“Out of the Depths I Cry to You”¹: Into the Dark Unknown Depths — Two-in-Oneness

ABSTRACT

The article introduces a fundamental dimension of analytic work that is created by the analyst/therapist’s “presencing” (being there) within the patient’s experiential world and within the grip of the process, and the ensuing patient–analyst two-in-oneness. This dimension, with its profound ontological implications, engenders markedly new possibilities for extending the reach of psychoanalytic treatment to more and most disturbed patients and the most difficult treatment situations. It goes beyond recent analytic notions of intersubjectivity and witnessing to more radical patient-analyst deep-level interconnectedness or “withnessing” that may grow into at-one-ment or being-in-oneness with the patient’s innermost emotional reality of unthinkable breakdown and catastrophic psychic trauma. Using a case example written by psychiatrist Yaron Gilat, the author illustrates the kind of knowledge, experience, and powerful transformative effects that come into being when the therapist interconnects psychically with the patient in living through extremely dark, unknown process in a difficult treatment with a severely disturbed patient.

Acknowledgment

I am very grateful to Yaron Gilat, M.D., psychiatrist, who wrote the case illustration in this article. Dr. Gilat is the Director of Adult Patient Clinic in the Ababrbanel Mental Health Center — Bat-Yam, Israel, and member of GIEP-NLS Société Israélienne de Psychanalyse de la Nouvelle Ecole Lacanienne.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

¹ Psalms, 130:1.

² For simplicity’s sake, throughout this article I will use analyst to refer both to analyst and therapist unless I am describing a particular patient-therapist situation.

³ Bion (1965), p. 15. According to Neville Symington (2016), it is called O by Bion for “Ontology” (private seminar, Tel Aviv). It is interesting that Winnicott (probably in 1968) joins these two words by writing about “ontological origin” (p. 213).

⁴ The term subjective object is used in Winnicott’s writing “in describing the first object, the object not yet repudiated as a not-me phenomenon” (Winnicott, 1971, p. 93, italics in original).

⁵ Coltart (1992, 1997) similarly describes “bare attention”; “concentrating more and more directly, more purely, on what’s going on in a session. You come to concentrate more and more fully on this person who is with you, here and now, and on what it is they experience with you … very, very closely attending to the patient, with my thoughts in suspension” (1997, p. 204).

Additional information

Notes on contributors

Ofra Eshel

Ofra Eshel, Psy.D., is a training and supervising analyst and faculty member of the Israel Psychoanalytic Society; a member of the International Psychoanalytical Association (IPA); vice-president of the International Winnicott Association (IWA); and founder and head of the postgraduate track “Independent Psychoanalysis: Radical Breakthroughs” at the Advanced Studies Program of Psychotherapy, Sackler Faculty of Medicine, Tel-Aviv University. She is also a visiting lecturer and supervisor at the advanced International training program in Winnicott’s psychoanalysis, Beijing, China; the book review editor of Sihot-Dialogue, Israel Journal of Psychotherapy; coeditor of the book Was It or Was It Not? When Shadows of Sexual Abuse Emerge in Psychoanalytic Treatment (2017, in Hebrew), and author of The Emergence of Analytic Oneness: Into the Heart of Psychoanalysis (2019). She was awarded the 2013 Frances Tustin Memorial Prize and the 2017 Symonds Prize, and was featured in 2012 in Globes (Israel’s financial newspaper and magazine) as sixteenth of the fifty most influential women in Israel. She is in private practice in Tel Aviv, Israel.