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Anaclisis: The interdependency between body and mind
International Congress Series 1286 (2006) 175 – 182
www.ics-elsevier.com
Anaclisis: The interdependency between body and mind Ioannis Vartzopoulos * Sitakis 30, 11142 Athens, Greece
Abstract. The body–mind question is examined from the aspect of continuity versus dichotomy. The concepts of body Ego, buseQ of the body and psychosomatic illness offer, among others, the ground for the investigation of this question. Some aspects of a borderline patient’s psychoanalysis are presented supporting the view of a functional continuity between body and mind both on the figurative and the functional level. The analysand’s olfactory hallucination was regarded as condensation of the primal scene and manifestation of the body Ego. His bodily manifestations were not considered as solely regressive phenomena, rather they seem to constitute the underpinning of psychic functioning. The psychosomatic illness suggested an interdependency between body and mind via conflict and unconscious fantasy. The concept of anaclisis as denoting the functional continuity between body and mind seems to be of pivotal importance in the course of this psychoanalysis. D 2005 Elsevier B.V. All rights reserved. Keywords: Anaclisis; Body; Mind; Body Ego; Psychosomatic illness
1. Introduction Anaclisis constitutes a fundamental concept of psychoanalysis pointing to the convergence that exists between the workings of the mind and those of the body. Anaclisis specifically denotes the dependence of the mind on the body in the sense that the mind takes the shape and the function of an important biological function. Anzieu [1], among others, offered an illuminating illustration of the interrelation between body and mind. Anzieu considers that the psychic Ego is immersed in and supplied by the body Ego. The skin Ego, his main theoretical position, refers to an image that the child’s nascent Ego uses during the early stages of development to represent itself on the basis of the child’s experiences with the surface of the body. It corresponds to the period of development in * Tel.: +30 2106820164; fax: +30 2106820164. E-mail address: [email protected]. 0531-5131/ D 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.09.058
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which the psychic Ego becomes differentiated from the body Ego on the functional level, but remains confounded with it on the figurative level. The psychic Ego assumes functions (functional level) representing the direct translation of skin functions in the psychic processes, retaining, at the same time, the configuration (figurative level) of the body surface that holds in, marks the boundary with the outside and is a place and principal means of exchange with others. In this regard, the skin Ego occupies the place of representation and simultaneously promotes the sense of a protective envelope and a stabilizing image. The relationship between the body Ego and the psychic Ego has been presented in the work of many psychoanalysts from a developmental point of view. Hoffer [2,3] postulates that the primal sensation of self is conveyed by the relationship between hand and mouth. The simultaneous excitation of the oral cavity and the proprioceptive sensations of the hand, which is placed in the mouth and provides oral satisfaction and tension discharge, is a first accomplishment of the nascent Ego, forms a first Ego nuclei and offers us an initial picture of intentionality. In this way the Ego emerges on the surface of the body and appropriates ways of lessening tension. Greenacre [4] has drawn attention to the fact that through moving its hands and looking at them, the infant establishes a first rudimentary awareness of the sense of self. In a similar vein, Weil [5] regards the dawning Ego as emerging in the interface between congenitally given trends, i.e. the basic core and early experiential factors. In borderline patients, we often encounter difficulties in differentiating the manifestations of the body from those of the mind. The insights gained by psychoanalysts in their efforts to treat psychoanalytically borderline patients helped us enrich our understanding of the body–mind interdependency. Kernberg [6] resorted to the concept of affect in order to place emphasis on the interface between body and mind. Green [7] considered drive as an inchoate mode of thinking. Fonagy and Target [8] brought to the fore the idea that in borderline patients the representations reside in the body and consequently the stage of the body could literally be used to express psychic conflicts. In the case report that follows, some aspects of a borderline patient’s psychoanalysis will be presented to illuminate the interrelation between body and mind. 2. Case report The body had an important presence in the psychic life of the analysand. His weak somatic idiosyncrasy and the tuberculosis transmitted to him by his father contributed to the establishment of the way he viewed himself and his peers. He felt incapable of joining in with his peers and angry with his parents, whom he considered responsible for his weakness (in a sense it was true because of the transmission of the tuberculosis). He envied his peers for being able to enjoy life. The overprotective attitude of his parents obliged him to watch them from the window of his house playing on the courtyard. The angry and indignant attitude towards his parents evolved to a kind of a demanding indolence on his part under the rubric: bI deserve to remain inert and enjoy everything I would have enjoyed if I hadn’t had the weak idiosyncrasy that you bequeathed meQ. The analysand’s attitude was resonant with a commensurably demanding attitude on his father’s part towards his own family due to the tuberculosis his father has suffered. His
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father demanded a considerable part of the family’s heritage because of his illness. He gave up every effort to actively earn his living and secured his survival by profiting through successfully trading his inherited property. What his father was successful in by following a policy of good relations to his relatives, the analysand requested in a direct and demanding manner. To his father’s leading attitude: bmy body is incapable of doing anything, I ask you to help meQ, he juxtaposed: bmy body is incapable of doing anything because of you, you are obliged to support me for a life timeQ. The analysand spent many hours in the company of his father, his body has developed a harmonious rapport to his father’s body. They used to lie for hours on their sofas without talking to each other, since it often led to horrible arguments. They compensated their common withdrawal from active life with a shared sense of arrogance. They had the feeling that their distanced attitude from real life bestowed them with an innovative and advantageous approach to the matters of life, especially when it was compared to others, who were more overburdened with everyday affairs. Concomitantly they shared a common envy towards others because they did not enjoy what the others could. As a result they did not manage to build up genuine object relations. His love life was characterized by superficial relationships and cynicism towards his sexual partners, whom he exclusively treated as objects of discharge of his sexual arousal. The sadistic tinge of his sexual behavior helped him intensify the sensations within his body. In this way he promoted a sense of aliveness of his own body. When he did not succeed in it, he confronted the resulting discomfort with heavy smoking, excessive alcohol consume and illegal substance abuse. This way of viewing himself and others influenced the development of the transference in this psychoanalysis. The analysand placed his body on the couch near the analyst’s body as he used to place his body near his father’s body. The demanding resignation towards a father who could and ought provide him with everything he needed, offered the ground for the development of an idealized transference. The psychoanalyst should be able to meet the analysand’s expectations and offer him what the alcohol, drugs and heavy smoking used to offer him till then. The psychoanalyst’s thoughts and interpretations should help the analysand maintain a warm and genuine attitude towards his psychoanalyst. The analysand, in a way preempting the positive outcome of the psychoanalysis, improved considerably his somatic performance. Despite the obvious improvement of his physical abilities, the feelings of anhedonia, boredom and frustration persisted. He tried to resist these feelings by renting a modern and expensive house. The owners gave him the impression of a harmonious couple who tried to meet his demands as best as they could, some of which, as he confessed, were at times exaggerated. The body of the analysand once again made its presence obvious and defined developments. The more the owners responded to his demands, the more he had the sense that the house smelled badly. The smell gradually became pungent, intolerable, and permeated his body. Eventually he felt the smell captivated him, drowned him, and to escape it he decided to sublet the apartment. To his great surprise the young couple that rented the apartment did not notice a smell. This shook his self-confidence even more, and the confidence in his analyst. He felt his analyst had let him down, had betrayed him. The smell restrained him from making a step forward in life, as the analyst did not help him just as his father had not during his adolescence. The analyst had the capacity to do so but did not, just as his father had had
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the capacity to help, but did not. An idealized analyst with intense feelings of rejection towards his analysand. The feelings of rejection led him to associate to a childhood memory which held the characteristics of the primal scene, where the smell had an important presence once again. When he entered his parents’ bedroom he was aware of an intense, repulsive smell. He was unable to recall other images of his parents except their stern, rejecting attitude towards him. All other aspects of their relationship, the characteristics of their personality, and all the aspects of his relationship with them, condensed into the olfactory sense of a repulsive smell. As the analysand said: bIt was the same smell. It prevented me from enjoying the new house. It was not the same for the young couple who rented the house afterwards. They were able to enjoy it. Again I was excluded. The smell condensed the multi-sided, multi-dimensional aspect of the primal scene to a single dimension, as it did the position of the analysand towards it. The intense smell which brought his parents together and kept him apart, allowed the young couple to rent the house and excluded him from enjoying it. The analysand could not allow himself anymore to rest side by side with the analyst, as he had done with his father’s body and engaged in the search for alternative means to support his faltering Ego. In one of his homosexual encounters, without being able to recall exactly how, he found himself in the passive position, whereas his initial intention had been the active role. bI realized this was what you wantedQ, his homosexual partner had said to him. He said, he did not fear he might be homosexual. What destabilized him was the loss of his limits, the diffusion of his identity between active–passive, homosexual–heterosexual. His concern about homosexuality brought to mind the association of the rectal functions and of the other bodily functions and their role in his life. His body that remained motionless for hours on the bed or the couch came to life only for his bodily needs. The functions of his body reminded him of his existence, they offered him a sense of cohesion. In contrast his thoughts plunged him deeper into a state of paralysis and stillness. Eventually he was unable to recall his thoughts. In reality he could not recall if there were any thoughts. In a state of desperation and rage he said: bI wish my thoughts were like faeces. Faeces are solid, they have weight, they smell. My thoughts get lost without leaving any trace behind.Q Further on he went back to his experience with the homosexual saying: bI hadn’t thought of the possibility of a homosexual contact. The presence of his phallus in my rectum filled me. It gave me a solid sense. I’d like to keep that sense. I haven’t felt as filled before, or now. I am abiding for so long with you. You never made me feel that way.Q The analysand blamed me of not being as perceptive as his homosexual partner. Although he was coming closer to me metaphorically in the transference and made me feel the weight of his body in the countertransference, I was not taking the initiative of filling him. I failed to respond to his homosexual expectations, the way his homosexual partner did. The faeces that come from within and his partner’s phallus that comes from without, provided him with a sense of self-identity and self-cohesion, that his relationship with me was unable to convey. In the symbolic equation, penis = thought = faeces and penetration = dialogue and in the projective mechanism that gave me the omnipotence of having the power to fill him but which selfishly I did not, I answered: bIt seems to me as if you were expecting my thoughts to enter you and to fill you. You perceive me as being as strong as you had thought your father was during your teens. Just one of his thoughts or his words
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were able to save or destroy your life, to fill you or empty you.Q Thoughts and words were perceived by the analysand mainly as bodily products, as having a direct influence on the analysand’s body, producing bodily sensations. The ideational content of thoughts and words has lost its capacity to stimulate the analysand’s mental apparatus. The analysand initially seemed to benefit from this line of interpretation and responded starting a heterosexual relationship. The object of love, strongly idealized, had the possibility of extracting him from his everyday misery and of giving his life value and content. It differed from other relationships whose sole purpose had been the relief of sexual tension. His girlfriend worked for a while abroad and they had planned their vacations together, when she would have returned. The more he experienced his desire for this woman and the more the date of departure grew closer, and despite the positive attitude of his girlfriend, or maybe because of it, he developed asthmatic bronchitis with a very difficult and lengthy course, due to which he cancelled his trip and drew away from the lady. The prospect of proximity to the object of his desire was prohibitive. The analysand told me that he was deeply disappointed in me. I did not help him with this relationship that would have changed his life, that would have offered him all he had ever wanted and had never had. He felt alone, my presence being indifferent to him. In fact he was about to give up psychoanalysis. Oddly enough I had a feeling in the opposite direction, a sense of suffocating embracement. I had the feeling that he was holding onto me, he was grasping me in a state of desperation. I interpreted to him that in his understanding the bronchitis did not allow him to leave with his girlfriend, held him back, close to me. He replied after a pause: b I was afraid, I was not going to live up to her expectations. At least here I feel secure, I can give up thinkingQ. Further on he said that his failure to depart with his girlfriend made him feel defeated, fearful, unable to lead an autonomous life. He was driven to the shameful position of being dependent on me. Fear and shame transformed his anger into resignation and immobilized him. His immobilized body along with my immobilized body offered him a sense of relief. It allowed him to bear the fantasy that he was one with me, merged with my body. His body was unable to sustain his feelings, it needed the support of my body to perform this task. The perspective heterosexual experience placed a challenge on his body, which led to the homosexual passive position, a position he had also adopted in his homosexual encounter. Everything that indicated the fragile character of the union of his body with my body was threatening to him. It was the end of each session that separated us. The analyst’s thoughts certified his otherness. He associated that when he suffered TB he had experienced analogous feelings towards his father in his youth as he lied next to him. The denigration he felt for his body brought his mother’s look to his mind, with regard to his bodily functions. He recalled that his mother expressed great disgust and rejection towards his body products, towards his sweat or his soiled underwear. That look held him captive, obliged him to feel alienated from his body and his body products. The searching, sadistically aroused and profoundly rejecting look of his mother when it encountered his body, his body products or his clothes, accompanied him even when he fulfilled his bodily needs. Ultimately her look was also his look towards his body and his body functions. He then talked about the fear he felt over the bodily functions he could not control. The natural mobility of his intestine and the sounds produced, terrified him. He mentioned his homosexual experience and said that, as he now understood things, the entry of the penis
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into his intestine showed him that his intestine was not completely autonomous, that he could control it, even through the intervention of another body. The phallic penetration gave the analysand a sense of stability and cohesion, intimacy with his own body, even at the cost of having to surrender this important ego function to the phallic partial object of another. A relationship of dependence that deters disorganization. Just as the hostile dependence on the father stabilized his life. Further on he referred to his feelings during periods of prolonged silence when he could hear the sounds from my intestine. They frightened him and he felt I was attacking him. My borborygmic sounds affected directly the analysand as he seemed to respond to them by moving himself nervously on the couch. He tried to connect them to the sounds of his intestine. Whether they preceded, followed, or were in question or response to his own. To my interpretation: bit’s as if we talked with our intestines and not with our mindsQ, he responded that he had never understood the way in which the functions of the mind differed from the functions of the intestine. As he said in his own words: bat the end of the day they have the same shit in themQ, I replied: bIt seems we have something in common. You have your intestine and I have mine. It keeps us in contact and apart alikeQ. Later on responding to a borborygmic sound of mine he said: P: Your intestine can’t pretend. It says to me that you are close enough and in a safe distance. It’s different with your words. They enter my body and make me feel awkward. A: You tolerate my physical presence, although at a distance. You don’t tolerate my words, even at this distance. You are afraid that my words will treat you badly. P: I have to rely on myself. What came from without was always painful to me. Along similar lines the analysand gradually realized that he was projecting onto me the condensed, rejecting figure of his parents. He was oscillating between a fantasy of merging with my body in an effort to stabilize his self-representation and a feeling of my body as intruding, inimical to him. These developments gradually facilitated the establishment of a rudimentary sense of Self with a demarcation of the body boundaries and of the psychic functions as is shown in the following dream bHe was in a house with many rooms and was successively opening doors in search of somebody. One of the doors he opened was the toilet of the house upon which the analyst was sitting satisfying his natural needs. He felt extremely embarrassed and stood still not knowing what to do. The analyst looked at him with no surprise. The analysand closed the door and went towards an adjacent room which was the analyst’s office.Q In the dream the bodily functions of the analyst had been separated from the bodily functions of the analysand and took place separately, at least to a point, free of the constraints exerted by the projective mechanisms. It also became obvious that psychoanalysis was a talking cure, the analyst’s office being a space with distinct features in terms of his bodily functions. This period coincided with remission of the asthmatic bronchitis. At the beginning of the psychosomatic illness we encountered a massive resomatisation of affect caused by the decathexis of the idealized object, the de-libinisation of aggressiveness and the surplus of the destructive aggressiveness that broke into the world of internalized object relations of the analysand, the result being the psyche transforming into body. The analytic work, as shown in the dream, gradually led to a distinction between the functions of the psyche and the body and the remission of psychosomatic symptoms.
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3. Discussion The concept of anaclisis points to a mode of morphological and functional connection between the body and the mind. The analysand found in the intense smell and in the weight of the faeces the somatic support and the morphological analogy of his disorganized thoughts when his thinking apparatus was decathected. In the intestine which moves, produces sounds and through these sounds communicates, the moving and communicative thinking found its functional support. The symbolic equation between thought and faeces is not only a point of regression and loss of the characteristics of thought, but also of support and maintenance of those somatic referrals that retain a feeling of cohesion and continuity of thought. The body and its functions present themselves as guarantee, in general and not only through the symbolic equation, of the psychic functions at times of psychic disorganisation. The repulsive odour expresses, through condensation, the polymorphic primal scene. The repulsive character of the smell refers to the aggressive feelings of the analysand. The primitive character of the olfactory sense, in comparison to the visual or auditory senses that have greater distinctive capacity, expresses the incapacity of the analysand to specify his position in the primal scene and the disorganization of his object relations. The observation of the body and its functions as genuine phenomena of the analytic process allows us the possibility to follow the sequence of psychoanalysis in situations of great regression. The symmetry between intestine and thought contributed to the preservation of continuity in his thought. The symmetry between the intestine of the analyst and the intestine from the analysand preserved the flow of the analytic dialogue. The psychosomatic disorder presented when the analysand approached the object of his desire under the unconscious phantasy that his body was not worth loving, it has never been loved. In the transference of the same period there was a sense that the idealized analyst was not executing his role. The course of this psychoanalysis supports theories that give priority to conflict and unconscious phantasy as opposed to defect in the aetiology of psychosomatic illness. The ailing body, the inadequate body shapes the transference of the analysand and becomes the venue of gaining access to important aspects of his psychoanalysis which otherwise would have gone unnoticed. The prospect of convalescence and virility through the fertilization of the idealised psychoanalyst’s phallus comparing with what he wished for but he had never got by the consumptive and tuberculous phallus of his father, offered the ground for the working through of the analysand’s Ego fragility. It was the prospect of empowering a sense of Self which had not the benefit of the vivifying influence of his parent’s smell. The smell did not embrace the analysand to a sufficient degree to form a protective skin, since his parents had relegated him from the conjugal bed. The repungent smell relegates him from the rented house, it has been transformed to an assailing object. The young couple simply did not notice the smell, they have internalized its benevolent aspect, they are identified with it. The transformation of an active, homosexual intention to a passive acceptance of a phallus incapable of fertilizing, just filling in an orifice, characterizes the transference at the beginning of this psychoanalysis. The analysand’s exposure to the object of his desire, did not encounter the appropriate internalized object relations to enhance the chances of a
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positive outcome and finally resulted to the psychosomatic illness. The analysand’s body deprived from his mentalising extentions, turns to a devitalized body clinging to the psychoanalyst’s body. The question of detachment without fatal bleeding remains open to further investigation. References [1] D. Anzieu, Skin Ego, in: S. Lebovici, D. Widlo¨cher (Eds.), Psychoanalysis in France, Int. Univ. Press, New York, 1980. [2] W. Hoffer, Mouth, hand and ego—integration, Psychoanal. Study Child 3–4 (1949) 49 – 56. [3] W. Hoffer, Development of the body-ego, Psychoanal. Study Child 5 (1950) 18 – 24. [4] P. Greenacre, Considerations regarding the parent–infant relationship, Int. J. Psychoanal. 41 (1960) 571 – 595. [5] A.-M. Weil, The basic core, Psychoanal. Study Child 25 (1970) 442 – 460. [6] O. Kernberg, Self, ego, affects and drives, J. Am. Psychoanal. Assoc. 30 (1982) 898 – 917. [7] A. Green, Affect and representation, Int. J. Psychoanal. 80 (1999) 277 – 315. [8] P. Fonagy, M. Target, Understanding the violent patient. The role of the father, Int. J. Psychoanal. 76 (1995) 487 – 502.
www.ics-elsevier.com
Anaclisis: The interdependency between body and mind Ioannis Vartzopoulos * Sitakis 30, 11142 Athens, Greece
Abstract. The body–mind question is examined from the aspect of continuity versus dichotomy. The concepts of body Ego, buseQ of the body and psychosomatic illness offer, among others, the ground for the investigation of this question. Some aspects of a borderline patient’s psychoanalysis are presented supporting the view of a functional continuity between body and mind both on the figurative and the functional level. The analysand’s olfactory hallucination was regarded as condensation of the primal scene and manifestation of the body Ego. His bodily manifestations were not considered as solely regressive phenomena, rather they seem to constitute the underpinning of psychic functioning. The psychosomatic illness suggested an interdependency between body and mind via conflict and unconscious fantasy. The concept of anaclisis as denoting the functional continuity between body and mind seems to be of pivotal importance in the course of this psychoanalysis. D 2005 Elsevier B.V. All rights reserved. Keywords: Anaclisis; Body; Mind; Body Ego; Psychosomatic illness
1. Introduction Anaclisis constitutes a fundamental concept of psychoanalysis pointing to the convergence that exists between the workings of the mind and those of the body. Anaclisis specifically denotes the dependence of the mind on the body in the sense that the mind takes the shape and the function of an important biological function. Anzieu [1], among others, offered an illuminating illustration of the interrelation between body and mind. Anzieu considers that the psychic Ego is immersed in and supplied by the body Ego. The skin Ego, his main theoretical position, refers to an image that the child’s nascent Ego uses during the early stages of development to represent itself on the basis of the child’s experiences with the surface of the body. It corresponds to the period of development in * Tel.: +30 2106820164; fax: +30 2106820164. E-mail address: [email protected]. 0531-5131/ D 2005 Elsevier B.V. All rights reserved. doi:10.1016/j.ics.2005.09.058
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I. Vartzopoulos / International Congress Series 1286 (2006) 175–182
which the psychic Ego becomes differentiated from the body Ego on the functional level, but remains confounded with it on the figurative level. The psychic Ego assumes functions (functional level) representing the direct translation of skin functions in the psychic processes, retaining, at the same time, the configuration (figurative level) of the body surface that holds in, marks the boundary with the outside and is a place and principal means of exchange with others. In this regard, the skin Ego occupies the place of representation and simultaneously promotes the sense of a protective envelope and a stabilizing image. The relationship between the body Ego and the psychic Ego has been presented in the work of many psychoanalysts from a developmental point of view. Hoffer [2,3] postulates that the primal sensation of self is conveyed by the relationship between hand and mouth. The simultaneous excitation of the oral cavity and the proprioceptive sensations of the hand, which is placed in the mouth and provides oral satisfaction and tension discharge, is a first accomplishment of the nascent Ego, forms a first Ego nuclei and offers us an initial picture of intentionality. In this way the Ego emerges on the surface of the body and appropriates ways of lessening tension. Greenacre [4] has drawn attention to the fact that through moving its hands and looking at them, the infant establishes a first rudimentary awareness of the sense of self. In a similar vein, Weil [5] regards the dawning Ego as emerging in the interface between congenitally given trends, i.e. the basic core and early experiential factors. In borderline patients, we often encounter difficulties in differentiating the manifestations of the body from those of the mind. The insights gained by psychoanalysts in their efforts to treat psychoanalytically borderline patients helped us enrich our understanding of the body–mind interdependency. Kernberg [6] resorted to the concept of affect in order to place emphasis on the interface between body and mind. Green [7] considered drive as an inchoate mode of thinking. Fonagy and Target [8] brought to the fore the idea that in borderline patients the representations reside in the body and consequently the stage of the body could literally be used to express psychic conflicts. In the case report that follows, some aspects of a borderline patient’s psychoanalysis will be presented to illuminate the interrelation between body and mind. 2. Case report The body had an important presence in the psychic life of the analysand. His weak somatic idiosyncrasy and the tuberculosis transmitted to him by his father contributed to the establishment of the way he viewed himself and his peers. He felt incapable of joining in with his peers and angry with his parents, whom he considered responsible for his weakness (in a sense it was true because of the transmission of the tuberculosis). He envied his peers for being able to enjoy life. The overprotective attitude of his parents obliged him to watch them from the window of his house playing on the courtyard. The angry and indignant attitude towards his parents evolved to a kind of a demanding indolence on his part under the rubric: bI deserve to remain inert and enjoy everything I would have enjoyed if I hadn’t had the weak idiosyncrasy that you bequeathed meQ. The analysand’s attitude was resonant with a commensurably demanding attitude on his father’s part towards his own family due to the tuberculosis his father has suffered. His
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father demanded a considerable part of the family’s heritage because of his illness. He gave up every effort to actively earn his living and secured his survival by profiting through successfully trading his inherited property. What his father was successful in by following a policy of good relations to his relatives, the analysand requested in a direct and demanding manner. To his father’s leading attitude: bmy body is incapable of doing anything, I ask you to help meQ, he juxtaposed: bmy body is incapable of doing anything because of you, you are obliged to support me for a life timeQ. The analysand spent many hours in the company of his father, his body has developed a harmonious rapport to his father’s body. They used to lie for hours on their sofas without talking to each other, since it often led to horrible arguments. They compensated their common withdrawal from active life with a shared sense of arrogance. They had the feeling that their distanced attitude from real life bestowed them with an innovative and advantageous approach to the matters of life, especially when it was compared to others, who were more overburdened with everyday affairs. Concomitantly they shared a common envy towards others because they did not enjoy what the others could. As a result they did not manage to build up genuine object relations. His love life was characterized by superficial relationships and cynicism towards his sexual partners, whom he exclusively treated as objects of discharge of his sexual arousal. The sadistic tinge of his sexual behavior helped him intensify the sensations within his body. In this way he promoted a sense of aliveness of his own body. When he did not succeed in it, he confronted the resulting discomfort with heavy smoking, excessive alcohol consume and illegal substance abuse. This way of viewing himself and others influenced the development of the transference in this psychoanalysis. The analysand placed his body on the couch near the analyst’s body as he used to place his body near his father’s body. The demanding resignation towards a father who could and ought provide him with everything he needed, offered the ground for the development of an idealized transference. The psychoanalyst should be able to meet the analysand’s expectations and offer him what the alcohol, drugs and heavy smoking used to offer him till then. The psychoanalyst’s thoughts and interpretations should help the analysand maintain a warm and genuine attitude towards his psychoanalyst. The analysand, in a way preempting the positive outcome of the psychoanalysis, improved considerably his somatic performance. Despite the obvious improvement of his physical abilities, the feelings of anhedonia, boredom and frustration persisted. He tried to resist these feelings by renting a modern and expensive house. The owners gave him the impression of a harmonious couple who tried to meet his demands as best as they could, some of which, as he confessed, were at times exaggerated. The body of the analysand once again made its presence obvious and defined developments. The more the owners responded to his demands, the more he had the sense that the house smelled badly. The smell gradually became pungent, intolerable, and permeated his body. Eventually he felt the smell captivated him, drowned him, and to escape it he decided to sublet the apartment. To his great surprise the young couple that rented the apartment did not notice a smell. This shook his self-confidence even more, and the confidence in his analyst. He felt his analyst had let him down, had betrayed him. The smell restrained him from making a step forward in life, as the analyst did not help him just as his father had not during his adolescence. The analyst had the capacity to do so but did not, just as his father had had
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the capacity to help, but did not. An idealized analyst with intense feelings of rejection towards his analysand. The feelings of rejection led him to associate to a childhood memory which held the characteristics of the primal scene, where the smell had an important presence once again. When he entered his parents’ bedroom he was aware of an intense, repulsive smell. He was unable to recall other images of his parents except their stern, rejecting attitude towards him. All other aspects of their relationship, the characteristics of their personality, and all the aspects of his relationship with them, condensed into the olfactory sense of a repulsive smell. As the analysand said: bIt was the same smell. It prevented me from enjoying the new house. It was not the same for the young couple who rented the house afterwards. They were able to enjoy it. Again I was excluded. The smell condensed the multi-sided, multi-dimensional aspect of the primal scene to a single dimension, as it did the position of the analysand towards it. The intense smell which brought his parents together and kept him apart, allowed the young couple to rent the house and excluded him from enjoying it. The analysand could not allow himself anymore to rest side by side with the analyst, as he had done with his father’s body and engaged in the search for alternative means to support his faltering Ego. In one of his homosexual encounters, without being able to recall exactly how, he found himself in the passive position, whereas his initial intention had been the active role. bI realized this was what you wantedQ, his homosexual partner had said to him. He said, he did not fear he might be homosexual. What destabilized him was the loss of his limits, the diffusion of his identity between active–passive, homosexual–heterosexual. His concern about homosexuality brought to mind the association of the rectal functions and of the other bodily functions and their role in his life. His body that remained motionless for hours on the bed or the couch came to life only for his bodily needs. The functions of his body reminded him of his existence, they offered him a sense of cohesion. In contrast his thoughts plunged him deeper into a state of paralysis and stillness. Eventually he was unable to recall his thoughts. In reality he could not recall if there were any thoughts. In a state of desperation and rage he said: bI wish my thoughts were like faeces. Faeces are solid, they have weight, they smell. My thoughts get lost without leaving any trace behind.Q Further on he went back to his experience with the homosexual saying: bI hadn’t thought of the possibility of a homosexual contact. The presence of his phallus in my rectum filled me. It gave me a solid sense. I’d like to keep that sense. I haven’t felt as filled before, or now. I am abiding for so long with you. You never made me feel that way.Q The analysand blamed me of not being as perceptive as his homosexual partner. Although he was coming closer to me metaphorically in the transference and made me feel the weight of his body in the countertransference, I was not taking the initiative of filling him. I failed to respond to his homosexual expectations, the way his homosexual partner did. The faeces that come from within and his partner’s phallus that comes from without, provided him with a sense of self-identity and self-cohesion, that his relationship with me was unable to convey. In the symbolic equation, penis = thought = faeces and penetration = dialogue and in the projective mechanism that gave me the omnipotence of having the power to fill him but which selfishly I did not, I answered: bIt seems to me as if you were expecting my thoughts to enter you and to fill you. You perceive me as being as strong as you had thought your father was during your teens. Just one of his thoughts or his words
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were able to save or destroy your life, to fill you or empty you.Q Thoughts and words were perceived by the analysand mainly as bodily products, as having a direct influence on the analysand’s body, producing bodily sensations. The ideational content of thoughts and words has lost its capacity to stimulate the analysand’s mental apparatus. The analysand initially seemed to benefit from this line of interpretation and responded starting a heterosexual relationship. The object of love, strongly idealized, had the possibility of extracting him from his everyday misery and of giving his life value and content. It differed from other relationships whose sole purpose had been the relief of sexual tension. His girlfriend worked for a while abroad and they had planned their vacations together, when she would have returned. The more he experienced his desire for this woman and the more the date of departure grew closer, and despite the positive attitude of his girlfriend, or maybe because of it, he developed asthmatic bronchitis with a very difficult and lengthy course, due to which he cancelled his trip and drew away from the lady. The prospect of proximity to the object of his desire was prohibitive. The analysand told me that he was deeply disappointed in me. I did not help him with this relationship that would have changed his life, that would have offered him all he had ever wanted and had never had. He felt alone, my presence being indifferent to him. In fact he was about to give up psychoanalysis. Oddly enough I had a feeling in the opposite direction, a sense of suffocating embracement. I had the feeling that he was holding onto me, he was grasping me in a state of desperation. I interpreted to him that in his understanding the bronchitis did not allow him to leave with his girlfriend, held him back, close to me. He replied after a pause: b I was afraid, I was not going to live up to her expectations. At least here I feel secure, I can give up thinkingQ. Further on he said that his failure to depart with his girlfriend made him feel defeated, fearful, unable to lead an autonomous life. He was driven to the shameful position of being dependent on me. Fear and shame transformed his anger into resignation and immobilized him. His immobilized body along with my immobilized body offered him a sense of relief. It allowed him to bear the fantasy that he was one with me, merged with my body. His body was unable to sustain his feelings, it needed the support of my body to perform this task. The perspective heterosexual experience placed a challenge on his body, which led to the homosexual passive position, a position he had also adopted in his homosexual encounter. Everything that indicated the fragile character of the union of his body with my body was threatening to him. It was the end of each session that separated us. The analyst’s thoughts certified his otherness. He associated that when he suffered TB he had experienced analogous feelings towards his father in his youth as he lied next to him. The denigration he felt for his body brought his mother’s look to his mind, with regard to his bodily functions. He recalled that his mother expressed great disgust and rejection towards his body products, towards his sweat or his soiled underwear. That look held him captive, obliged him to feel alienated from his body and his body products. The searching, sadistically aroused and profoundly rejecting look of his mother when it encountered his body, his body products or his clothes, accompanied him even when he fulfilled his bodily needs. Ultimately her look was also his look towards his body and his body functions. He then talked about the fear he felt over the bodily functions he could not control. The natural mobility of his intestine and the sounds produced, terrified him. He mentioned his homosexual experience and said that, as he now understood things, the entry of the penis
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into his intestine showed him that his intestine was not completely autonomous, that he could control it, even through the intervention of another body. The phallic penetration gave the analysand a sense of stability and cohesion, intimacy with his own body, even at the cost of having to surrender this important ego function to the phallic partial object of another. A relationship of dependence that deters disorganization. Just as the hostile dependence on the father stabilized his life. Further on he referred to his feelings during periods of prolonged silence when he could hear the sounds from my intestine. They frightened him and he felt I was attacking him. My borborygmic sounds affected directly the analysand as he seemed to respond to them by moving himself nervously on the couch. He tried to connect them to the sounds of his intestine. Whether they preceded, followed, or were in question or response to his own. To my interpretation: bit’s as if we talked with our intestines and not with our mindsQ, he responded that he had never understood the way in which the functions of the mind differed from the functions of the intestine. As he said in his own words: bat the end of the day they have the same shit in themQ, I replied: bIt seems we have something in common. You have your intestine and I have mine. It keeps us in contact and apart alikeQ. Later on responding to a borborygmic sound of mine he said: P: Your intestine can’t pretend. It says to me that you are close enough and in a safe distance. It’s different with your words. They enter my body and make me feel awkward. A: You tolerate my physical presence, although at a distance. You don’t tolerate my words, even at this distance. You are afraid that my words will treat you badly. P: I have to rely on myself. What came from without was always painful to me. Along similar lines the analysand gradually realized that he was projecting onto me the condensed, rejecting figure of his parents. He was oscillating between a fantasy of merging with my body in an effort to stabilize his self-representation and a feeling of my body as intruding, inimical to him. These developments gradually facilitated the establishment of a rudimentary sense of Self with a demarcation of the body boundaries and of the psychic functions as is shown in the following dream bHe was in a house with many rooms and was successively opening doors in search of somebody. One of the doors he opened was the toilet of the house upon which the analyst was sitting satisfying his natural needs. He felt extremely embarrassed and stood still not knowing what to do. The analyst looked at him with no surprise. The analysand closed the door and went towards an adjacent room which was the analyst’s office.Q In the dream the bodily functions of the analyst had been separated from the bodily functions of the analysand and took place separately, at least to a point, free of the constraints exerted by the projective mechanisms. It also became obvious that psychoanalysis was a talking cure, the analyst’s office being a space with distinct features in terms of his bodily functions. This period coincided with remission of the asthmatic bronchitis. At the beginning of the psychosomatic illness we encountered a massive resomatisation of affect caused by the decathexis of the idealized object, the de-libinisation of aggressiveness and the surplus of the destructive aggressiveness that broke into the world of internalized object relations of the analysand, the result being the psyche transforming into body. The analytic work, as shown in the dream, gradually led to a distinction between the functions of the psyche and the body and the remission of psychosomatic symptoms.
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3. Discussion The concept of anaclisis points to a mode of morphological and functional connection between the body and the mind. The analysand found in the intense smell and in the weight of the faeces the somatic support and the morphological analogy of his disorganized thoughts when his thinking apparatus was decathected. In the intestine which moves, produces sounds and through these sounds communicates, the moving and communicative thinking found its functional support. The symbolic equation between thought and faeces is not only a point of regression and loss of the characteristics of thought, but also of support and maintenance of those somatic referrals that retain a feeling of cohesion and continuity of thought. The body and its functions present themselves as guarantee, in general and not only through the symbolic equation, of the psychic functions at times of psychic disorganisation. The repulsive odour expresses, through condensation, the polymorphic primal scene. The repulsive character of the smell refers to the aggressive feelings of the analysand. The primitive character of the olfactory sense, in comparison to the visual or auditory senses that have greater distinctive capacity, expresses the incapacity of the analysand to specify his position in the primal scene and the disorganization of his object relations. The observation of the body and its functions as genuine phenomena of the analytic process allows us the possibility to follow the sequence of psychoanalysis in situations of great regression. The symmetry between intestine and thought contributed to the preservation of continuity in his thought. The symmetry between the intestine of the analyst and the intestine from the analysand preserved the flow of the analytic dialogue. The psychosomatic disorder presented when the analysand approached the object of his desire under the unconscious phantasy that his body was not worth loving, it has never been loved. In the transference of the same period there was a sense that the idealized analyst was not executing his role. The course of this psychoanalysis supports theories that give priority to conflict and unconscious phantasy as opposed to defect in the aetiology of psychosomatic illness. The ailing body, the inadequate body shapes the transference of the analysand and becomes the venue of gaining access to important aspects of his psychoanalysis which otherwise would have gone unnoticed. The prospect of convalescence and virility through the fertilization of the idealised psychoanalyst’s phallus comparing with what he wished for but he had never got by the consumptive and tuberculous phallus of his father, offered the ground for the working through of the analysand’s Ego fragility. It was the prospect of empowering a sense of Self which had not the benefit of the vivifying influence of his parent’s smell. The smell did not embrace the analysand to a sufficient degree to form a protective skin, since his parents had relegated him from the conjugal bed. The repungent smell relegates him from the rented house, it has been transformed to an assailing object. The young couple simply did not notice the smell, they have internalized its benevolent aspect, they are identified with it. The transformation of an active, homosexual intention to a passive acceptance of a phallus incapable of fertilizing, just filling in an orifice, characterizes the transference at the beginning of this psychoanalysis. The analysand’s exposure to the object of his desire, did not encounter the appropriate internalized object relations to enhance the chances of a
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positive outcome and finally resulted to the psychosomatic illness. The analysand’s body deprived from his mentalising extentions, turns to a devitalized body clinging to the psychoanalyst’s body. The question of detachment without fatal bleeding remains open to further investigation. References [1] D. Anzieu, Skin Ego, in: S. Lebovici, D. Widlo¨cher (Eds.), Psychoanalysis in France, Int. Univ. Press, New York, 1980. [2] W. Hoffer, Mouth, hand and ego—integration, Psychoanal. Study Child 3–4 (1949) 49 – 56. [3] W. Hoffer, Development of the body-ego, Psychoanal. Study Child 5 (1950) 18 – 24. [4] P. Greenacre, Considerations regarding the parent–infant relationship, Int. J. Psychoanal. 41 (1960) 571 – 595. [5] A.-M. Weil, The basic core, Psychoanal. Study Child 25 (1970) 442 – 460. [6] O. Kernberg, Self, ego, affects and drives, J. Am. Psychoanal. Assoc. 30 (1982) 898 – 917. [7] A. Green, Affect and representation, Int. J. Psychoanal. 80 (1999) 277 – 315. [8] P. Fonagy, M. Target, Understanding the violent patient. The role of the father, Int. J. Psychoanal. 76 (1995) 487 – 502.