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KENNETH SANDERS
POST-KLEINIAN
PSYCHOANALYSIS
TheBiellaSeminars
Foreword by
DONALD MELTZER
KARNAC
POST-KLEINIAN
PSYCHOANALYSIS
POST-KLEIN IAN
PSYCHOANALYSIS
The Biella Seminars
Kenneth Sanders
Foreword by
Donald Meltzer
KARNAC BOOKS
First published in 2001 by
H. Karnac (Books) Ltd,
118 Finchley Road, London NW3 5HT
A subsidiary of Other Press LLC, New York
10 9 8 7 6 5 4 3 2 1
www.karnacbooks.com
ACKNOWLEDGEMENTS VII
FOREWORD by D o n a l d Meltze r ix
PREFACE XI
1 Prologue a n d a consultation 1
2 A n a d o l e s c e n t emerges f r o m c o n f u s i o n 11
3 D r e a m s : w h o w r i t e s t h e script? 23
5 T h e m e r m a i d a n d t h e sirens 53
6 T h e c o m b i n e d part-object:
from "the w o m a n w i t h a penis"
to " t h e breast-and-nipple" 65
v
Vi CONTENTS
7 T h e c o m b i n e d p a r t - o b j e c t in infan t o b s e r v a t i o n
and practice 79
10 Epilogue:
c l a u s t r o p h i l i a a n d th e " p e r e n n i a l p h i l o s o p h y " 111
REFERENCES 121
INDEX 125
ACKNOWLEDGEMENTS
I
am especially indebted to Selina Marsoni Sella for her invita
tion to contribute to the teaching at the school in Italy that she
founded in 1990—the Scuola Biellese di Psicoterapia Psicoana
litica. Her enthusiasm for the work was a constant encouragement
to the seminar.
The membership of the seminars varied over the years, so that
the names of the most regular contributors to the discussions,
listed below in grateful acknowledgement, must stand for all.
Lydia Bozzolo
Antonella Graziano
Selina Marsoni Sella
Carla Perinotti
Marco Rolando
Mario Sabucco
Pieralda Stagliano
Marilena Vottero
vii
Viii ACKNOWLEDGEMENTS
Donald Meltzer
T
lhis book by Dr Kenneth Sanders, his third, published now
by Karnac Books, is taking its place in what is becoming a
strong corpus of post-Kleinian literature, in a genre begun
by Wilfred Bion and carried on by Donald Meltzer, notably in
Barcelona, Buenos Aires, and Stockholm, and others devoted to
clinical work and discovery and devoid as much as possible from
theoretical invention.
The chapters in this book not only contain fascinating clinical
accounts but in Dr Sanders exposition cover the wide range of
ideas of extended metapsychology as they pertain to children,
adolescents, and adults. Here what is rather scattered throughout
the existing literature is a well-knit exposition of the substance of
this evolving school of psychoanalysis. Clear, precise, and rising to
poetic heights at times, it makes rich reading.
Oxford
ix
PREFACE
T
he essays in this book began as informal talks at a school of
psychoanalytic psychotherapy in Biella, Italy. The students
were at different stages of their psychoanalytic education,
and I was invited to "give a talk" of general interest, rather than a
formal lecture, once a term.
I found a method of doing this by selecting a subject from
current issues in the day-to-day work in my practice, using the
dreams to organize the material. The talks sometimes began with a
brief historical survey, reviewing the relevant line of development
from Freud and Abraham, through Klein, to Bion and Meltzer,
followed by the clinical material and concluding with questions
and a discussion. As the students were at different stages of their
learning experience, there was always a problem of presenting
material that was familiar and elementary to some and compli
cated and obscure to others. The only solution I found to this
dilemma was to ensure that the material I offered reached the
minimum requirement of being at least of interest to myself, at
whatever level of sophistication.
***
xi
Xii PREFACE
* **
1
2 POST-KLEINIAN PSYCHOANALYSIS
This anxiety about arriving at the truth about the aesthetic object—
and therefore its value—makes for a "family resembance" (Witt
genstein) between artistic, scientific, theological, and philosophical
endeavours to comprehend the mind with its passion to under
stand itself and its world, internal and external. But the truth,
like beauty, has a blinding quality, and the offer of anaesthesia
is constantly available from - L H K — t h a t is, narcissistic organiza
tions, internally and externally. Inevitably, the artist-scientist as
psychoanalyst finds that the problems with which he grapples
have already been addressed by the world's poets and artists—for
example, this passage from a letter of William Blake's:
* **
A woman from abroad on a visit to her daughter, Sarah, was
distressed to discover the degree of anxiety and confusion in her
daughter's fiance. She encouraged the couple to seek help for his
panic attacks and his inability to continue with his work, in which
he had shown artistic promise.
***
" M r A " came for the consultation accompanied by his fiancee:
He is tall and thin, dressed in jeans and shirt. He smiles anx
iously, then talks freely, gathering momentum, impatient with my
infrequent comments. It started, he says, when he was nineteen,
four years ago, when he left home for college—he saw the college
psychologist. A sudden depression, headaches, then unable to
work at his studies. When he gets them, he goes to bed. It isn't
logical—his father is logical, a civil servant. His work is as a
draughtsman—Sarah does the same work, they met at college.
These attacks are terrible, he is a perfectionist, obsessive, but de
pression is different. It comes from nowhere. He has been to see his
GP, but she wasn't interested. He worries about money, the pay
isn't very good—they pay you by the foot—he smiles at me and
points to his foot—if they go to the USA, the pay is better—his last
job was only twenty pounds a foot, there was an argument, he had
to leave. It's not that, it's the depression, it lasts about a week or so
and then it goes—it isn't logical. M y mother says it's the subcon
scious—he breaks off and laughs at me—I hope you are not like
that—she sent me to see her friend who is a therapist, a colour
therapist, you think of different colours—what they mean, yellow,
green—I went to talk to her, but I am obsessive—for example,
I think living in a rented flat is expensive, it isn't perfect, my father
6 POST-KLEINIAN PSYCHOANALYSIS
***
PROLOGUE AND A CONSULTATION 7
Discussion
An adolescent emerges
from confusion
I
n contrast to the plight of the confused young man who was
unable to imagine what psychoanalytic help might be, as de
scribed in chapter one, this situation with a confused 16-year
old allowed psychoanalysis to proceed.
***
I had first met " J i m " in a general practice setting when he was 5
years old. His parents' worry then was about his enuresis, but they
also told me that he was generally bad-tempered, he masturbated
in front of the television, and sometimes he slept with his finger in
his anus. When a star chart had been suggested—a star as a re
ward for a dry night—he had replied, "What's the use? I'll never
be dry."
I was told that Jim was very good with his two younger siblings
and showed no jealousy, although his mother was still breast
feeding the baby. He was a bold and excitable little boy whose
cheeks were rouged red, like a clown's, and who prowled round
the room as I talked to his mother. At one point he growled in a
comical way, which his mother explained was an imitation of a
11
12 POST-KLEINIAN PSYCHOANALYSIS
hole
Fig. 2.1
draw a little blood, and then asked for help. There had been minor
episodes before: this time it was just before school examinations,
and Jim said that it was because he was worried about a girl at
school. A few days later he ran away from home, and his father
found him nearby, lying on a bench by the side of the road, very
confused.
Jim agreed to see me once again. He spoke slowly about his
feeling of depression, suicidal impulses, and reluctance to ask for
help. He had fallen in love with a girl so intensely that she was
scared off and avoided him. He then felt compelled to follow her to
explain that he didn't want to frighten her, but, predictably, this
frightened her even more.
Jim felt his sanity was in danger. Initial reluctance to investi
gate the problem touched on the defence of the privacy of his
bedroom and the concealed soiled underwear that betrayed his
guilt. He was now eager to continue where we had left off ten
years earlier: he remembered the good Jim and bad Jim formula
and settled down to a three-session-a-week routine in which
dream analysis came to be the centre of interest. His schoolwork
resumed.
Jim said that cutting himself had started when he noticed the
growth of pubic hair. He disliked hair on his body and secretly
shaved it off. He was self-conscious about his skin generally and
did his best to cover up spots over his back and neck. Anxieties
about his maturing body and his sexuality lay behind his determi
nation to protect his privacy, and this was a powerful factor in the
transference.
The anxiety that he had harmed his girlfriend—in truth it was
only his disturbed mind that had frightened her, as indeed it
frightened everyone else, including himself—had its origin in a
worry about his young sister and her welfare. I reminded him that
she was being fed at his mother's breast when we first met. He was
relieved that this matter could be discussed and explored. His
admiration was heartfelt for the achievements and wide interests
of both parents, for his father's knowledge and practical skills and
for his mother's beauty and grace. This helped to establish a work
ing relationship in the transference.
A n incident from his childhood remained in Jim's mind: as a
boy he had liked to dress up and perform. Usually his parents'
AN ADOLESCENT EMERGES FROM CONFUSION 15
"A famous ballet dancer was to appear in the school play, Nureyev or
perhaps Nijinski. I volunteered to assist backstage and found myself
clinging onto a trapeze, high up. Then I felt myself slipping, as if Yd
tried a manoeuvre with two trapezes and been left hanging upside
down. Nureyev-Nijinski walked through the school hall with every
one crowding round—he was like a pop star. I wanted to attract his
attention and tap him on the shoulder and say 'Mr Nureyev.. /, but
I was feeling very nervous. Then he stopped near me and I asked him
for help with a weighty problem that I had. He offered me a very big
book, like a box, with a thousand pages, to look at until he returned.
Then I saw there was a little boil—or perhaps a cancer—near my
navel"
Jim said that the boy was the fastest runner at his school, but one
day he discovered that he could overtake him. He agreed that
Tomorrow's World symbolized for him the world of adult interests
and responsibilities—for example, he often speculated that he
would train as a psychoanalyst himself one day.
The analysis was—like his mother—waking him up to inner
reality. Knocking on the door before entering is a reference to
resisting intrusions into his sister's room, as later the "faeces
chocolate" is resisted.
Here is one more dream from a year later, during his time at
the university:
He commented that the book being studied was like the book in
the dream about Nureyev. The Boulez composition is in reality
very complex, and he has to struggle to understand the pitch and
harmony. The blond woman reminded him of a woman musician.
Last night he had watched a film on television called Zardoz—a
version of The Wizard of Oz. He was frightened as a child by the
booming voice of the wizard, like the incident in a film of Alice in
Wonderland where Alice grew very big and got stuck. He won
dered whether it was connected with getting an erection.
He went on: "One of the things I remember from my childhood
was being cross when my mother dragged me away from the T V
while I was watching The Wizard ofOz, because we had an appoint
ment to come and see you!"
I reminded him again of the temptation for the little boy to
dress up as an adult—man or woman—which creates a world in
A N A D O L E S C E N T EMERGES F R O M C O N F U S I O N 19
Discussion
Q: A n d of re birth!
Q: I would like to know the meaning of the enuresis. Is it an attack
on the mother and father?
A: O n them as a couple, an oedipal attack on the combined object,
which also has the meaning of an attack on his internal objects
as an apparatus for thought (Bion). It has the identical meaning
as the dribbled spittle and the hole rubbed through the paper of
his drawing.
Q: A n d the masturbation?
A : Yes. Thoughtfulness about growing up includes struggling
with the sad feelings of separating from the parents if they are
loved—to overcome the childlike desire to stay a baby and to
deny the passage of time. It is not clear to one part of the
personality that the pleasures of adult life, which include carry
ing responsibilities, are in fact desirable. If that part of the
personality that has thinking function—internal good objects or
the mind/breast according to Bion—is damaged by intrusion
or by oedipal hostility, then the possibility of identification with
the adult world is also affected.
Q: The enuresis sheet with the bell was an invitation not to think.
A: Yes, behaviour therapy!
Q: Yes, and he rebelled against it.
A: The parents were exhausted at the time. In the third dream
there is a picture of being woken up not by the bell but by
thinking: " M y mother asked me to wake up the g i r l . . . " I take
that to mean being the analytic process pulling him out of
intrusive identification.
Q: I find it intriguing that in the dream the image of the spots is not
on his back but near the umbilicus.
Q: For a son it may be difficult if the mother is not able to think in
terms of a psychological birth mediated by analysis?
Q: There are elements of homosexuality—I am concerned about
the transference of the patient towards a male analyst?
Q: Do you think the friend who observed him as a five-year-old
walking in his mother's high-heeled shoes and carrying her
A N A D O L E S C E N T EMERGES F R O M C O N F U S I O N 21
Translator: E. K. Rahsin
Language: German
Epilog
I. Kap. Pläne zu Mitjäs Rettung 1569
II. „ Auf einen Augenblick ward die Lüge Wahrheit 1579
III. „ Iljuschas Beerdigung. Die Rede am großen Stein 1595
Zur Einführung.
Bemerkungen über Dostojewski
Dmitri Mereschkowski.
Vorwort