Sheldon Bach - Getting From Here to There: Analytic Love, Analytic Process

2006 by The Analytic Press, Inc., Publishers

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Index by Cynthia Swanson

is reprinted from The Journal of Clinical Psychoanalysis, Vol. 11, No. 2, pp. 225255, by permission of International Universities Press, Inc., 2002 by International Universities Press, Inc.

Library of Congress Cataloging-in-Publication Data

Bach, Sheldon

Getting from here to there : analytic love, analytic process / Sheldon Bach

p. ; cm. - (Relational perspectives book series ; v. 32)

Includes bibliographical references and index.

ISBN 0-88163-439-5

1. Mind and body therapies. 2. Countertransference (Psychology). 3. Psychoanalysis. 4. Love. I. Title. II. Series.
[DNLM: 1. Professional-Patient Relations. 2. Countertransference (Psychology). 3. Love. 4. Psychoanalytic Therapy. 5. Transference (Psychology) WM 62 Bl 18g 2005]

RC489.M53B33 2005

616.89 14dc22

2005057053

Printed in the United States of America

10 9 8 7 6 5 4 3 2 1

CONTENTS

Body-Mind Integration
A Holistic Perspective

Even before I published my paper on the narcissistic state of consciousness (Bach, 1977), I had been engaged in piecemeal attempts to integrate in my own mind different ways of thinking about body and mind, subject and object, and process and content. I now believe that on some level all of us are continually engaged in a similar project, but that this effort becomes visible only when it is least successful, as happens with certain patients who are often consciously struggling to pull things together and make sense out of the disparate elements of their lives.

Although some of the chapters in this book were written for different occasions, they are all bound together by the particular viewpoint that I am espousinga holistic or body-mind perspective. From this perspective, the psychoanalytic process can be viewed in both its spiritual and its animal aspects. To do less than to see the polarities of mind and body as a unity is, I believe, to severely distort elements of the human and the psychoanalytic situation. This unified vision is, after all, at the heart of the psychoanalytic effort as we try to do a close reading of the patient's words and feelings from an immediate empathic or subjective point of view, without losing sight of the larger objective, historical, and potential context.

If I reflect on psychosomatics as it was taught to me in the 1950s, it always seemed to incorporate some element of surprised discovery: learning that an established physical condition, such as gastric ulcers or immune response, might be affected by psychological variables, or that an established psychological condition, such as hysteria, might effect a change in the physical body. We have long since noticed that this categorization game leads down blind alleys, but it still somehow strains our everyday conceptual abilities to imagine that what we categorize as physical and what we categorize as mental may simply be views of a larger unity from different perspectives. This body-mind problem is, of course, linked to our difficulty dealing with the interdependence and interpenetration of subject and object or observer and observed, an issue that I touch on in as it relates to our understanding of human development and to the psychoanalytic situation.

For it is my firm conviction that as psychoanalysts we generally do better not to treat diagnostic conditions, or even particular symptoms, but that we work in the best interests of our patients by helping them to build or restore their own mental and physical regulatory and regenerative capacities. What these capacities are and how we go about helping to build or restore them is the subject matter of this book. I have generally tried to avoid elaborate theorizing and to concentrate instead on presenting a therapeutic attitude or frame of mind that incorporates and exemplifies the holistic vision I am trying to attain.

Changing our therapeutic frame of mind seems to involve, among other things, a change in the metaphors through which we view the analytic situation. In the early history of psychoanalysis great emphasis was placed on trauma and uncovering repressed secrets, which led to an investigative metaphor that viewed the analysis as a crime scene or natural catastrophe and the analyst as detective or archeologist. Later on, as experience accumulated, the emphasis shifted to the patient's resistance, which led to a military metaphor in which the analyst struggled against the patient's defenses and character armor. Still later, under the influence of object relations theorists, the analyst was seen more as a facilitator of growth, like a nanny or gardener, with images of hatching, holding, and unfolding and the transference as playground. More recently, the emphasis on mutuality and interdependence has promoted a systems metaphor in which the analyst is viewed as one part of a larger world that both influences and is influenced by him.

Although none of these metaphors are totally accurate, since they all emphasize certain aspects of the psychoanalytic situation while slighting or even obscuring other aspects, as long as they hold sway in the analyst's imagination they exert a powerful pressure on how he thinks and behaves with his patients. For example, the detective and military metaphors tend to highlight structure, content, and discontinuities like separation, whereas the nursing and systems metaphors tend to emphasize state, process, and continuities like attachment. Likewise the detective and military metaphors draw attention to boundaries, authority, and obedience; the gardener and systems metaphors tend to emphasize process, mutuality, and agency. In the detective and military metaphor there is a very clear demarcation between the observer and the observed or between the opposing forces; the nanny metaphor includes merging tendencies while the systems metaphor opts frankly for coconstruction and interdependence.

Since structure and state, content and process, continuity and discontinuity, obedience and agency, and interdependence and separateness all imply one another and are essential elements of life, it seems that, rather than selecting among them, one ought to look for some higher level of integration. But perhaps the main problem with some of these therapeutic metaphors is that they focus predominantly on the analyst and the analyst's goals, actions, and conceptualizations. The patient's goals and conceptualizations seem to have somehow been relegated to a secondary position, just as they so often are in certain areas of modern, fragmented, high-tech medical practice.