Commentary on Paper by Hilary Hoge

Abstract

In this discussion the author raises the question of the analyst's freedom to sustain paradoxical viewpoints, specifically with regard to dream interpretation and related links to internal objects and the self as they appear in the transference. Paradox allows for the creation of multiple, coexisting meanings that can be played with by patient and analyst. Paradox also makes possible an experience of decentering and destabilization pursuant to Bion's catastrophic change. The risk inherent in the emotional experience of catastrophic change may limit and at times foreclose both patient's and analyst's freedom to tolerate and sustain the effects of paradox.

Notes

¹The difficulty encountered by certain patients such as those Hoge refers to who have been traumatized is likely due to excessive involuntary reliance on splitting to maintain divisions within an unstable personality. This in large part precludes surrender to the creative splitting inherent in the experiencing of paradox.

²Passion involves a constantly evolving balance of L (love), H (hate), and K (knowledge; Meltzer, 1984).

³In a paper describing a child patient who relied excessively on pseudologia fantastica (Dithrich, 1991), I described how my initial frustration with and confrontation of my young patient evolved to an unconditional acceptance of his construction of reality. This allowed him to bring material forward that otherwise would have remained hidden. His truth was embedded in his lies.

⁴Rather than assume a preexisting latent dream meaning, Bion (1991) believed the so-called latent content is created by the analyst as she interprets the dream. I would add that the so-called latent content is created by both patient and analyst, and it often evolves during a session and in the days and weeks following. There may thus be potentially many meanings to one dream.

⁵ Chasseguet-Smirgel (1986) wrote of a phantasy of the interior of the mother's body as perfectly smooth, white, and devoid of obstacles (siblings, paternal penis, etc.). This suggests another possible meaning of nesting, that is, the wish to be alone inside the analyst (Meltzer, 1992).

⁶ Meltzer (1988) made a distinction between external surface and internal psychical qualities associated with beauty. For the latter, truth is beauty and beauty is truth.

⁷When translated technically, both concepts—Winnicott's holding and Bion's container–contained—can take on basic assumption qualities, the former involving passivity and nonengagement suggestive of emotional detachment and neglect, and the latter authoritarianism, arrogance, and usurping the patient's capacities.

⁸The idea of embeddedness suggests that, like nested dolls, stories may reside within stories, until one reaches the “navel” of the story.