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ABSTRACT
This paper describes the psychoanalytic treatment of a woman patient during the first six months of the COVID-19 pandemic, when the setting was profoundly disrupted and was transferred from in-person psychoanalysis to telephone sessions. Drawing on Bleger’s formulations on the construction of the analytic frame and on André Green’s on the function of the framing structure in the construction and elaboration of phantasy life, the case study shows how, in the absence of the physicality of the setting, the most primitive anxieties about the symbiotic relationship with the mother were expressed and contained in the transference and countertransference in the analysis. The author offers some considerations about the notion of “background of the uncanny”, derived from Yolanda Gampel, which draws attention to the challenges when both patient and analyst are inserted into the same traumatic wider context. It is suggested that the production of an art object by the patient during this period represents a step in the elaboration of the work of mourning and towards symbolization.
Le divan vide : amour et deuil en temps de confinement
Cet article décrit le traitement psychanalytique d’une patiente durant les six premiers mois de la pandémie de la COVID-19, au cours desquels de nombreux bouleversements se sont produits, et notamment la nécessité d’adapter le cadre des séances avec des séances par téléphone. S’appuyant sur les formulations de Bleger concernant la construction du cadre analytique, et sur la fonction de structure encadrante dans la construction et l’élaboration des fantaisies développée par André Green, ce cas clinique montre de quelle manière, en l’absence de la réalité physique du cadre, les angoisses les plus primitives en lien avec la relation symbiotique avec la mère sont exprimées et contenues dans le transfert et le contretransfert de l’analyse. L’auteur expose quelques réflexions en lien avec la notion d’ « arrière-plan de l’inquiétante étrangeté » de Yolanda Gampel, qui attire l’attention sur les défis en jeu lorsque le patient et l’analyste sont tous les deux insérés dans un même contexte plus vaste et traumatique. Cet article suggère que la production d’un objet artistique par la patiente durant cette période représente une étape franchie dans l’élaboration du travail de deuil et vers la symbolisation.
Die leere Couch: Liebe und Trauer in Zeiten isolierender Beschränkung
Dieser Beitrag beschreibt die psychoanalytische Behandlung einer Patientin während der ersten sechs Monate der COVID-19-Pandemie, als das Setting zutiefst durcheinandergebracht und die persönlichen Begegnungen in der Psychoanalyse in Telefonsitzungen umgewandelt wurde. Die Fallstudie schöpft aus Blegers Formulierungen zum Aufbau des analytischen Rahmens und André Greens Gedanken zur Funktion der rahmengebenden Struktur für die Gestaltung und Entfaltung des Fantasielebens und zeigt, wie Urängste in Bezug auf die symbiotische Beziehung zur Mutter in Abwesenheit der Körperlichkeit des Settings in der Übertragung und Gegenübertragung in der Analyse ausgedrückt und durch Containing gehalten wurden. Die Autorin stellt einige Betrachtungen zum Begriff der „Gegenwart des Unheimlichen“ an, der von Yolanda Gampel geprägt wurde und der die Aufmerksamkeit darauf lenkt, welche Herausforderungen sich ergeben, wenn Patient und Analytiker in denselben traumatischen größeren Kontext eingeführt werden. Es wird nahegelegt, dass ein von der Patientin während dieser Zeit geschaffenes Kunstobjekt einen Schritt in der Entwicklung der Trauerarbeit mit Hinwendung zur Symbolisierung bedeutet.
Il lettino vuoto. Amore e lutto in tempi di isolamento sociale
L'articolo descrive il trattamento psicoanalitico di una paziente durante i primi sei mesi della pandemia di COVID-19: un periodo in cui il setting è stato soggetto ad alterazioni assai disturbanti, compreso il passaggio dall'analisi condotta di persona alle sedute telefoniche. Prendendo spunto dalle formulazioni di Bleger sulla costruzione della cornice analitica e da quelle di André Green sulla funzione della cornice nella costruzione e nell'elaborazione delle fantasie inconsce, il caso clinico qui presentato mostra come, laddove sono venuti meno gli aspetti fisici del setting, le angosce più primitive relative alla relazione simbiotica con la madre sono state espresse e contenute nell'analisi all'interno del transfert e del controtransfert. L'autrice propone inoltre una serie di considerazioni sul "sostrato del perturbante", un concetto tratto dai lavori di Yolanda Gampel e focalizzato sulle difficoltà che si creano quando paziente e analista si trovano inseriti all'interno di uno stesso contesto sociale traumatico. Si suggerisce infine che la creazione da parte della paziente di un oggetto d'arte in questo particolare periodo rappresenta un passo nell'elaborazione del lavoro del lutto - un passo cioè verso la simbolizzazione.
El diván vacío: amor y duelo en los tiempos de confinamiento
El artículo describe el tratamiento psicoanalítico de una paciente durante los primeros seis meses de la pandemia del COVID-19, cuando el encuadre se vio profundamente afectado y pasó de un psicoanálisis presencial a sesiones telefónicas. El estudio se basa en los planteamientos de Bleger sobre la construcción del marco analítico y en los de André Green sobre la función de la estructura encuadrante en la construcción y elaboración de la vida de la fantasía. Muestra cómo, en ausencia de la fisicalidad del encuadre, se expresaron, y contuvieron, las angustias más primitivas acerca de la relación simbiótica con la madre en la transferencia y la contratransferencia del análisis. La autora presenta algunas consideraciones acerca del concepto de “sustrato de lo siniestro”, de Yolanda Gampel, que llama la atención sobre los desafíos que surgen cuando tanto el paciente como el analista están insertos en un mismo contexto traumático más amplio. Se sugiere que la producción de un objeto de arte por parte de la paciente durante este periodo representa un paso en la elaboración del trabajo de duelo y hacia la simbolización.
Notes
1 This experience was a different from that of another patient, who cried on the phone for weeks, saying: “I had never realized how important it was for me to come and see you. I felt that it was just one more thing I did before fetching the children from school. Now I am so aware of how much I need to come to see you.”
2 Kohon suggests that the concept of the setting
should be applied … to the physical environment of the psychoanalytic situation: the room, the couch, the chairs, the bookshelves, the pictures, as well as, for example, the formal aspects of it: the times and the duration of the sessions and the details of the contract between patient and analyst (payment, arrangements concerning holidays, etc.). Ideally, these things change only occasionally, thus, as such, they contribute to the establishment and maintenance of the non-process.
the concept of frame (or framework) evokes a much more accurate and precise internal reference to the mind of the analyst, to his or her analytic attitude – an aspect quite different to “setting”. … The frame exists in the mind of the analyst, and it is up to him to preserve it, trust in it, have the ability to use it. The existence and preservation of this frame, and the analyst’s own basic trust in the psychoanalytic process, are the conditions for the moments of illusion to be created. (Kohon Citation2019, 61–62)
3 Dingue: in French, “mad” – fou, furieux, insensé, enragé (furious, incensed, enraged).
4 Indeed, that same week another patient said to me: “When I hear your voice, I imagine myself in your consulting room.”
5 I opened my previous paper on Madeleine with the following quotations: “Your hair was not your own. It was mine, the work of twenty years of care and attention. You have disposed of a precious trust that I confided in you” (Letter to Colette by Sido, 1953, 13; quoted in Perelberg Citation2019); “Beauty, my mother would call me, and ‘Jewel-of-pure-gold’; then she would let me go, watching her creation – her masterpiece, as she said – grow smaller as I ran down the slope” (Colette Citation1953, 147).
6 Nebenmensch – the capacity to be in touch with a fellow human being, which Freud refers to in his “Project” (Citation1950 [1895]).
7 Although Freud does not refer explicitly to the mother–baby relationship, the notion of Nebenmensch refers to a quality of humanity that enables one to be profoundly in touch with the distressing experiences of the baby. The baby is then able to internalize the perceptual experiences of this fellow human being. Throughout his work, Rolland (Citation2006, Citation2010, Citation2015) has been particularly interested in how perceptual experiences may gain representation in the analytic process through language.
Let us suppose that the object that furnishes the perception resembles the subject – a fellow human-being. If so, the theoretical interest [taken in it] is also explained by the fact that an object like this was simultaneously the [subject’s] first satisfying object and further his first hostile object, as well as his sole helping power. For this reason it is in relation to a fellow human-being that a human-being learns to cognize. Then the perceptual complexes [italics added] proceeding from this fellow human-being will in part be new and non-comparable – his features, for instance, in the visual sphere; but other visual perceptions – e.g. those of the movements of his hands – will coincide in the subject with memories of quite similar visual impressions of his own, of his own body, [memories] which are associated with memories of movements experienced by himself. (Freud Citation1950 [1895], 331)