
alpha elements [Bion], 279, 286, 288 and food and regression, 87
amplification, 4, 41 and monster/breast, 79
analysis therapeutic techniques in, 72,
in old age, economic 80-81
considerations, 343—44 and unsatisfying feeding
termination of [Kohut], 147 experiences of infant, 87
analyst anti-semitism, 309-26
existence of denied, 107, 110-11 anxiety, in infant, 32
knowledge of own archetypal atmosphere, awareness
psychopathology of, 12 of, 223
professionalism of, 12 archetypal experiences, non­
as wounded healer, 191 humanized, 107-8

347
348 INDEX

archetypal images, absorbed by -ego, alchemical vessel analogue

infant, 25 of, 217
archetypal polarities, senex and image, distorted, 82-83
puer, 330 imagery, in dreams, 37
archetypal womb, flight to, 106 borderline personality, 157-204
archetype disorder, diagnostic criteria for,
coniunctio [Jung], 39 195-96
definition, 292 boredom, analyst's, as defence, 63
incest, 30 Bosnak, R., 205-12
mother, 311, 316 boundaries, need for, from mother,
[Jung], 5, 32 34
self, completeness of [Jung], 95 breast
totality [Meier], 72 defective relationship to, 110
unity [Jung], 39 monster, and anorexia nervosa, 79
archetypes -penis, first part object, 95
animus and anima, 278 Bruch, H., 74
innate, 278 Bruno, G., 41
in marriage, 291-309 Burton, R., 25
spectrum of [Jung], 279, 286, 288
theory of [Jung], 4 Camus, A., 210-11
Aries, P., 337, 340 castration, 258-62
Aristotle, 17 anxiety, fetishism and
asthma, and fear of suffocating transvestism [Freud], 257
mother, 80 causae efficientes [Aristotle], 17
autism [Fordham], 230, 235 causae finales [Aristotle], 17
Azzolini, A., 84 character disorder, narcissistic, 160
childhood, analysis of [Jung], 18
clinical examples, 27-30, 47, 49,
Baeyer, W. R. von, 310 51-56, 57-59, 61-62, 64-65,
Baker, L., 75 73-77, 81-87, 104-6,122­
Balint, M., 5 25,131-37,149-52, 160-77,
Barabino, A., 84 176-77,17&-86, 230-32,
Barcal, A., 77-78 238-40, 246-51, 259-61,
barrier, 116 263-69, 281-85, 299-305,
to analysis, and narcissism, 105-7 311-15, 321,
of schizoid patients, 131 clinical work, masochism in, 245-51
Beauvoir, S. de, 333, 336, 337, 341 closeness, fear of in analytic
Beebe, J . , 8 situation, 56-57
Berne, E . , 143 Cohn, N., 310
beta elements [Bion], 279, 288 coincidentia oppositorum, 188-89
Binswanger, L. , 4, 211 collective unconscious [Jung], 4
biochemical changes, in collusion, definition, 292-93
schizophrenic disorders coniunctio, 193
[Jung], 235 alchemical imagery of, 159
Bion, W. R., 197, 275, 276, 279, 281, oppositorum, 23-43, 215
286 as pattern, 175-76
blanking, 36-37 container
Bleuler, 4 and contained [Jung], 294
Boll, H., 96 lack of, in psychotic [Jung], 5
body makeshift, 216
chemistry and personality Copleston, F., 18&-89
distortions [Bleuler, Jung], countertransference, 3
4 and over-stimulation, 62-66
INDEX 349

and narcissism, 118 Dreifuss, G., ix, 19, 309-26

and psychotic patients, 223-25 drive fixations, secondary to
syntonic [Fordham], 115 coherence of the self
and narcissism, 116 [Kohut], 142
and technique, 34-38 dual mother [Jung], 5
couple, unconscious, 161, 197-98 Dvorjetski, M., 311
creativity, failure to develop. 51-56 dyad, unconscious, 157-77, 197
Crisp, A. H., 74 parental, splitting of, 163
Cross, St. John of, 194-97
cultural motifs and clinical
materia], 4 ecstasy, in anticipation of death,
Cusa, N. of, 188-89, 193 341-42
Edwards, A., ix, 10-11, 127, 229-36
ego, 11, 46
death analyst's, flooding of, 63
analysis as preparation for, child's struggle for [Jung], 92
333-35 containment by, 220
drive, 237 content of, 141-42
in borderline person, 199 defences, pathological, and
[Freud], 241 narcissism, 111
fear of, 239 developing, and object constancy,
faced in analysis of the old, 90
332-33 division of, 91
-force, 201 flooding of, 49
instinct [Klein], 242 and alcohol, 60
before rebirth, archetypal image restriction-, 65
of, 324 self vs. [Hartmann], 141
taboo, 337 Eigen, M., 159, 203
Dee, J . , 41 Eitinger, L., 310
Deegener, G., 85 Eliade, M., 340, 341
defence, depressive, 45-70 Eliot, T. S., 57-59
to over-stimulation, 45-70 enantiodromia [Jung], 8
and retreat, 59 energy, of warring and combining
splitting, 109-10, 215 opposites, 224^-25
deficit and psychopathology, 15 environment
deintegration [Fordham], 103, 234 analytical, integrative function of,
depression, 23—43 114-15
adult, and deprivation in infancy, containing, in treatment of
31 narcissistic disorders, 114
and archetypal disposition, 32 therapeutic, organization of,
attributes of, 25 225-26
and developmental studies, 32 envy
and environmental influence, 32 and anorexia, 81
[Jung], 17 attacks of, 38-39
depressive defence, 45-70 equilibrium, narcissistic [Kohut],
depressive position [Klein], 91 144-45
Dicks, H„, 292, 293, 294, 298-99, extraversion [Jung], 128
305
divisio, 40
division, of ego, 91 family therapy, in anorexia nervosa,
Dostoievsky, F., 333 77-78
dream interpretation, extravert and fantasies, abnormal, child's [Jung],
introvert approach to, 129 32
350 INDEX

father Gordon, R., x, 31, 112, 114,153,

abandonment by, 177-86 237-54, 335, 340, 341
imago and mother imago, Gorer, G., 337
integration of, 39 gratitude, 66-69
lack of goal of analysis, 67
and father transference, 36 Green, A., 182,183,187,188,198,
and narcissism, 102 201
feed, symbolic [Segal], 118 Greenson, R., 13
feeding, defence against, 11 Griesinger, W., 207
feeling [Jung], 128 Grinberg, L., 166-67
Fenichel, O., 256, 265 Grotstein, J . , 163-64,178, 200
fetish [Freud], 182 Gumbel, E. , 315
fetishism Gyomroi, E. L., 310
heterosexual, 265-72
psychopathology of, 255-74 Hadfieid, J . A., 265
Ficino, M., 41 Harding, B., 74
field, interactive, structured by the harmony, search for, 41
unconscious dyad, 158-11 Hartmann, H., 91,141
Flannery, E . H., 310 Hauser, A., 243-44
flooding healer, wounded [Guggenbuhl-
of analyst's ego, 63 Craig], 12
of ego, 49 Henderson, D. K., 74
and alcohol use, 60 Heracleitos, 8
fear of, 64 Herzog, E. , 340
Fludd, R., 41 Hillman, J. , 1,6,10, 332
Fordham, F., ix, 1,101, 103, 114, Hippolytus, 37
116,145,146, 149, 118, 210, Holocaust, 309-26
230, 233-34, 235, 275-89, Homans, P., 155
292 Homer, 267
Foucault, NL, 336 homosexuality, as phallus-fetishism,
Frankl, V. E . , 310 262
Franz, M.-L. von, 280 Hubback, J. , x, 23-43
Freedman, A., 130 Hultberg, P., x, 45-70
Freud, A., 50 Humbert, E„ 31, 244
Freud, S. and Jung humour [Kohut], 154
break with, 4 hunger, craving for love, 78
differences between, 128 hypnosis, dynamics of [Freud], 167
Frey-Wehrlin, C. T., ix-x, 205-12
function, transcendent, 201 J Ching, 136
[Jung], 171 idealization
emergence of [Jung], 200 fear of, 64
and over-stimulation, 56
identification, 27
Galdston, R., 76-77 and boundaries, 34
Gedo, J . , 116 projective, 181
gerontophobia, 337-42 and analyst's powerlessness, 35
Gilbert, G. M., 310 [Jung], 6
Gillespie, R. D., 74 and over-stimulation, 56
Gillespie, W., 247, 256 identity
God, existence of, concern about, development of, 230
239 primary [Jung], 5
Goldberg, A., 57 Illich, I., 336
Goodheart, W 14
M imaginal sight, 157
INDEX 351

imagination Lacan, J, , 193

active [Jung], 92 Laing, R. D., 4, 220, 292
true and fantastic [Jung], 186 Lambert, K., 276, 288
imagos Langegger, F., 205-12
internal, harmonization of, 39-42 Lawrence, D. H., 238, 244-45
parental, disappearing, 36 Levi-Strauss, C , 159, 202
impotence, 258-62 Levy-Bruhl, 5, 26-27
incest Ledermann, R., x, 31, 101-26
taboo, 297-98 libido
uroboric [Neumann], 198, 240-41 kinship, 297-98
individuation narcissistic
of Jewish people, 317 -exhibitionistic [Kohut], 153
[Jung], 146 maturation of [Kohut], 140-41
and object constancy, 89-99 transformation of [Jung], 94
process, 216 Liebman, R., 75
infancy, analysis of [Jung], 18 Lowen, A., 218
integration, of parental imagos, 39 Lull, R., 41
integrative function of analytical
environment, 114—15
internalization, transmuting madness, 190-94
[Kohut], 144, 151 of borderline personality, 184—85
interpretation and borderline states, 177-86
denial of, 187-88 Magus, S., 37
insightful, fear of [Kohut], 57 Mahler, M., 5, 222
premature, refraining from in March, H., 310
narcissism, 116-17 marriage, archetypes in, 291-307
rejection of, 181 masochism, 237-54
introjection, 27 clinical consequences of. 251-54
introversion, [Jung], 127-37 forms of [Freud], 246
and schizoid personality, [Freud], 241
difference between, 127-37 [Khan], 242
intuition [Jung], 128 trickster figure and [Jung], 253­
isolation, degree of, of schizoid 54
personality, 131 maturation
narcissistic libido, of [Kohut],
Jacobson, E . , 92 140-41
Jacoby, M., x, 31, 139-56 and regression [Jung], 5
Jones, E., 9 McCurdy, A., 14
Joseph, B., 9, 237, 242, 246 McGuinness, B., 74
McLean, A., 162
Kalsched, E . , 31 meaning, search for transpersonal
Kaplan, H., 130 [Jung], 145
Keats, J . , 60 medicalization of life, 336
Kerenyi, K., 210 Meier, C. A., 72, 211
Kernberg, O. F., 31,119 Meissner, W., 201
Kettner, M., 131 Meltzer, D., 115, 198, 275-89
Khan, M., 158, 242, 243, 287, 288 Mendelsohn, J . , 318-19
Kirsch, T., x, 127-37 Mickiewicz, A., 60
Klein, M., 3, 9, 91, 97, 241, 242, 275, migraine, dread of separateness
276, 281 from mother, 80
Kohut, H., 31, 46, 57, 69, 103, 117, Miller, F. J . , 112-13
139-56 Milner, M. [Joanna Field], 243
Kutzinski, D., 320-21, 324 Minuchin, S., 75
352 INDEX

Mirandola, P. della, 41 [Kohut], 139-56

mirroring [Winnicott], 115 and Ovid's myth of Narcissus,
mortificatiOy 40 112-13
mother pathological, treatment of, 101-26
and anorexia, 71-88 primary [Freud], 114, 145
archetypal treatment of, 113-25
Great, 107 working through, 33-34
all-good, desire for, 108 narcissistic deprivation, 31-34
flight to womb of, 124 Neumann, E. , 115, 198, 142, 214,
retreat to in narcissism, 106 217, 222, 237, 240-41, 269,
archetype [Jung], 32, 311, 316 271
complex Newton, K , 217, 220
analyst's, and therapeutic nigredo, 40, 162
technique, 129-37 normality
negative, and introversion, definition of [Freud, Jones, Klein],
129-30 9
and baby, bad fit between, and and individuation, 9
narcissism, 102 numinosum, 193, 194-95,198, 200,
as container, 216 201
depressed
introjected image of, 35 Yahweh the source of, 196
pathological effect of, 23—43
dread of separateness from, and object
migraine, 80 background [Grotstein], 200
dual [Jung], 5 constancy
fear of suffocating, and asthma, alternatives to, 93fF
80 and individuation, 89-99
gleam in eye of [Kohut], 143, 152 internal
good and bad [Jung], 5 collated [Khan], 287, 288
great, 271-73 dominant, emergence of
stage, 214 [Teruel], 298
imago and father imago, good [Klein], 97
integration of, 39 lack of, 110
-infant relation [Jung], 5 relations
need to separate from [Jung], 5 model, 159
phallic, 268-72 psychology [Jung], 5
role of in depression, 23-43 lack of, and narcissism, 102,
as self-object [Fordham], 115 103
-therapist, see therapist, mother­ transitional [Winnicott], 92
-vessel-self archetype, 217 oedipal triangle [Freud], 5
mourning, mother's, pathological old age, analysis in, 327-45
influence of, 23-43 economic considerations, 329-33
Munch, E., 83 omnipotence, illusion of, 35
mysterium coniunctionis, 39-42 opposites
myth, as guide to analytical theory of [Jung], 118
treatment [Jung], 112 warring and combining, 213-26
order, central archetype of
narcissism [Fordham], 146
clinical manifestations, 104-11 over-stimulation, 45-70
cosmic [Kohut], 145 and alcohol use, 59-62
definition, 102 definition [Jung, Kohut], 46
and Jungian self and primal self, and depressive defence, 45-70
31 fear of, 54-56
induced by gratitude, 66-68
INDEX 353

in the transference, 56-62 projective identification

Ovid, 112-13 [Jung], 6
and analyst's powerlessness, 35
and over-stimulation, 56
Padel, J . , 112 Proust, M., 262
Paracelsus, 41 pseudo-health, 214, 218
paradox psyche
of borderline patient, 188-89 dissociability of [Jung], 92
sense of, 181-84 geography of [Jung], 280
parents, devouring, and narcissism, psychic development, uroboric stage
108 of [Neumann], 214
part objects, 93fT psychic structure, psychopathology,
comparable to luminosities, 95 15
functioning on basis of, 281-83 psychic totality, feeling of, and
participation mystique [Jung], 5-6, gratitude [Jung], 67
26 psychopathology, 6-10
persecution, victims of, and and culture, 18-19
analysis, 310-26 dialectical, 12
persona, regressive restoration of [Jung], 13-15
[Jung], 49-50, 68 modes of, 15-18
personality objections to, 7
borderline, 157-204 use of labels in, 8
schizoid, 127-37 psychosis, 213-26
and introversion, difference chronic, treatment of, 205-12
between, 127-37 [Jung], 4
phallus, worship of [Jung], 93-95 psychogenic causation of [Jung], 4
phantasies transference, 164
of anxious and angry patient, psychotic patients,
32-33 countertransference
grandiose, 45 towards, 223-25
Plato, 293 puer } 330
Plaut, F., xi, 78, 89-99 Ipuella, 327-28
playfulness, 171, 183
[Kohut], 140 Radin, P., 340
[Winnicott], 248 rebis, 162, 171
pleasure principle, 182 Redfearn, J . , xi, 213-27
position, depressive [Klein], 91, 185 regression, maturation and [Jung],
power, search for, and narcissism, 5
104-5, 112 Reich, W., 218
primal relationship reintegration [Fordham], 103
[Neumann], 142 religious experience
level of, 214 and borderline states, 194-97
primal scene excitement, 219 masochism in, 243-51
primal self [Fordham], 233-34 religious motifs and clinical
primary identity [Jung], 5 material, 4, 5
process, symbolic, 216 resistances, during analysis
processes [Greenson], 13
deintegrati ve—reintegrati ve, Robinson, Ch., 205-12
archetypal, 230 robot personality and ego defence,
tertiary [Green], 202 111
professionalism and poesy, split Rolandi, E . , 84
between, 9-10 Rosenbaum, C , 8, 10
projection, 27 Rosencreutz, C , 41
354 INDEX

Rupp, P. H., 208 Spielrein, S., 241

spirit and matter, dissociation
sacrifice, in religious experience, between [Jung], 39
244 splitting, 91-92
Samuels, A., xi, 1-21, 23-24, 45-46, defences, 109-10, 215
71-72, 89-90, 101-2,127­ mother and [Jung], 5
28,139-40,157-58, 205, stammer, as manifestation of ego
213-14, 229, 237-38, 255­ defence, 111
56, 275-76, 291, 309-10, Stein, L . 235, 292
f

327-28 Stoller, R., 255

Sartre, J.-P., 239 Storr, A., xi, 16, 255-74
Schafer, R., 126 Strauss, E . , 262, 264
Schenk, K , 85 structure, psychic, and
schizoid personality, 127-37 psychopathology, 15
and introversion, difference success and over-stimulation, 46-51
between, 127-37 super-ego, idealization of [Kohut],
schizoid, workable [Kettner], 131 144
schizophrenia, 234 symbolic attitude, to depressed
[Jung], 3-4 patient, 32
schizophrenic communication, symbolism, alchemical [Jung], 197,
decoding of, 4 198
Schreber, D. P., 229-36, 278 symbolizing, difficulty with, 110-11
Schwaber, E . , 103, 116, 117 synthetic method [Jung], 17-18
Schwartz-Salant, N., xi, 31, 157­
204 technique, therapeutic, Freudian vs.
Searles, H., 12-13, 180-81, 220 Jungian, 334
seduction, by analyst, fear of, 57 techniques, healing, 34-38
Segal, H., 97,118 Tedeschi, G., 317-18, 323-24
self teleology, emphasis on [Jung], 17
coherent [Kohut], 145 temenos, of personal relationship,
evolution of [Kohut], 143 320
defences of [Fordham], 116 Teruel, G., 298, 306
disorders of [Jung], 229, 230 tests, psychological, typology and
vs. ego [Hartmann], 141 [Jung], 128
-feeling, 31-34 thanatos, 241, 242, 335
grandiose [Kohut], 153 therapeia, 208
manic and depressive parts of, therapist, mother-, as container,
221-23 216
meaning of [Kohut], 141-42 thinking [Jung], 128
-object relations, primitive, time, desire to reverse, 108-9
234-35 totality, psychic, gratitude and
pathology of, 230 [Jung], 67
transcendent, 200 toxins and psychosomatic disorder
-view, negative, 33 [Bleuler, Jung], 4
Seligman, E . , xi, 71-88 transcendent function, 27
senex, 327-28, 330 transference, 37
sensation [Jung], 128 archetypal, 158
separatio, 40 delusional [Schreber], 229-36
sight, imaginal, 176-77, 200 mirroring [Kohut], 115
Simenhauer, E . , 325-26 projections, 35
soul, loss of [Jung], 162 study of [Jung], 280
space, transitional [Winnicott], 171 transitional phenomena [Winnicott],
creativity of, 183 92
INDEX 355

transvestism, psychopathology of, Virgil, 334

255-74
Trautmann, E . C., 310 Walker, K., 262, 264
travelling, importance of, 155 White, R. B., 233
treatment, of borderline psyche, Wilde, 0., 328
197-202 Wilke, H.-J., 80
trickster figure and masochism Williams, M., xii, 194-95, 241, 291­
[Jung], 253-54 307, 321-23, 325-26
typology, psychological [Jung], 128, wings, symbolic significance of,
130, 133 93-95
Winnicott, D. W., 92, 182, 248, 323
unconscious identification, 26 Winnik, H. Z., 315
union Wolf, E., 115
experience, 198-99 word association, use of, 4
and separation, archetypal work block and narcissism, 111, 122
aspects of, 215
uroboros, level of, 214-15
Yates, P., 41
veneration and worship, archetypal
need for, 237-54 Zoja, L., xii, 19, 327-45
Venzlaff, U., 310 Ziirichberg Clinic, description,
via negativa [Nicholas of Cusa], 188 206-7
1
The latest addition t o t h e Library o fAnalytical Psychology
is a n o u t s t a n d i n g c o l l e c t i o n o f p a p e r s w r i t t e n b y J u n g i a n
analysts f r o m different schools o f analytical psychology o n
various aspects o f psychopathology. T h e subjects covered
include depression, anorexia, schizoid personality, narcis­
sistic p e r s o n a l i t y disorder, mania, psychosis, paranoia,
masochism, fetishism, transvestism, perversion, marital
dysfunction, survivor syndrome, and o l d age.

The b o o k is i n t e n d e d t o appeal b e y o n d t h e Jungian

community, andt h eeditor's introductory remarks which
precede each paper highlight ( a n d w h e r e necessary explain)
concepts a n d a t t i t u d e s w h i c h seem special t o analytical
psychology. I n this way, asw i t h A n d r e w Samuels previous 9

e d i t e d v o l u m e T h e Father: Contemporary Jungian Perspec­

tives, psychoanalytically a n d eclectically orientated
practitioners canmake full useo f this book.

The papers i n this volume contain a wealth o f clinical

knowledge - pragmatic, flexible, disposable, b u t above all
r o o t e d i n w h a t actually happens i n analysis.

'What is m o r e , a l t h o u g h these papers speak t o discrete

p a t h o l o g i e s , i t is m y c o n t e n t i o n t h a t t h e w r i t e r s have, as a
group, achieved a difficult balancing a c tb e t w e e n t h e claims
of t h e individual, t h e soul a n dt h e imagination - a n d t h e
claims o f t h e t y p i c a l ,t h e professional a n dt h e clinical t a s k o f
healing.'

A n d r e w Samuels f r o m I n t r o d u c t i o n

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