The function of the analyst's boundaries in the psychoanalytic relationship

Abstract

Two definitions of the concept of analytic boundaries—the analyst's boundaries in the analytic relationship and the boundary between analyst and patient—focus, respectively, on the analytic function and the analytic relationship. A long analysis of a 20-year-old girl is characterized by the analytic work being slowed down by her chronic tendency to arrive late. A miscarriage very early in her pregnancy, occurring almost at the end of the analysis, produces associations and fantasies on ‘crushed’ fetuses and children. It also encourages reflection on the importance of the analytic space, equated by the analyst with the womb, in fostering the development of fetal aspects of the self that do not develop. In the clinical material from two sessions 4 months before termination, two analytic events—the introduction in the analytic field of the character of the autistic child and the episode of self-disclosure—mark a turning point in the analytic process. In the discussion, the author demonstrates the creative and mutative effects of alterations in technique and style of working, changes that might be seen as a breach of her analytic boundaries and a transgression in relation to her theoretical frame of reference.

Keywords:

• Boundaries
• autism
• analytic space
• self-disclosure
• symbolization
• technique implications

Acknowledgements

An initial version of this paper was presented, and discussed by Sira Dermen, at the British-Italian Dialogue, held in Rome on March 1–2, 2003. This paper is a revision of the paper presented and discussed by Roger Kennedy at the Scientific Meeting of the British Psychoanalytic Society, held in London in March 2005, and published in the Bulletin of the British Psychoanalytic Society, 41(1) in January 2005. The author would like to thank Sira Dermen and Roger Kennedy for their interesting comments, which she has integrated into the discussion section of this paper.

Notes

¹Frankel's question of “whether what's on one side of the boundary is really different from what's on the other side” is sometimes raised dramatically between patient and analyst, when there is what Puget and Wender (1982) have called an “overlapping world”: a resonance between the analyst's traumatic experiences and those of the patient, a specular reflection of experiences of void and nonexistence, a narcissistic type of relationship, a juxtaposition of post-traumatic structures. These and other conditions can lead to the formation of blind spots and impasse or failure in psychoanalytic treatment.

Meterangelis and Spiombi (2003) identify three levels of complexity in self-disclosure: (1) the confirmation or the opposite of a patient's perception; (2) answers to specific questions concerning aspects of the analyst's private or social life; and (3) spontaneous and deliberate communication by the analyst of his or her own countertransference experiences. I would add a fourth: self-disclosure as a communication that introduces a dimension of greater spontaneity and mutuality in the analytic relationship, since it reveals to the patient the effect the patient has on the analyst. Mutuality must be considered not as parity or identity, but as an encounter between subjectivities. With regard to the relation between asymmetry and mutuality in the analytic relationship, Hoffmann (1998) emphasizes that these should be in a dialectic relation: while the analyst's asymmetry depends on the rituality of the analytic relationship, the mutuality depends on a spontaneous attitude that facilitates a reciprocal identification between analyst and patient.

³The self-disclosure aspect of my second clinical communication is reminiscent of Neville Symington's (1983) paper on the analyst's “act of freedom” in moving from a position of relative impasse.

⁴A few pieces of research on prenatal trauma and autism conducted by Felton and cited by Rosenfeld (1987) and Maiello (2001) attribute some disorders of the primal object relation to maternal depression during pregnancy.

Rosenfeld quotes interesting results of research carried out by Felton on autistic children and their mothers, according to which disturbed areas of the mother's mind, excluded from consciousness, are passed on to the fetus through the placental bloodstream via an “osmotic pressure phenomenon.” Rosenfeld considers that children who have been impinged on, in utero, by projective processes from the mother can, after birth, show a tendency to avoid contact with the mother and to develop eating disorders.

Maiello, in a study on “prenatal trauma and autism,” affirms that a risk of miscarriage and the emotional and mental state of the mother, linked to a depression, can lead to a failure of those protomental processes, based on auditory experiences, that promote three-dimensionality and the opening to the presymbolic. The following withdrawal into the safer, concrete mode of tactile bidimensional experience could be an extreme attempt to escape annihilation. In these kinds of situation, the reciprocity might end up as a shared experience of freezing between the container and the content.

⁵The lizard aroused E.'s imagination and mine, and was associated with mythological and fantasy figures. I have given different meanings to the lizard represented in her dreams and associations, according to the clinical material. The lizard represented in her dreams, associated with the crushed fetus and children, made me think of a primitive and rudimentary aspect of the infantile self that functions at an autistic-contiguous level and that opposes a mentalization—an infantile self that does not develop owing to inadequate maternal functions of containment and reverie. The lizard as sacred monster, an image that combines idealized aspects and monstrous aspects, seems to me to be a reference to an alien part of the self that condenses sensory and drive aspects of the self with invasive aspects of the mother and rejecting aspects of the father. The latter expropriates the infantile self of its vital project and interferes with the development of the sense of self, with introjective identifications, and with the child's mental functioning. The hypothesis that E. experienced her pregnancy as a threat of invasion inside the body by an object of this type, which is experienced as something that is part of the self and yet alien to the self, is quite convincing. The lizard has also been interpreted as a fecal child strangled by the anus and associated with anal masturbation, which attacks creative sexuality and the analyst's “analytic babies”.