In his Studies on Hysteria (1893–95, p. 291) Freud stated, making use of a New Testament image, that it is as difficult to pass from the uncon- scious to the ‘defile’ of consciousness as for a camel to pass through the eye of a needle: this metaphor, which highlights the dissimilar- ity of the two substances – the physical body and linear, symbolic thought –, seems newly relevant today because it evokes the diffi- culty in passing from the concrete physical body to symbolic thought which we now encounter with increasing frequency in our patients.
Freud (1893–95), in his work with hysterical patients, noticed a con- nection between the body and the unconscious, such that the entry into the conscious of the relevant repressed material made possible the resolution of the physical hysterical symptom. Today we are faced with a widening scope of analytic practice, being more common today to work with more disturbed patients. Consequently we meet clinical situations in which we cannot assume the presence of a clear link between body and mind, as in Freud’s day: a link that seems, in these cases, fraught with obstacles and conflicts which require spe- cific working through (Liebermann 2000; Lombardi 2002; Aisenstein 2006). This peculiarity of contemporary clinical practice prompts us to devote particular attention to the body and its place in our idea of the unconscious. In this chapter I shall be drawing inspiration from some of Matte Blanco’s epistemological theories and bi-logic, in order to deal with certain aspects of the mind-body relationship.
In addition to the well-known repressed unconscious, Freud intu- ited the existence of a ‘non-repressed unconscious’, since, for exam- ple, he specifies that ‘the Ucs. does not coincide with the repressed;
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it is still true that all that is repressed is Ucs., but not all that is Ucs.
is repressed’ (1923, p. 18), and he further states that we can look upon
‘an individual as a psychical id, unknown and unconscious’ and that
‘the repressed merges into the id as well, and is merely a part of it’
(1923, pp. 23–24). Freud developed this broader understanding of the unconscious particularly when attempting to describe the more disorganized levels of the mind which are involved in profound emo- tions. More recently Matte Blanco (1975, 1988) developed and sys- tematized Freud’s insight, devising the model of a ‘non-repressed unconscious’ or ‘structural unconscious’ as a normal human mental system which is continuously active and completely impervious to the common coordinates of space and time that organize thought. As I see it, this rearticulation of the idea of the unconscious gives new relevance to Freud’s contribution by relating it more clearly to what we see in today’s patients, who increasingly present strong signs of non-differentiation. In other words, our more serious patients, instead of presenting limited areas of repression and specific defence mecha- nisms (A. Freud 1937), seem, particularly at the beginning of analysis, almost ‘swamped’ by their unconscious, so that a significant part of the analysis consists in activating mental differentiation and organ- izing resources of consciousness. It is no accident that Bion (1962) noticed that the mind needs an orientation (an alpha function) for the unconscious to be able to organize itself and then be subjected to conscious unfolding; such an orientation can by no means be taken for granted.
In this chapter I shall contend that the existence of a non-repressed unconscious, unrelated to the mental categories of space and time, implies that the body itself is originally unknown to the conscious and therefore unrepresentable for the mind. The unfolding of the non-repressed unconscious that takes place in the course of analysis leads to the development of an awareness of the body, and this level, in many serious cases, becomes something requiring psychoanalytic working through more urgently than defences and conflicts of a more developed nature.
Mental processing of the body
The importance for psychoanalysis of the body and the body-mind relationship was obvious to Freud starting as far back as his first study of hysteria (Breuer & Freud 1895), in which the body and somatic
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sensations seemed like a compass that could serve for orientation in the working through. From then on, throughout the course of Freud’s studies the body constantly emerges as an essential reference point that organizes his principal psychoanalytic concepts, from his notion of psychosexuality (1905) and the theory of thinking con- ceived as a function of the containment of somatic discharge (1911), to the concept of instinct as a measure of the ‘demand for work’
that connection with the body makes on the mind (1915a), and to the re-emergence of the ‘enigmatic Ucs.’ in narcissistic psychoneuro- ses, where ‘the whole train of thought is dominated by the element which has for its content a bodily innervation (or, rather, the sensa- tion of it)’ (1915b, p. 198). At a turning point in the 1920s, Freud (1923) declares that ‘the ego is first and foremost a bodily ego’ (p. 26), an idea elaborated in a footnote added to the 1927 English edition and authorized by Freud: ‘the ego is ultimately derived from bod- ily sensations, chiefly from those springing from the surface of the body. It may thus be regarded as a mental projection of the surface of the body’ (p. 26 n.1). Finally, in his last writings in ‘An Outline of Psycho-Analysis’ (1940), Freud states that ‘the physical or somatic pro- cesses . . . concomitant with the psychical ones’ are ‘the true essence of what is psychical,’ thus confirming the fundamental role of bodily sensations for psychoanalysis (p. 158). Many authors other than Freud have investigated the role of the body in psychoanalysis, from Tausk (1933) to Schilder (1950), Scott (1948), Deutsch (1954), and Greena- cre (1971), with more recent contributions from Lichtenberg (1978), Anzieu (1985), Ogden (1989), Meissner (1997, 1998a, 1998b, 1998c), Bion (1979/1988) and Ferrari (2004), who variously underline the importance of the body in mental functioning and the development of object relations.
The characteristics of Matte Blanco’s structural unconscious, which include the unconscious processes being extraneous to space and time, lead to the consequence that unconscious manifestations, in their extreme form, result in the disappearance of that basic human spatio-temporal structure, the body. This absence of bodily space-time that characterizes the unconscious world appears in various known psychoanalytic manifestations, such as the fantasy of not having been born and of still inhabiting the maternal belly, which M. Klein describes (1923/1977, 1928) in small children, or in the omnipotent fantasy of being God, as it appears, for instance, in the case of Schreber (Freud 1910), where God, by definition, is extraneous to the limits of
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space-time and is for this reason, in certain traditions, unrepresentable.
From the point of view of the unconscious, which takes no account of the parameters of logic or reality as they are normally understood, an integrated and ‘embodied’ mental life is by no means to be taken for granted, but is the result of a specific mental development.
a) The invisible man can make his own body visible
‘The child has only her/his body to express mental processes. . . . An inner world begins. The child feels inside his/her body that there are objects, persons and parts of persons, and that they are alive and active and can influence or be influenced by him/her.’ This statement by Paula Heimann (1952, quoted by Matte Blanco 1975, pp. 155–160) receives the following comment from Matte Blanco: ‘It is from this experience of the body and the external world that our psycho- analytic study begins’ (Matte Blanco 1988, p. 143). Interest in the mind-body relationship does not permeate Matte Blanco’s research, but this statement makes explicit his assumption of the importance of the role of the body in clinical and psychoanalytic research.
The body, although it always exists in external reality, comes onto the individual’s horizon only when it becomes in some way an object of mental processing. With regard to indivisibility, which can only be known when clothed in bivalent logic, Matte Blanco, in his work on dreams (1984), refers to Wells’s invisible man, who could only be perceived when dressed. Invisibility obviously refers to the body. If we use the model of the invisible man with reference to the body/mind relationship, we can say that the body can be mentally seen only when clothed in asymmetrical elements: an unfolding which can be brought about by bivalent logic, or through that mixed product of the two logics, bi-logic. In the clinical part of this chapter I shall give some examples of the mind’s discovery of the body. The way mental opera- tions hook onto the physicality of the body is extremely important and can, if neglected, be transformed into a contributing element to impasse in the psychoanalytic process.
b) Sensation, sensation-feeling and thought
It is often through the emotions that the body indirectly makes its presence felt. Matte Blanco finds emotion to be ‘the expression of a corporeal state’ (1975, p. 242), which shows itself either as such or as
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a drive to action, and he calls the psychological apprehension of cor- poreal events sensation-feeling. To the sensation arising from the bodily matrix he adds a propositional activity which introduces relationships more proper to thought activity. Emotion is thus conceived by Matte Blanco as a composite of sensation-feeling and thought.
Although Matte Blanco sees the setting up of relationships as an essential part of sensation, he is punctilious in defining an extreme case of pure sensation, where sensation presents itself to consciousness in a state of absolute nudity: it is felt to be simple and indivisible, outside time and all the other distinctions which characterize the phenomena of thought; if such distinctions appear, it is only because we have covered the sensory event with our thought (Matte Blanco 1975, p. 259).
The distinction between pure sensation, sensation-feeling and thoughts connected with sensory activity I hold to be a significant one, above all in the light of the different paths which lead from each of these single components, creating the conditions for the dominance of symmetri- cal or asymmetrical components in every single experience of life.
Using these distinctions, we can for instance hypothesize that pure sensation might close itself off and stagnate to the point of becoming infinite and indivisible, or rather an exclusive area radically dissoci- ated from the possibility of being registered by thought, as happens, for example, in drug addictions. When these sensory states are actually experienced, even in certain normally integrated patients, the presence of sensation in the mind tends to saturate it and block any participation of thinking activity, as is the case in clinical situations of erotic transfer- ence, particularly in patients in whom even simple experiences of emotional contact activate confusion and uncontainable excitation tending towards acting out. In these states, which are distinguished by the dominance of the symmetrical component, the analyst’s most urgent task is to help the analysand to differentiate asymmetrically among the sensations he/she is experiencing. Thus bodily experience can pass through the eye of the needle of thought, allowing the analysand, for example, to distinguish within his/her emotional turmoil what can be defined verbally: excitation, fear, curiosity, relaxation, trust, aggres- sivity, desire for possession, etc. Freud, in his essay on the two princi- ples of mental functioning (1911), had already distinguished between a primordial sensory level proper to the pleasure principle and a second level consisting of consciousness linked to the sense organs, the activation of which can lead to obtaining pleasure through the mediation of the
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recognition of reality. Freud thus seems to emphasize that the pure sensory level, when the primordial level is not integrated with the conscious, tends to assert itself outside of the differentiation proper to thought. The best-known development of this hypothesis of Freud’s is Bion’s distinction (1957) between psychotic and non-psychotic areas, in which the psychotic area needs to be integrated with the non-psychotic area to bring about emotional containment. In this context the action of the non-psychotic area provides differentiation of a realistic kind: a form of differentiation which is altogether for- eign to the psychotic area. In all these authors – Freud, Bion, Matte Blanco – a polarity is set up: (1) pleasure principle, psychotic area, pure sensation; (2) reality principle, non-psychotic area, thoughts connected with sensory activity. The interaction of these conflictual areas leads to the possibility of integrated mental activity allowing for the containment of primitive sensory data which, by dint of their original intensity (Klein 1932), know no boundaries and structurally tend towards the infinite (Matte Blanco 1975).
c) Infantile catastrophe and body-mind dissociation
The systole and diastole proposed by the oscillation between sensa- tions and feelings on the one hand and the asymmetric activity of thought on the other, can thus become the support of the mental circulatory system proposed by psychoanalytic experience: a system which is often set in motion by analysis, but which is not terminated at its close, becoming instead part of that interminable analysis spoken of by Freud (1937). Right from birth, the body provides us with feelings and emotions which are difficult to contain and originally extraneous alike to space-time boundaries and to asymmetrical differentiation.
The body-mind relation is formed at a very early stage of life, when the ego is not yet structured and is subject to the impact of external traumas (first of all separation from the mother) and to traumas caused by shortcomings of the maternal reverie (Winnicott 1953/1958; James 1960; Gaddini 1980/1992; Mahler & McDevitt 1982). It is not always possible during analysis to reconstruct these subjects’ trauma histo- ries; at the same time this aspect of reconstruction does not have the same importance it has in other more evolved types of mental disturbance. Various authors have noted how trauma affects mental integration, causing differing degrees of dissociation (Krystal 1988;
Laub & Auerhahn 1993; Bromberg 1998); they have also pointed out
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how the body takes it upon itself to be the repository of whatever the mind has not succeeded in working through and integrating (Balint 1987; van der Kolk 1996; Kaplan 2006). Matte Blanco (1988) stresses the importance of Melanie Klein’s insight about ‘memories in feel- ings’: in fact, he maintains that in analysis, in certain conditions, we find ourselves working through the sensory-emotional implications of traumatic memories, which are presented as densely symmetric zones that are not integrated with the normal asymmetric function- ing typical of verbal thinking. What is most important in more seri- ous disturbances of body-mind relation activated by trauma is the experience one has in analysis; this allows the subject, with the help of the analyst’s reverie, to draw closer to his/her physical and emotional being: a meaningful and concrete change which also influences the patient’s way of being in the world.
Of all the periods of life, adolescence is perhaps that in which the relationship with one’s body becomes most important, due to the changes brought about by puberty and to the transformation of a child’s body into the body of an adult (Laufer & Laufer 1991). In this stage of life the subject finds, with peculiar intensity, that he/she must get to know and come to terms with his/her own actual body as an expression of the changes that have taken place through the passage of time. This requires a particular working through that often leads the adolescent to analysis.
First clinical vignette: adolescence and the discovery of the body
I shall first be discussing an 18-year-old adolescent, Giorgio, who presented anxiety attacks, hashish dependence and psychogenic sexual impotence. This clinical material seems interesting because it renews our sense of adolescence as the birth of a new body and also suggests the importance of the activation of a connection with the body in this phase of life. During the entire initial phase of his analy- sis, communication with G. was rather stiff, thanks to his tendency to remain as superficial as possible and to avoid facing situations that evoked anxiety. The countertransference seemed problematic, since it was often virtually impossible to follow his confused remarks and find logical elements in what he communicated.
The development, in the transference with me, of a trusting rela- tionship led G. to tell me after a while about his intense agoraphobia
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and suicidal fantasies. He was haunted by the fantasy of throwing himself off his balcony, because he experienced the limits represented by the railing as a prison that was suffocating him and that he wanted to escape from. At the same time G. spoke of his almost delusional conviction that his legs would be elastic enough to withstand the impact of his fall from the fifth floor. G. in fact tended to be unaware of his body, thus placing his very life at risk.
In subsequent sessions other material confirmed his unconscious suicidal tendencies. He reported that he had, at the last moment, avoided a serious crash on his motorcycle when he turned the wrong way into a one-way street. He was apparently in a sort of trance brought about by the excitation of driving at high speed, so he hadn’t noticed the No Entry sign at the corner. Thus he suddenly found himself about to run into a car, which he just managed to avoid, convinced that it was the other driver who was going the wrong way.
Only later was he able to reconstruct what had actually happened.
I confronted G. directly with the fact that he was running the risk of fatal accidents, since I wished to stimulate his perception of his resort- ing to acting out.
‘Clearly,’ I said, ‘you have such hatred for yourself and for your actual body that you want to destroy it, in part as a means of doing away with the limits of reality that your body imposes.’ G. answered,
‘It is not my intention to go that far.’ And I replied, ‘But if it were to happen, you obviously have an omnipotent fantasy that you could keep on living even after a fatal accident: as if you could live inde- pendently of your body.’ G.’s response to this approach was ‘I often have the fantasy of going backwards in time to when I was a baby.’
G.’s association revealed his confusion about the existence of realistic temporal limits and also his being trapped in a structural unconscious on which time and space tended to have no bearing. So I said, ‘You arrange your mind as if time and corporeal space didn’t exist: thus it not only is unable to protect itself but, however unwillingly, it even attacks itself.’
Among other things, the fantasy of being able to continue to be a baby seemed very closely connected with his sexual impotence.
The working through of the existence of both time and a real adult body – as ‘asymmetrical’ elements of mental functioning – therefore played an important role in the resolution of his symptoms.
After about two years’ work, when we were on the brink of the summer separation, G. brought in a dream which signalled an
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