What is the psychic, how can it be grasped and understood? Bernd Nissen, Berlin

ABSTRACT

When can we speak of psychic quality? Does an affect, e.g., anxiety, already have mental quality? Does the expectation of the breast, for example, already have a psychological quality? The author puts forward the thesis that psychic quality only arises when elementary and conceptual levels are combined. The sensory impressions and sensations transformed into α elements combine in the conception, which is resulting from the realized pre-conception, and stabilize it. It is theoretically and metapsychologically explained how mental quality arises in a moment of presence and how the transformation of this moment into the presentational brings about a naming and the differentiation of the mental system. Since this process takes place in the analysis in the transference relationship, it is accessible to both participants and leads to understanding. Only the pair can discover and create psychic quality. In a detailed clinical vignette of an initial interview, this view is traced in detail and the interwoven interplay between emerging pre-concept and the grasping of sensory phenomena is traced. A young woman, severely ill with hypochondria, instantly stages a storm of sensual impressions that cannot be understood. Only an idea of the patient’s inner world opens up a perspective and can then connect with a specific silence that appears twice. In this way, an interpretation succeeds that makes the patient listening up.

KEYWORDS:

• Sensual data
• α elements
• pre-conception
• conception
• presence moment
• psychic quality
• thought
• hypochondria as autistiod disorder
• Freud
• Bion

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. In “Learning from Experiences”, Bion drops the distinction between inner and outer world (Chapter two, 1). Sense data of the self therefore means that the inner and outer sense impressions are registered by the consciousness of the self.

2. In my opinion, the term ‘emotion’ is an unfortunate choice because in my view emotions are already qualified inner impressions and sensations.

3. In 1962 Bion speaks of β-elements as non-altered, undigested sense impressions. This means that not the ‘raw data’ are already β-elements but only when the α function cannot affect them. Grotstein (2007) considers β-elements to be secondary, also referring to the choice of Greek letters.

4. Freud already spoke in 1900 and 1915 of the communication from unconscious to unconscious, i.e., an interpsychic exchange. But in order for the psychic qualities to be recognized, this communication must be perceived by the consciousness, i.e., it must pass the censorship and be capable of consciousness. However, we have to realize that maternal/paternal reverie as well as successful equally suspended attention are deeply preconsciously able to grasp psychic qualities. Interpretations then still need transformation and translation into the conscious and naming. Parental ‘interpreting’ in reverie is usually so finely tuned that facial expressions, gestures, actions, tenderness can replace verbal clarity.

5. See Bion: ‘For example, a baby discovers its hand; it might as well have discovered its stomach-ache, or its feeling of dread or anxiety, or mental pain. In most ordinary personalities this is true, but people exist who are so intolerant of pain or frustration (or in whom pain or frustration is so intolerable) that they feel the pain but will not suffer it and so cannot be said to discover it.’ (1970, p. 9; italics BN).

6. In a certain sense, Bion’s observation that ‘anxiety has no shape or colour, smell or sound’ in the psychoanalytical reference system becomes more understandable at this point. For the experience of raw sensations is momentarily quality-less.

7. S. Bion’s O. With a completely different theoretical context, Stern (2004) arrives at similar results when he understands the presence moment as a central point of change.

8. Everyone knows such moments in which we think a sentence that seems harmless to us, then have to experience how it unfolds its own power and dymanic when spoken – and what has been said – now in interpsychic space – can no longer be retrieved or relativized.Here there are areas that overlap with Ogden. He sees the subjugation in the light on Hegel’s dialectic (1994, p.98ff): Since both the projecting one and the recipient are partially and temporarily negated in their subjectivity, are therefore ego and not-ego, they create in this way a new subject:“ … projective identification can be understood only in terms of a mutually creating, negating, and preserving dialectic of subjects, each of whom allows himself to be ‘subjugated’ by the other, that is, negated in such a way as to become, through the other, a third subject (the subject of projective identification).“ (1994, p. 100 f) This intersubjective third subject then opens up new moments of understanding. In a subsequent paper (2001) Ogden expands this version and postulates “that the dreams and reveries being generated by analyst and patient at the frontier of dreaming draw not only on the unconscious experience of analyst and analysand as individuals, but involve a set of unconscious experiences jointly, but asymmetrically, constructed by the analytic pair“ (p. 11; see also Ogden, 2004). Contrary to Ogden, I do not conceive this process dialectically and think the dynamic about O, which I set as the origin. See also Levine’s discussion of Ogden’s approach. According to Levine Ogden describes processes ‘ … in which representations have already been formed and linked to chains of meaning’ (2013, p. 59).

9. In my experience, autistoid phenomena can be clearly distinguished from psychotic (in the broadest sense) phenomena by differential diagnosis. Psychotic phenomena retain an objectal reference, however difficult it may be to discern: the occupation of space, for example, would have felt aggressive, provocative – only things were dispersed here. In the following mirror scene, a psychotic patient would have felt my gaze on her/on her back, would have seized these viewpoints and would have fixated me suspiciously with these torn eyes on her back. The patient looked into the mirror to hold herself together; she did not register me.